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Co-occurring and substance-induced disorders are common in psychiatric patients, and mental health practitioners can enhance outcomes from both disorders by applying 12-step facilitation (TSF).

TSF is not Alcoholics Anonymous (AA) nor is it endorsed by AA. It is an evidence-based therapy performed by the clinician to help a patient begin to attend and benefit from 12-step meetings, including AA.

Co-occurring disorders (COD) TSF is a practical enhancement of TSF that includes typical psychiatric issues and treatment but has not been separately tested.

Twelve-step approaches and meetings are ubiquitous, inexpensive, and evidence based and provide long-term, recovery-based help with patients with substance use disorders.

Twelve-step approaches to acceptance and denial for the chronic and often relapsing illness of addiction are appropriate for and benefit most psychiatric disorders.

The official policy of AA is supportive to seeing psychiatrists and taking psychiatric medications for mental disorders. However, a good deal of variability exists with many 12-step communities having COD 12-step meetings and others being neutral or even hostile toward the idea.

Developing COD TSF skills is an effective way for the mental health practitioner to stay productively involved with his or her COD patient, provides a good model of integrated care, and provides a great deal of low-cost but high-frequency psychosocial support to the patient.

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