Alternative To Twelve Step Therapy

12-step therapy has become a cornerstone of alcohol addiction treatment. 12-step was initially developed to provide practical advice and support for individuals struggling to control their relationship with alcohol. This method of support has developed from a modest peer-based intervention to becoming integrated as a lucrative recovery model within drug rehab. This movement from a support group to clinically embedded treatment recognises the significance of 12-step as a lucrative intervention. 

However, this does not mean that 12-step is something that will work for everyone. Whilst this type of intervention is very visible in alcohol and drug intervention circles, there have been a range of criticisms levied at 12-step. For this reason, treatment providers need to offer alternatives to the 12-step programme.

What is 12 step therapy?

12-step therapy (also known as the 12-step programme) is a recovery model that hinges on 12 key traditions. The programme was designed in 1935 by Bill Wilson and Bob Smith, the founders of Alcoholics Anonymous (AA). AA describe themselves as being ‘concerned solely with the personal recovery and continued sobriety of individual alcoholics who turn to the Fellowship for help.’ 

Wilson and Smith drew from their own experiences of alcohol addiction when outlining the 12 steps. The aim was to create a set of guidelines that would not only help individuals curb their addictions but would also provide a framework for continued long-term self-improvement. 

The 12-steps

The 12-Steps are as follows:

1. ‘We admitted we were powerless over alcohol – that our lives have become unmanageable.’
2. ‘Came to believe that a Power greater than ourselves could restore us to sanity.’ 
3. ‘Made a decision to turn our will and our lives to the care of God as we understood Him.’
4. ‘Made a searching and fearless moral inventory of ourselves.’ 
5. ‘Admitted to God, to ourselves and to another human being the exact nature of our wrongs.’ 
6. ‘Were entirely ready to have God remove all these defects of character.’
7. ‘Humbly asked Him to remove our shortcomings.’
8. ‘Made a list of all persons we had harmed, and become willing to make amends to them all.’
9. Made direct amends to such people wherever possible, except when doing so would injure others.
10. Continued to take personal inventory and when we were wrong promptly admitted it.’
11. Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out.
12. Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics and to practise these principles in all our affairs.’ 

In short, the 12-step promotes a practice of acknowledging the presence and impact of addiction through a continuous process of self-reflection, acceptance of responsibility and amend-making. It also foregrounds the importance of extending alcohol addiction help to others where possible.

 

In Great Britain, there are an estimated 4,661 AA meetings. This means an estimated 25,490 people regularly attend AA groups and practise the 12-step programme. Alcoholics Anonymous suggests that there are over 4.24 million individuals attending meetings in Great Britain every year. 

The limitations of 12-step

Historically, 12-Step has been associated with long-term recovery from addiction, with ‘a strong correlation between length of membership and length of sobriety’ emerging over time. The use of the 12-step recovery method has also been mapped onto drug use (particularly by Narcotics Anonymous, or (NA) and is now a key component of drug addiction treatment as well as alcohol rehab. 

However, if the recovery model appears to be lucrative for so many individuals, why may the 12-step approach not work for everyone?

Firstly, it is important to note that recovery is never one-size-fits-all; individuals will always find a specific mode of support more helpful than others, and it is not possible to identify the ‘one’ most successful type of intervention. Secondly, however, there have been a range of criticisms of the 12-step approach, which can undermine the programme’s effectiveness for specific individuals.

These criticisms include:

• the self-help / peer-support model can reduce the importance of accessing professional support 
• the programme focuses on making personal  or moral changes to recover – this may not be possible for individuals with a mental health diagnosis 
• the focus on God can be alienating for certain groups who do not practise religion in a traditional sense
• accepting that a ‘higher power’ will change our behaviour can reinforce the idea that we are powerless 
• the 12-Step recovery model is stringent, and therefore cannot be tailored to individual needs 
• 12-Step has been known to have more success among white men as opposed to other demographics 

What alternatives are available?

There are various other treatment models available that, alongside 12-step, are commonly utilised in the context of drug addiction help.

These include

• psychotherapy
• holistic therapy
• medically assisted therapy 

Psychotherapy is a type of talking therapy that involves exploring elements of your inner life with an appropriate professional. Examples of psychotherapy include:

• Cognitive Behavioural Therapy (CBT)
• Dialectical Behavioural Therapy (DBT)
• Group Therapy
• Family Therapy 

Holistic therapies aim to approach addiction from all angles, thinking about the body, mind and soul as connected entities. In rehab, you may encounter:

• Art
• Music
• Drama
• Adventure
• or Animal Therapies

In some contexts, medical assistance is required in order to address underlying mental and physical health challenges. This can take a number of forms, including:

• prescription medications 
• alcohol / drug detox 

Finding the Right Path for You 

Addiction is a deep-rooted and complex experience. In order to move forward towards recovery, many individuals find that engaging with multiple models of recovery provides a strong foundation to build a sober future. In addiction rehab, it is important to ensure individual needs are prioritised. For that reason, specialist rehabs offer bespoke support that blends a range of recovery models to create a unique recovery path designed with the individual in mind.

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