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  • Title: A randomized controlled trial of intensive referral to 12-step self-help groups: one-year outcomes.
    Author: Timko C, DeBenedetti A.
    Journal: Drug Alcohol Depend; 2007 Oct 08; 90(2-3):270-9. PubMed ID: 17524574.
    Abstract:
    OBJECTIVE: This study implemented and evaluated procedures to help clinicians make effective referrals to 12-step self-help groups (SHGs). METHODS: In this randomized controlled trial, individuals with substance use disorders (SUDs) entering a new outpatient treatment episode (N=345; 96% had previous SUD treatment) were randomly assigned to a standard referral or an intensive referral-to-self-help condition and provided self-reports of 12-step group attendance and involvement and substance use at baseline and at six-month and one-year follow-ups (93%). In standard referral, patients received a schedule for local 12-step SHG meetings and were encouraged to attend. Intensive referral had the key elements of counselors linking patients to 12-step volunteers and using 12-step journals to check on meeting attendance. RESULTS: Compared with patients who received standard referral, patients who received intensive referral were more likely to attend and be involved with 12-step groups during both the first and second six-month follow-up periods, and improved more on alcohol and drug use outcomes over the year. Specifically, during both follow-up periods, patients in intensive referral were more likely to attend at least one meeting per week (70% versus 61%, p=.049) and had higher SHG involvement (mean=4.9 versus 3.7, p=.021) and abstinence rates (51% versus 41%, p=.048). Twelve-step involvement mediated the association between referral condition and alcohol and drug outcomes, and was associated with better outcomes above and beyond group attendance. CONCLUSIONS: The intensive referral intervention was associated with improved 12-step group attendance and involvement and substance use outcomes. To most benefit patients, SUD treatment providers should focus 12-step referral procedures on encouraging broad 12-step group involvement, such as reading 12-step literature, doing service at meetings, and gaining self-identity as a SHG member.
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