Twelve Step Approaches in Drug and Alcohol Treatment

Twelve Step Approaches dominate the treatment industry in the United States. Up to 90% of facilities advocating some form of 12-step involvement. This approach, known as Twelve Step Facilitation Therapy, educates individuals about the benefits of participating in a 12-step program. Goals and objectives related to 12-step integration are integral to treatment plans in Intensive Outpatient Programs (IOPs). In order to complete treatment patients need to achieve goals such as:

1. Meeting Attendance: Attend a specified number of meetings each week.
2. Group Selection: Choose a home group.
3. Sponsorship: Obtain a sponsor or temporary sponsor.
4. Step Work: Engage in steps one, two, and/or three, known as “doing the work”.
5. Social Support: Call or socialize with a certain number of individuals in recovery.

Individual Readiness and Resistance

While we believe the goals of 12-step programs are commendable and important to explore, many individuals may not feel immediately prepared or comfortable with 12-step programs at the outset of their recovery journey.

At our practice, we encourage clients to educate themselves about these programs. We offer guidance on navigating the program – finding meetings that are a good match for them and understanding the advantages of the 12-step approach. We respect individual choices and won’t push this approach on clients. If a client is resistant to 12-step programs, we will challenge the resistance so we can better understand the underlying reasons. The goal is to uncover obstacles that prevent you from getting the most from meetings.

Common examples of feelings of resistance to 12-step programs include the following. If any of these feel familiar we can help you explore the feelings deeper to better understand them.

• Sometimes people don’t like meetings because it reminds them of their own depression.
• Sometimes people get hung up on the emphasis on God.
• Sometimes people dislike the concepts of “powerlessness,” the disease model, or “suffering from an incurable and chronic illness from which there is no known cure.”

While these concepts are daunting to some, many people are able to find loopholes, personal understanding, flexibility, agnostic and atheist friends, and meetings which more than meet their individual needs.

Exploring Alternatives and Additional Support

For those who decide that Alcoholics Anonymous (AA) or similar programs are not suitable, we emphasize that alternative support groups also offer valuable social support.

An option such as SMART Recovery can provide a different framework that may be better tailored to a patient’s individual needs.

However, we still strongly advocate integrating long-term individual outpatient psychotherapy alongside these support group initiatives.

Essential Elements of Recovery

If you are looking for an alternative approach to 12-step approaches we recommend that you read Dr. George Vaillant’s research. A Harvard research psychiatrist, Dr. Vaillant’s research underscores the four essential elements crucial for achieving sustainable recovery:

• structure and supervision
• social support of friends, significant others, or family
• individualized spirituality
• meaningful non-substance-related activities that give meaning and purpose to a person’s life

These elements serve to replace addictive behaviors and foster overall well-being. Individuals grappling with addiction and recovery need to learn how to replace their addictive behaviors with these curative factors.

Considerations and Recommendations

If you are willing to try 12-step meetings we highly recommend it. It appears to work for about 1 million people in the United States in any given year.

It is by far the least expensive form of support that exists. We often joke that you can spend three dollars a day and get the best education about addiction and recovery. All you need to do is spend several hours a day attending meetings and drop three dollars in the baskets of those AA meetings each day. Or we can assist you in finding a rehab. It will cost significantly, and afterward you will still need to make new sober friends and navigate 12-step programs.

Even if AA doesn’t resonate long-term, the experience offers valuable insights, personal growth, and the opportunity to forge new supportive relationships. It’s a win-win scenario in our view. You will meet new people and consider all sorts of ways to change your own drinking behavior.

Whether one chooses to engage with 12-step programs or explore alternative approaches, the journey towards recovery is enhanced by understanding, support, and a commitment to personal growth and well-being.