Many people are familiarized with 12-step programs like AA. They assist people suffering from alcoholism or other substance abuse disorders (SUD) to stay sober by regularly meeting, sharing their stories, and identifying themselves as addicts. They are not led by therapists but members.
What 12-step programs are most effective?
Because 12-step programs are anonymous, no one can determine the success rate. A 2020 review of 35 studies revealed that 42% of AA members remained sober for at most one year, compared to 35% of those who were undergoing Cognitive Behavioral Therapy. This was due to a higher retention rate of AA members at the end the study period. According to a 2000 report, the newcomer rate was as low as 5%. This study found that structured and organized clinical methods were more effective. For clinicians to reap the benefits of 12-step programs, they must be used.
Why choose non-12-step programs?
Regardless of their success rate, 12-step programs may not be the best option. Because:
The 12 steps are not enough to treat the problem. Although they can be helpful and valuable, 12 step programs are not treatment. They are mutual aid societies, fellowships, or support groups that bring together people who have a similar problem to offer them moral, judgment-free support. They are not usually managed by professionals.
The 12 steps are all about God. Four of the 12 original steps directly refer to God, while two (Power greater than us; Him) indirectly. There are also “Moral”, “prayer,” as well as “spiritual”. These mentions can be removed, but they still have faith and are not based on science or evidence. This can be a problem for some.
Twelve-step programs are not for everyone. However, this doesn’t mean that another program will not work. There are many fellowships. If they are based upon sound scientific principles and show evidence of success, there may be more options.
AA works with some people, but not all its principles are scientifically sound. For example, AA believes that addiction is a result of AA’s principles.
What causes addiction?
AA was a pioneer in recognizing addiction as a disease model. However, it maintains that addicts are still addicts and that only a higher power (like AA) can save them.
However, most addiction specialists believe that addiction is not solely due to behavior. Genetic predisposition plays a significant role. People who have suffered trauma, mental or physical abuse or are suffering from a mental illness or are at higher risk of abusing substances may also be affected by environmental factors.
Military Programs
Overdose deaths and substance abuse are not inevitable. The rate of opioid abuse in active-duty military personnel has been declining because:
Army Substance Abuse Program. Community members have support programs, which include education and counseling resources. Monthly ‘Prime for Life’ classes are offered to equip them with the tools they need to make low-risk decisions regarding alcohol and other substances.
Employee Assistance Program Coordinators. For those aged 18 or older, confidential counseling is available for retired and former Army and Air Force civilians as well as their families.
- Marriage Family Life Counselors. Similar to EAPC but with a focus on substance abuse and referrals, if necessary.
- Chaplains for military personnel. Sometimes spiritual support is all you need.
- Prescription drug controls. Similar to the general public but better.
- Pain management. There are more options than the general population.
What does a non 12-step program consist of?
A Non 12 Step Recovery Program can be any program with fewer, more or different steps than a 12 step program, but it is usually a secular program that is based upon evidence and not faith.
These include:
What groups are considered non 12-step programs?
There are many alternatives to the well-known 12-step program, such as secular fellowships, mutual assistance societies and self-help groups.
SMART (Self Management and Recovery Training) Recovery. This plan is science-based and abstinence-based. It consists of four points.
Moderation Management (MM). Moderation Management (MM) is a non-profit that teaches moderation and abstinence from drinking alcohol. You can track your alcohol consumption in moderation, contented or uncomfortable abstinence using the tool they have. You can keep this ledger private or make it public to receive and lend support.
Secular Organizations for Sobriety. Cognitive approach to recovery and abstinence, with sobriety as the highest priority.
Women for Sobriety This non-profit is for women who have substance abuse disorders. It emphasizes personal responsibility, spiritual and emotional growth.
LifeRing Secular Recover. Permanent workshop for personal and abstinence based on the “3-S” principles of Sobriety and Secularity.
Matrix Model. This is a comprehensive, inclusive and therapist-driven treatment program that targets people with SUDs that involve stimulants like cocaine or methamphetamine (meth).
Behavioral therapies
Programs that are scientifically based and supported by evidence include:
Cognitive-behavioral Therapy (CBT) Psychotherapy is a method of helping people recognize and correct inaccurate or negative thinking. It is also useful for mental disorders such as OCD, depression, and post-traumatic stress disorder.
Dialectical behavior treatment (DBT) is a form of psychotherapy. This is a variant of CBT used for women with alcohol abuse disorder. It is especially useful when it co-occurs with borderline personality disorder (BPD).
Motivational enhancement therapy (MET) This is a method that can be used to treat alcohol abuse disorders, but it can also be used to help people with other SUDs overcome resistance to seeking treatment.
Group therapy. Group therapy is similar to peer support groups, but with a trained therapist leading the group. Because of the support and challenges offered by peers, many experts believe that group therapy is more effective than individual therapy for SUDs.
