Findings from this analysis suggest that the observed lower rates of adolescent post-treatment 12-step group participation are not due to a lack of referrals or negative perceptions of AA and/or NA by treatment providers. Instead, lower participation may be due to other intrinsic (e.g., adolescents’ lower motivation for abstinence, low problem recognition) or extrinsic (e.g., predominantly adult composition of AA/NA groups, lack of parental support for attendance, lack of transportation) barriers, which may require additional clinical awareness and proactive facilitation efforts. The study raises questions regarding the nature of the referrals and whether there are qualitative differences in referrals of adolescents to 12-step groups as compared with referrals of adults. Adolescents treated for SUDs appear to benefit from participation in AA /NA. However, as compared with adults, fewer adolescents attend, and those who do attend do so less intensively and discontinue sooner. The principal aims of this study included: (1) describing staff perceptions, referral rates, and AA/NA participation expectations and examining their relationship to programs’ theoretical orientation and level of care, (2) examining staffs’ perceived benefits of and barriers to adolescent 12-step participation, and (3) exploring the relationship between staff characteristics and AA/NA referrals and participation expectations. Tables and references