Empirical evidence suggests that participation in self-help (SH) is beneficial to substance-abusing clients' outcomes. As length and intensity of services become more limited, the extent to which the treatment system succeeds in engaging clients in SH will increasingly influence client outcomes. Clinicians play an important role in involving clients with SH and there is evidence that they do refer many substance-abusing clients to SH but some (e.g., dually-diagnosed individuals) are much less likely to be referred. This may result in missed opportunities to provide clients with a potentially effective and much needed lifelong resource for recovery. Further, clients are often ambivalent about SH and their concerns need to be addressed so as to promote engagement in SH. Little is known about where clinicians learn about SH, what they know, how they arrive at referrals are made, or about clients' perspectives on the process.
The aims of the proposed study are: 1. To determine where clinicians acquire their beliefs and attitudes about SH differ according to their sources. 2. To document empirically the process of referral to SH (including """"""""matching rules"""""""") from both clinicians' and clients' perspectives, so as to identify missed opportunities (e.g., clients not referred, clients' ambivalence about SH) as well as miscommunication or lacunae in the process. 3. To compare clinicians' and clients' views on self-help and perceptions of the referral process. 4. To generate hypotheses for a future large-scale study of the association between referral to SH and client outcomes. Clinicians (N=100) and clients (N=100) recruited in a large New York City outpatient treatment program will be interviewed about their experiences with making or receiving referrals to SH and about their attitudes and beliefs about SH using parallel versions of a semi-structured instrument. Findings will provide knowledge that can contribute to enhancing the number and outcome of referrals to SH, help identify the potential need for training and contribute information about the integration of SH in service delivery. In sum, the proposed study is a first step to exploring how the treatment system can maximize client engagement in SH by reducing existing barriers.
