This study examines three preparatory strategies that can be used during treatment sessions to bridge the gap between clinician recommendations for client participation in 12-step programs (TSPs) and client adherence to such recommendations.

A sample of 284 clinicians completed an online survey. Clinicians responded to items measuring their willingness to motivate client participation in TSPs, integrate 12-step principles into sessions, and form positive attitudes toward 12-step culture. Analysis was conducted using structural equation modeling (SEM).

Clinician attitudes toward 12-step culture had a significant effect on clinician willingness to motivate client participation in TSPs. Clinician attitudes toward 12-step culture also mediated the effect of integrating 12-step principles into treatment sessions on willingness to motivate client participation in TSPs.

Because positive attitudes toward 12-step culture play a central role in the referral-making process, it is recommended that clinicians cultivate positive attitudes toward 12-step culture.