12 Steps for Best Practices in Referral to Mutual Self-Help Groups

While membership is completely voluntary, mutual self-help group participation represents a significant portion of the de facto system of care for substance use disorders in the United States. Clinicians who treat patients with substance use disorders often refer patients to Mutual Self Help Groups (MSHG) and are met with resistance by patients who do not engage in MSHG involvement. A brief historical overview of the original 12-step program, Alcoholics Anonymous, will be provided as well as subsequent derivatives of this program. In addition, this paper will, summarize the existing literature concerning attendance at mutual self-help groups and outcomes, and make recommendations about “best practices” for clinicians contemplating referral. This discussion will be limited to mutual self-help groups that address substance use disorders (AA, NA, CA, etc.), both 12-step and non-12 step.