Intensive referral to 12-Step self-help groups and 6-month substance use disorder outcomes

ABSTRACT

Aims  This study implemented and evaluated procedures to help clinicians make effective referrals to 12-Step self-help groups.

Design  Randomized controlled trial.

Setting  Out-patient substance use disorder treatment.

Participants  Individuals with substance use disorders (SUDs) entering a new treatment episode (n = 345) who were assigned randomly to a standard referral- or an intensive referral-to-self-help condition.

Measurements  Self-reports of 12-Step group attendance and involvement and substance use at baseline and a 6-month follow-up.

Intervention  The intensive referral intervention focused on encouraging patients to attend 12-Step meetings by connecting them to 12-Step volunteers.

Findings  Among patients with relatively less previous 12-Step meeting attendance, intensive referral was associated with more meeting attendance during follow-up than was standard referral. Among all patients, compared with those who received standard referral, those who received intensive referral were more likely to be involved with 12-Step groups during the 6-month follow-up (i.e. had provided service, had a spiritual awakening and currently had a sponsor). Intensive referral patients also had better alcohol and drug use outcomes at 6 months. Twelve-Step involvement mediated part of the association between referral condition and alcohol outcomes.

Conclusions  The brief intensive referral intervention was associated with improved 12-Step group involvement and substance use outcomes even among patients with considerable previous 12-Step group exposure and formal treatment. Future 12-Step intensive referral procedures should focus on encouraging 12-Step group involvement in addition to attendance to benefit patients most effectively.