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:
- Teaches tools for recovery based on evidence-based addiction treatment
Does not use the labels "addict" or "alcoholic" Encourages participation only for as long as it is perceived to be useful, Allows for truly anonymous participation via a screen name on the website Allows participants their own perspective on whether addiction is a disease Teaches tools for recovery that are useful regardless of what the participant believes (or not) about God Accepts the validity of appropriately prescribed addiction and psychiatric medication.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.
Our 2024 Coverage Needs You
It's Another Trump-Biden Showdown — And We Need Your Help
The Future Of Democracy Is At Stake
Our 2024 Coverage Needs You
Your Loyalty Means The World To Us
As Americans head to the polls in 2024, the very future of our country is at stake. At HuffPost, we believe that a free press is critical to creating well-informed voters. That's why our journalism is free for everyone, even though other newsrooms retreat behind expensive paywalls.
Our journalists will continue to cover the twists and turns during this historic presidential election. With your help, we'll bring you hard-hitting investigations, well-researched analysis and timely takes you can't find elsewhere. Reporting in this current political climate is a responsibility we do not take lightly, and we thank you for your support.
Contribute as little as $2 to keep our news free for all.
Can't afford to donate? Support HuffPost by creating a free account and log in while you read.
The 2024 election is heating up, and women's rights, health care, voting rights, and the very future of democracy are all at stake. Donald Trump will face Joe Biden in the most consequential vote of our time. And HuffPost will be there, covering every twist and turn. America's future hangs in the balance. Would you consider contributing to support our journalism and keep it free for all during this critical season?
HuffPost believes news should be accessible to everyone, regardless of their ability to pay for it. We rely on readers like you to help fund our work. Any contribution you can make — even as little as $2 — goes directly toward supporting the impactful journalism that we will continue to produce this year. Thank you for being part of our story.
Can't afford to donate? Support HuffPost by creating a free account and log in while you read.
It's official: Donald Trump will face Joe Biden this fall in the presidential election. As we face the most consequential presidential election of our time, HuffPost is committed to bringing you up-to-date, accurate news about the 2024 race. While other outlets have retreated behind paywalls, you can trust our news will stay free.
But we can't do it without your help. Reader funding is one of the key ways we support our newsroom. Would you consider making a donation to help fund our news during this critical time? Your contributions are vital to supporting a free press.
Contribute as little as $2 to keep our journalism free and accessible to all.
Can't afford to donate? Support HuffPost by creating a free account and log in while you read.
As Americans head to the polls in 2024, the very future of our country is at stake. At HuffPost, we believe that a free press is critical to creating well-informed voters. That's why our journalism is free for everyone, even though other newsrooms retreat behind expensive paywalls.
Our journalists will continue to cover the twists and turns during this historic presidential election. With your help, we'll bring you hard-hitting investigations, well-researched analysis and timely takes you can't find elsewhere. Reporting in this current political climate is a responsibility we do not take lightly, and we thank you for your support.
Contribute as little as $2 to keep our news free for all.
Can't afford to donate? Support HuffPost by creating a free account and log in while you read.
Dear HuffPost Reader
Thank you for your past contribution to HuffPost. We are sincerely grateful for readers like you who help us ensure that we can keep our journalism free for everyone.
The stakes are high this year, and our 2024 coverage could use continued support. Would you consider becoming a regular HuffPost contributor?
Dear HuffPost Reader
Thank you for your past contribution to HuffPost. We are sincerely grateful for readers like you who help us ensure that we can keep our journalism free for everyone.
The stakes are high this year, and our 2024 coverage could use continued support. If circumstances have changed since you last contributed, we hope you'll consider contributing to HuffPost once more.
Support HuffPostAlready contributed? Log in to hide these messages.