INT’L. J. SELF HELP & SELF CARE, Vol. 3(1-2) 63-71, 2005 MENTAL HEALTH CLINICIANS’ 12-STEP REFERRAL PRACTICES WITH DUALLY DIAGNOSED CLIENTS* CHERIE L. VILLANO, PSY.D. ALEXANDRE LAUDET, PH.D. ANDREW ROSENBLUM, PH.D. CHUNKI FONG, MS STEPHEN MAGURA, PH.D. National Development & Research Institutes, Inc., New York THOMAS BETZLER, MD Albert Einstein College of Medicine (AECOM), Bronx, New York HOWARD VOGEL, MSW Double Trouble in Recovery, Inc., Brooklyn, New York EDWARD KNIGHT, PH.D. ValueOptions Health Care Services, Colorado Springs ABSTRACT This study examines mental health clinicians’ beliefs about dually diagnosed clients’ self-efficacy and capacity for recovery and attitudes toward and referrals to traditional 12-step groups for such clients. Clinicians evidence moderate confidence in dually diagnosed clients’ self-efficacy and capacity for recovery, positive attitudes toward 12-step groups, but rarely refer dually diagnosed clients to traditional 12-step groups. Clinicians’ beliefs that dually diagnosed clients were unlikely to achieve total recovery are associated with less frequent 12-step referrals. Findings support the need for a dual- focus 12-step group that addresses both substance use and mental health disorders—such as Double Trouble in Recovery (DTR)—and the importance of staff training on client empowerment for recovery, including 12-step utilization. *This study was funded by NIDA Grant #R01DAO15912 (PI: S. Magura). 63 © 2005, Baywood Publishing Co., Inc.