Attitudes and Beliefs About 12-Step Groups Among Addiction Treatment Clients and Clinicians: Toward Identifying Obstacles to Participation.
Abstract; Participation in 12-step groups during and after formal treatment has been associated with positive outcome among substance users. However, the effectiveness of 12-step groups may be limited by high attrition rates and by low participation, areas on which there has been little research.
Clinicians play an important role in fostering 12-step participation, and the insights which they develop in their practice can greatly contribute to informing the research process. Yet, little is known about clinicians’ attitudes about 12-step groups or about their experiences in referring clients.
This study surveyed clients (N = 101) and clinicians (N = 102) in outpatient treatment programs to examine 12-step-related attitudes and to identify potential obstacles to participation. Data collection was conducted between May 2001 and January 2002 in New York City.
Both client and clinician samples were primarily African-American and Hispanic; 32% of clients reported substance use in the previous month, with crack and marijuana cited most frequently as the primary drug problem. On average, clinicians had worked in the treatment field for 8 years.
Both staff and clients viewed 12-step groups as a helpful recovery resource.
Major obstacles to participation centered on motivation and readiness for change and on perceived need for help, rather than on aspects of the 12-step program often cited as points of resistance (e.g., religious aspect and emphasis on powerlessness).
Clinicians also frequently cited convenience and scheduling issues as possible obstacles to attending 12-step groups.
Clinical implications of these findings are discussed, including
- the importance of fostering motivation for change,
- the need to assess clients’ beliefs about and experiences with 12-step groups on a case-by-case basis, and to
- find a good fit between clients’ needs and inclinations on the one hand, and
- the tools and support available within 12-step groups on the other.
Research; Alexandre B. Laudet, Attitudes and Beliefs About 12-Step Groups Among Addiction Treatment Clients and Clinicians: Toward Identifying Obstacles to Participation, Substance Use & Misuse, Volume 38, Issue 14 December 2003, pages 2017 – 2047