CLINICIAN REFERRAL AND MATCHING OF SUBSTANCE-ABUSE PATIENTS TO SELF-HELP GROUPS AFTER TREATMENT

Objective: The clinical practice guidelines for substance use disorder s from the American Psychiatric Association (APA) recommend referral o f some patients to self-help groups, The purpose of this study was to determine current patterns of referral to self-help groups in substanc e abuse treatment programs in the United States and compare them with referral recommendations in APA guidelines, Methods: Directors of all 389 substance abuse treatment programs in the Department of Veterans A ffairs health care system completed a mailed survey on posttreatment s elf-help referral practices, Results: Survey responses indicated that a large proportion of substance abuse patients were referred to Alcoho lics Anonymous (79.4 percent), with other self-help organizations rece iving a smaller but significant number of referrals. Referrals to 12-s tep self-help organizations were more common in programs that endorsed a le-step treatment orientation and that employed a higher proportion of staff members in recovery from substance use disorders. Consistent with APA practice guidelines, clinicians were less likely to make a r eferral to a 12-step self-help group if a patient was an atheist, had a comorbid psychiatric disorder, or had less severe substance abuse pr oblems, In deciding whom to refer to self-help groups, clinicians also considered other variables that are not addressed in current practice guidelines, such as age and previous involvement in 12-step groups. C onclusions: Clinicians make extensive use of self-help groups for thei r patients: as recommended in APA practice guidelines, However, some d ifferences between current practice and recommended practice warrant f urther investigation.