Attitudes towards 12-step groups and referral practices in a 12-step naive treatment culture; a survey of addiction professionals in Norway

Data collected by a self-administered questionnaire, adapted from established US and UK instruments. Information covered the attitudes, knowledge and referral practices towards TSGs among addiction treatment professionals in Norway in mid 2008.The return rate was 79.7% (n = 291). Participants had moderately positive attitude scores towards TSGs, but referral to these groups among Norwegian addiction professionals was low, as was the level of knowledge about TSGs. More than six out of ten did not refer any patients to TSGs in the previous week. Local variation with more referrals to TSGs in the county with the one established 12-step treatment facility was observed. Respondents' integration of the 12-steps in their own treatment work, higher self-efficacy for making a successful referral, and greater TSG knowledge were associated with referring patients.Low referral rates to TSGs point to the need for education and training to raise the awareness and knowledge about it among addiction professionals unfamiliar with these 12-step fellowships. Training should focus on the usefulness of these groups for all types of treatment models regardless of therapeutic orientation. Increased knowledge is expected to lead to higher referral rates, which in turn would maximize the likelihood of positive long-term patient outcomes.Substance use disorders are, for many, a chronic condition and recovery requires ongoing support [1]. Public treatment systems are typically limited in resources and often cannot provide services of sufficient duration to address effectively the needs of severely dependent individuals. Self-help groups including Twelve Step groups (TSGs) such as Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) represent a useful complement to formal treatment services that contribute to sustaining treatment gains [2,3]. These organisations offer recovery support that is continuously available and free of charge to those who wish to attend, though small donations are ty