09 Jul 12-step Treatment as Part of Rehab Treatment
Pioneered by Alcoholic Anonymous, the 12-step or twelve-step philosophy or treatment program is used by 74 percent of rehabilitation treatment centers around the world. The premise of this addiction rehabilitation model is to assist others in helping each other achieve and maintain abstinence from illicit and/or addictive substances in a regimented or step-by-step manner.
Because of the religious nature of AA or NA and its establishment with the assistance of a pastor, it typically involves faith and surrendering to a supposed higher power, which is where the healing is supposed to begin. However, there are versions of the treatment that’s more secular in nature so that those who don’t share the Christian or any religious faith can get AA-style or NA-style treatment.
The Alcoholics Anonymous Connection with 12-Step Treatment
The 12-steps program was first introduced to the general public in the 1939 book “Alcoholics Anonymous: The Story of How More Than One Hundred Men Have Recovered from Alcoholism”. The method and philosophy was then adapted into many drug and alcohol rehabilitation centers, with the original program serving as the mold for other 12-step programs around, such as the Narcotics Anonymous or NA program.
According to the summary of the APA or the American Psychological Association, the 12-step program involves the following processes:
- Admission: You have to admit that you cannot control your alcoholism, compulsion, or addiction. Admission is the first step towards recovery and denial just delays the process.
- Higher Power: You have to recognize and surrender yourself to a higher power who can give you strength when it comes to recovery. In more secular versions of the program, this involves letting go of egotism or selfishness.
- Examination: With the help of a sponsor a more experienced member of the 12-step program, you should examine your past errors with an objective eye. This can be a painful experience but it’s also liberating in a sense.
- Amends: Once you’ve done some error examination, it’s time you made amends for those mistakes and for those you’ve done wrong to. This will help you gain closure, even if some people might be less forgiving than others.
- New Life: After making amends, you should also learn to live a new life with a new code of behavior specifically developed to keep you from making the same mistakes as before.
- Charity: You can also make your life a productive one by helping others, such as fellow alcoholics who are suffering from the same alcohol addictions and compulsions you have. You can become a sponsor yourself.
In regards to the connection that AA and the 12-step treatment has, almost all of the 12-step programs in drug and alcohol rehab follow the same template as AA, with differences including substituting alcohol for some other illicit or prescription substance as well as behavioral problem.
Overview on the 12-Step Program and Its Gradual Spread
12-step methods have been used to address various problems, including alcoholism, substance abuse or drug addiction, and psychological dependency problems. Over 200 self-help organizations or fellowships employ these principles for recovery, and some of them have memberships numbering by the millions all across the globe even.
- From AA to NA: While Alcoholics Anonymous was the first ever 12-step program of its kind, it also spawned the drug rehabilitation version known as Narcotics Anonymous. NA was founded by addicts who aren’t able to relate to the specifics of alcoholism and alcoholic dependency. As as result, they created a program that’s more suited to the dire consequences of heroin, meth, and cocaine abuse as well as marijuana addiction.
- Splinter Anonymous Groups for Drugs: Speaking of which, from NA spawned other splinter groups with similar mindsets. Now there are 12-step programs and groups known as Cocaine Anonymous or CA, Crystal Meth Anonymous or CMA, and Marijuana Anonymous or MA. After all, when dealing with the specific withdrawal and addiction symptoms, you need to be specific.
- 12-Steps for Behavioral Problems: Naturally, the tenets of the 12-step program have also been used for behavioral issues such as addiction or compulsion for debt, hoarding, sex, food, crime, and gambling. That’s why you have groups for Debtors Anonymous, Sexaholics Anonymous, Overeaters Anonymous, and Gamblers Anonymous, among many other anonymous groups.
- Support and Assistance for Friends and Family Members: It’s not only addicts that are getting step-by-step treatment from different 12-steps-based groups. There are also auxiliary groups such as Al-Anon and Nar-Anon that were developed for the friends and family members of addicts and alcoholics. They serve as a response to addiction treatment as a disease rather than a crime involving family support systems.
- Children of Dysfunctional Families and Codependent Relationships: Even children growing up in alcoholic, drug-addicted, or otherwise dysfunctional families affected by addiction can get support from the 12-step program paradigm. As for Co-Dependents Anonymous, it addresses relationship compulsions and dysfunctions, referred to by psychologists as codependency.
12-Step Programs versus Non-12-Step Programs
Among the many residential or inpatient programs out there, the 12-step rehab program is among the most prevalent out there. There are alternatives to this service that also take care of the addict when it comes to helping him overcome his “demons” by building his willpower in a group setting with other addicts and ex-addicts. Group therapy in general need not follow the 12-step paradigm and still have all the perks.
- Research First and Budget Later: Don’t put the cart before the horse though. Rehab cost shouldn’t be introduced early into the equation as though you’ve already made up your mind that cost instead of technique is important for your rehab choice.
Only after you’ve selected which program is the perfect rehabilitation service for you should you add rehab cost as a consideration. This major decision should not be made solely on what your insurance can pay for or saving money. Instead, go with the addiction rehab program that makes sense.
- Main Criticism of AA and 12-Step Methods: According to an article in the 2015 Atlantic Monthly written by Gabrielle Glaser entitled, “The Irrationality of Alcoholics Anonymous”, the main criticism she has of AA is that it’s not equipped to address mental health issues.
Also, it’s mostly a support group who has leaders and volunteer sponsors that lack professional training to handle case-by-case individualized treatment. This is disconcerting because alcoholics suffer from higher-than-normal rates of mental health issues to boot. This is so in spite of AA’s many success stories, especially when used in conjunction with other rehab techniques.
- Religious and Success Rate Limitations of the 12-Step Approach: Remember, the 12-step approach has roots with AA or Alcoholics Anonymous as a recovery method from alcoholism that involves surrendering to God or a Higher Power, which can be a problem for those who are not religious, not Christian, atheists, or don’t wish to involve their religion and faith with their addiction recovery.
Furthermore, standalone 12-step programs also have a number of pros and cons to them as well involving success rate and individualized therapy, so other methods of recovery might seem better suited for certain cases. Nevertheless, there are secular versions of the program readily available everywhere and its value as a psychological and sociological rehabilitation system cannot be denied.
With that said, does the 12-step treatment still belong with all the modern rehabilitation treatments available or has it gone the way of the dodo and Freudian psychology? Has it become too antiquated or too religion-rooted to be of any use to the more global-minded and secular front of modern-day substance abuse addiction treatments?
Let’s take a closer look by listing down the pros and cons of the 12-step treatment in comparison to other similar group treatments.
The Pros and Cons of 12-Step Treatment
Here are the pros of availing of a 12-step treatment.
- A Myriad of Options: If you decide to avail of 12-step rehab services that are either inpatient or outpatient in nature, you have plenty of options available to you in terms of treatment types thanks to the model being the most common one in the rehab industry. It’s estimated by the American Addiction Centers that over 74 percent of U.S. treatment centers use the 12-step method.
- The Utmost of Convenience: You’re offered the utmost of convenience as well given how ubiquitous 12-step rehab facilities are. You won’t need to look far and wide to either avail of places with exclusively 12-step rehab services or holistic wellness centers that include the 12-step method as part of their arsenal of inpatient or outpatient options. Every state and metro area around the world has this technique available.
- Aftercare Coverage Included: The 12-step methodology can be found all over the United States and beyond since it’s a proven and usable rehabilitation technique that engages both former and current addicts together in cooperative harmony through group therapy sessions. From small towns to large cities, from the U.K. to Thailand, changes are you’ll find a 12-step support group available for weekly meetings or inpatient sessions within addicts in the facility.
- Insurance Coverage: Given how common 12-step rehabilitation is, it’s only natural that you’ll find the quite a number of them covered by major insurance plans. Even if you opt to go the rehab tourism route wherein you pay for a tourism package towards another country in order to get more affordable rehab care even when taking travel expenses into account, there are also international wellness centers abroad that also accept insurance payment when push comes to shove.
- Doubtless Affordability: Quite a number of 12-step programs depend on volunteers in order to offer support and lead sessions, particularly when it comes to the sponsor and sponsee relationship with the sponsor being an ex-addict volunteer and the sponsee being the addicts in rehab. It’s a huge leg up compared to the expensiveness of therapists and professional counselors. With insurance coverage, it’s certainly one of the primary options for affordable rehab care.
- Cultural Norm: As far as the current addiction rehabilitation industry is concerned, the 12-step treatment program hasn’t gone the way of electroshock therapy and lobotomy as far as treating compulsions are concerned. It’s actually the current cultural norm for recovery. Even popular culture has incorporated the terminology of the 12-steps approach and its originator, Alcoholics Anonymous. Many people automatically think of “_____________ Anonymous” when availing of recovery services for addictions.
As for the cons of the 12-step treatment program, they include the following.
- Low Standalone Success Rates: Because addiction and compulsion is hard to kick, the success rate of programs like Alcoholics Anonymous is from 5 to 10 percent according to a study cited by Harvard researcher Dr. Lance Dodes. It’s better to go avail of 12-step methods in conjunction with major inpatient treatment modes and therapy found in many wellness centers than simply depending on this treatment type alone.
- No Support for Dual Diagnosis: You also need services that specifically deal with dual diagnosis or an addict that has a mental disorder or condition on top of being addicted to a substance. Many of the 90 to 95 percent of patients who don’t respond to the 12-step method because they’re suffering from a concurrent mental health condition that make addiction treatment difficult to deal with. These issues include PTSD or Post-Traumatic Stress Disorder, self-loathing, anxiety, and depression.
- Pro Counselors versus Volunteers: The 12-steps program is a member-driven brotherhood, sisterhood, or family of support. Volunteers are the ones who head sessions that are often recovering addicts who themselves have graduated through the program as well. The trade-off of affordability comes at the cost of counseling from professionally trained and certified experts whom you need to treat any deeper psychological and mental health issues.
- Lack of Individualized Care: According to Dr. Dodes, 12-step methods are useful for 5 to 10 percent of addicts because the other 90 to 95 percent of alcoholics and drug addicts are being hurt from being sent into a program with no individualized or holistic care. The lack of individualized care results in underlying conditions that undo the typical benefits of the standalone 12-step program. After all, nearly 50 percent of the general population will deal with some sort of mental health issue in their lifetime according to 2013 CDC findings.
Pros and Cons of Non 12 Step Rehab Programs
Here are the advantages of non-12-step rehab programs that make them ideal substitutes for the 12-step method.
- More Effective Treatments: It’s unfair to compare 12-step rehab to a whole swathe of other treatments that aren’t 12-step rehab. However, in light of its low success rates, there are (naturally) other treatments available that offer higher than 5 to 10 percent success rates out there. Of course, when 12-step methods are used in conjunction with other treatments, it success rates rise. Nevertheless, you shouldn’t compare apples to oranges and instead look for common ground when asking about success rates of one treatment paradigm to another.
- Integration of Evidence-Based Psychology: Many non-12-step programs also integrate evidence-based psychology into their approach. On top of engaging in group therapy, addicts can also get a more well-rounded treatment from counseling-based sessions that utilize therapy to heal any underlying core emotional and mental issues that drive people to drink or take drugs. To kick your bad habits relating to substance abuse, your rehab therapy requires more substance.
- Dual Diagnosis Support Included: A significant majority of addicts to alcohol and drugs also deal with some sort of mental health condition, thus necessitating dual diagnosis support. Some non-12-step programs offer support for dual diagnosis, particularly those that also offer individualized therapy and a holistic approach towards treating its patients. It’s these services that address the root cause of addiction instead of only treating its surface symptoms.
- More Expert Counseling: Several non-12-step rehab techniques also incorporate more professional therapists and certified mental health counselors. This usually results in a greater number of opportunities when it comes for customized counseling based on the specific situation of the client in question. For example, if the addict is suffering from PTSD, the counselor can help treat that issue so that it doesn’t undermine his addiction rehab.
- A Diversity of Approaches: Some non-12-step programs are strictly spiritual or faith-based. Others are more secular and evidence-based, thus including tools such as physical craving alleviation with the help of amino acid injections. There are also others that are a hybrid of multiple approaches or holistic in nature. The funny thing is that holistic therapy can integrate both 12-step and non-12-step program so that you can enjoy the best of both worlds from the two program types.
As for the disadvantages of other treatments compared to the 12-step approach, here they are.
- Fewer Non-12-Step Rehab Centers: According to the Substance Abuse and Mental Health Services Administration or SAMSHA, non-12-step rehab centers only compose of 26 percent of all residential rehab centers in the United States of America. So out of 4,000 inpatient rehab facilities, only 1,000 of them are not of the 12-step variety. When it was mentioned earlier that 12-step programs are more common than their non-12-step counterparts, we weren’t kidding.
- Potential Inconvenience: The 12-step method is more convenient because it’s more readily available. In turn, you have fewer non-12-step centers available, so you might have to look beyond your neighborhood, city, state, or even country to find the right fit. You still have 1,000 centers to choose from give or take a hundred or so, but compared to Alcoholics Anonymous, Narcotics Anonymous, and so forth, you have to search harder. Luckily, rehab tourism exists to help you out.
- Insurance Coverage Is More Limited: That’s not to say there’s no insurance involved in non-12-step programs at all. It’s just that since there are fewer of them, the numbers game would suggest that 12-step groups have the advantage in terms of the number of centers with coverage. There’s simply more in-network and out-of-network insurance plans available for 12-step programs by their sheer numbers.
- Rehab Cost Is Higher: Because non-12-step services have more professional counseling resources and limited insurance coverage, there are more expenses involved. These programs and centers are costlier from an out-of-pocket point of view. This is especially true because most non-12-step programs are inpatient ones while most 12-step programs are outpatient weekly meetings. You might need to get financing for these centers through crowdfunding, borrowing money, healthcare loans, and the like.
Do 12-Step Programs Still Have a Place in Modern Rehab?
Low standalone success rates and other limitations aside, there’s still a place for the 12-step program and its guiding principles that showcase an addict’s course of action when it comes to treating addiction, compulsion, and similar behavioral issues. It really does play its part, especially as a support for people that have completed rehab. This is why rehab clinics like Lanna include some 12-step work and 2 meetings per week, to introduce the concept so people know what to do.
Regardless, the program is best utilized in conjunction with other treatments or as part of a holistic treatment model that uses more evidenced based treatment such as CBT DBT, TA, ACT, mindfulness meditation and so forth. Also, some people like the 12-step method, while others do not. It can also be a matter of preference as well as effectiveness.
Avail of the 12-Step Treatment from Lanna Rehab
Lanna Rehab is a long-established wellness center and rehabilitation service in Thailand. It gets clients from all around the world, including North America, Europe, Asia, and Australia. It also offers the 12-step treatment that has been a mainstay when it comes to drug and alcohol rehabilitation, like those seen in Alcoholics Anonymous and Narcotics Anonymous.
Call Lanna Rehab right now through their 24/7 hotline in order to avail of their affordable and high-quality rehab services, including 12-step treatment programs. Please also contact us today and get a FREE consultation.