Alcoholics Anonymous (AA) and other 12-step groups are the leading U.S. approach to addiction recovery. Millions have attended these meetings and "worked the steps." Popular media include countless references to AA-oriented recovery. Many scientific studies show that attending these meetings is associated with recovery.
However, many individuals will not attend these meetings, or will not attend them long enough to solidify change. Their reasons include not wanting to accept the labels "addict" or "alcoholic," not wanting to attend groups of any kind, not wanting to consider oneself powerless, not thinking of oneself as having a disease, or not wanting an approach that encourages lifelong attendance.
Perhaps we should encourage these individuals to set aside their objections and attend AA anyway? When such strong encouragement is given it probably works in some cases. However, the reality is that only a small percentage of those who have addiction problems attend AA. We need to have additional approaches.
Actually, other approaches already exist, but they are not well-known. There is a range of mutual aid groups in addition to 12-step groups, as well as a range of treatments in addition to 12-step-based treatment. The non-12-step mutual aid groups include SMART Recovery, Moderation Management, Women for Sobriety, LifeRing Secular Recovery and Secular Organizations for Sobriety. Each group has an active presence on the Internet. Through their websites, one can also find information about non-12-step based treatments.
These non-12-step groups can be more positively defined as self-empowering groups. Self-empowering groups encourage individuals to take charge of their lives and leave addiction (and eventually recovery) behind. In contrast to the 12-step approach, self-empowering groups support individuals in taking charge of their lives rather than accepting powerlessness and turning their lives over to a higher power.
The Serenity Prayer, often used at AA meetings, provides a framework for understanding a fundamental difference between powerlessness and self-empowering recovery:
"God, grant me the serenity to accept the things I cannot change,
Courage to change the things I can,
And wisdom to know the difference."
The 12-step approach is a serenity approach to recovery. The self-empowering approach is a courage approach. As the Serenity Prayer suggests, we all need both serenity and courage. However, most of us prefer one approach to the other. To use the language of scientific psychology, some of us tend toward external locus of control (serenity) and others tend toward internal locus of control (courage). Locus of control refers to our expectation about what in the future will shape our lives more (e.g., what controls us, or who is in charge): What happens to us, or what we do about it.
Self-empowering approaches to addiction recovery are well-suited for individuals who have an internal locus of control. Rather than thinking they have lost control of their lives because they have a disease, these individuals want to learn how to build motivation, control craving, resolve their underlying problems, and move on with creating meaningful and purposeful lives.
Two addiction treatment facilities I am aware of offered both the powerlessness and self-empowering approach. Clients were allowed to choose the approach they preferred. The choice was about 50/50 in each facility (one outpatient, one residential).
SMART Recovery is the best-known and most widely available of the self-empowering recovery groups. With fewer than 1,000 meetings, it is about 100 times smaller than AA. The SMART Recovery website and its activities and community could be a substitute for face-to-face meetings for many individuals and locations. Many SMART Recovery participants include 12-step meetings in their recovery plans, either to have a sufficient face-to-face component, or because they find aspects of both programs helpful.
Consistent with the overarching self-empowering perspective, SMART Recovery:
In addition to providing free, science-based, self-empowering addiction recovery mutual aid groups, SMART Recovery advocates for choice in recovery. All individuals seeking recovery support or treatment should be informed of the full range of options available, and be free to choose among them.
Disclosure: Tom Horvath, Ph.D., serves as president of SMART Recovery.
For more by Tom Horvath, Ph.D., click here.
For more on addiction and recovery, click here.
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Kimberly Williams: Recovery Month 2011: Getting Rid of Addiction Stigma
Viral Mehta: 5 Reasons Vulnerability Makes You Stronger
Ethlie Ann Vare: My Brain Not on Drugs
Take a good look at what is ranked # 38 in effectiveness. http://www.behaviortherapy.com/whatworks.htm
I have a web site called www.recoveringfromrecovery.com which is for those who have moved away from the 12 step world, which some people here may like.
Anyhow, I've managed to stay sober for 7 years. I just finally came to the understanding that, for me, "one drink is too many, 100 is not enough."
I attend AA meetings purely to develop sober friendships and because nothing else is available in my area, use the Lifering Secular Recovery e-mail lists for real support, practice Charlotte Kasl's sixteen steps to empowerment, and don't drink or use no matter what.
Thanks for bringing good information to the public about alternatives to AA.
And, yes, AA members can cite examples here and there, but those are the minority.
Then, there's the issue that AA is still officially only about alcohol problems. No "drug talk" allowed,and yes, many meetings still follow this.
Given that in today's world, there's few "pure alcoholics," this doesn't make sense.
Next, there's openness to scientific research and findings in places like Lifering that you don't necessarily find in AA.
Related to that, Lifering and other alternatives don't insist on a need for "labels." You don't have to call yourself an "alcoholic" or your problem a "disease." (Lifering doesn't officially believe it is one.)
Then, there's the acknowledgement that a sobriety support group doesn't have expertise or insight to treat depression, bipolar disorder or other dual diagnosis issues. And won't try to suggest that 12-step action is a proper way of treating them.
Want to know more? http://lifering.org
The book gives the reader tools and instructions for changing their interactions with their loved one, which in turn changes the loved one's behavior. In repeated clinical trials, CRAFT'sapproach proved twice as likely as the Johnson intervention and six times as likely as Al-Anon to get a loved one into treatment.
I found my own recovery by attending AA purely for support and friendship (and not doing any of the work) and using DBT and NLP to change my thinking, separately. I now use the same methods with my clients, and it works really well - but I always advise people to join some sort of support group, from fellowships to forums, depending on how much support they need and what they have access to.
And why should anyone have to deny their own values in order to fit into a process that's admittedly saturated with Christian religious concepts and procedures.
No matter how you sugarcoat it, AA is a very hierarchical, top-down approach. That's why it's occasionally effective for desperate authoritarian followers. That's why it's RARELY effective for iconoclastic individuals who chafe at authoritarians...
The other recovery methods like Lifering Secular Recovery, acknowledge other styles of recovery. Lifering recognizes the efficacy of individual "programs" tailored to each individuals makeup and needs instead of ONE Program imposed by self-styled "sponsors". They encourage each members participation instead of slavish adherence to self-proclaimed "experts". They encourage positive reinforcement of positive behavior instead of fear as the main motivator.
I also found AA rather complicated. Why 12 steps when one really only needs one: "Don't Drink or Use No Matter What!"...?
And why a premier step (the one I gagged on) that demeans one, tears a person down when what many of us needed was for our power to be acknowledged and strengthened?
I volunteer for an organization which provides education on all types of recovery options. I have met people in AA who approach it in an authoritarian manner. However, most of the people that I know in a AA are not "desperate authoritarian followers" but strong-willed realists who have not had to "sacrifice their values" to fit in.
Alcohol and drug abuse is different from addiction. Science has revealed that addiction is a complex phenomenon that can alter an individual's brain function and change their perception of reality. To these individuals "Do not use no matter what" is an incomprehensible statement. These people are not necessarily weak or lacking intelligence. Not to elevate celebrity but as an example, the list of successful, strong-willed people who needed more than "one step" is very long: Buzz Aldrin, Robin Williams, Betty Ford, and Eric Clapton to name a few.
Whether SMART, LifeRing, or AA, a support system seems to offer the best chance for long-term recovery. All these have the potential to be self-empowering or self-defeating, depending on the individual. Bashing AA by presenting an unfair caricature is a poor way of promoting another method, no matter how badly that method is needed.