title: Intensive referral to 12-step dual-focused mutual-help groups.
abstract: BACKGROUND
  This study implemented and evaluated procedures to help clinicians effectively refer dually diagnosed (substance use and psychiatric disorders) patients to dual-focused mutual-help groups (DFGs).
  
  
  METHODS
  Using a cohort cyclical turnover design, individuals with dual diagnoses beginning a new outpatient mental health treatment episode (N=287) entered a standard- or an intensive-referral condition. Participants provided self-reports of 12-step mutual-help (DFG and substance-focused group [SFG]) attendance and involvement and substance use and psychiatric symptoms at baseline and six-month follow-up. The intensive referral intervention focused on encouraging patients to attend DFG meetings.
  
  
  RESULTS
  Compared to patients in the standard condition, those in the intensive referral intervention were more likely to attend and be involved in DFGs and SFGs, and had less drug use and better psychiatric outcomes at follow-up. Attending more intensive-referral sessions was associated with more DFG and SFG meeting attendance. More need fulfillment in DFGs, and more readiness to participate in SFGs, were associated with better alcohol and psychiatric outcomes at six months. However, only 23% of patients in the intensive-referral group attended a DFG meeting during the six-month follow-up period.
  
  
  CONCLUSIONS
  The intensive referral intervention enhanced participation in both DFGs and SFGs and was associated with better six-month outcomes. The findings suggest that intensive referral to mutual-help groups focus on its key components (e.g., linking patients to 12-step volunteers) rather than type of group.
authors.affiliation: Center for Health Care Evaluation, Department of Veterans Affairs Health Care System, and Stanford University Medical Center, 795 Willow Road (152-MPD), Menlo Park, CA 94025, USA. ctimko@stanford.edu
authors.forename: Christine
authors.initials: C
authors.lastname: Timko
authors.forename: Anne
authors.initials: A
authors.lastname: Sutkowi
authors.forename: Ruth C
authors.initials: RC
authors.lastname: Cronkite
authors.forename: Kerry
authors.initials: K
authors.lastname: Makin-Byrd
authors.forename: Rudolf H
authors.initials: RH
authors.lastname: Moos
mesh_terms: D000328:Adult; D015928:Cognitive Behavioral Therapy; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology / Q000628:therapy*; D008875:Middle Aged; D012017:Referral and Consultation; D012657:Self-Help Groups; D019966:Substance-Related Disorders / Q000523:psychology / Q000628:therapy*; D016896:Treatment Outcome