Treatment programs for substance use disorders come in many different forms. The types of therapy offered by different facilities can vary widely, thereby accommodating the different needs of the many different people who need treatment. Some treatment programs follow a model of treatment established by 12-Step groups, like Alcoholics Anonymous, while others structure treatment differently.

12 Steps

What Are 12-Step Treatment Programs?

There are several different organizations that use a 12-Step model to facilitate recovery from substance abuse, but the most well-known groups are Alcoholics Anonymous (AA) and Narcotics Anonymous (NA). Various offshoots of these organizations have been formed to address specific drugs of abuse, such as Heroin Anonymous and Marijuana Anonymous, as well as specific destructive behaviors, such as Co-Dependents Anonymous and Gamblers Anonymous.

Treatment Structure

Twelve-step programs, in and of themselves, are not an official form of therapy, but rather function more as peer support groups and self-help organizations. AA and NA meetings are offered freely to the public, and they are open to anyone who wishes to attend. Some people join 12-step programs independently or through the recommendation of a friend, but others are introduced to this method of recovery through 12-Step facilitation therapy.

Therapy in the 12-Step model uses the principles of 12-Step programs for the basis of their substance abuse treatment offerings. This type of therapy predominately focuses on three main ideas:

  • Acceptance: realizing that addiction is a chronic disease over which the individual has no control, and that willpower alone is not enough to overcome substance abuse
  • Surrender: giving control to a higher power (religious or otherwise), and accepting help and support from treatment professionals and other individuals in recovery
  • Participation: attending 12-Step meetings and events on a regular basis, and following the tenants of that program

The goal of 12-Step facilitation is to encourage the individual to become actively involved in a 12-Step program and to commit to remaining in the program. The intention of this is to establish lasting recovery with the ongoing involvement of a peer support group.

Treatment Efficacy

Programs like Alcoholics Anonymous have been in use for decades, and they have remained popular choices over time. While the effectiveness of these programs has largely been reported through unofficial means, some research has been conducted in an attempt to establish the success rates of these programs. A literature review from the Journal of Addictive Diseases reports that those who attend AA meetings show rates of abstinence that are twice as high compared to those who do not, and attendance at these meetings increases the likelihood of maintaining abstinence in the future. However, proof of the efficacy of 12-Step programs tends be somewhat inconsistent across studies. This could be partially due to the widely varying structure and content of 12-Step meetings; there tends to be little consistency across different 12-Step groups. The anonymous nature of the groups also makes research studies difficult.

It’s widely accepted that participation in peer support groups and aftercare, like 12-Step meetings, can benefit long-term recovery. In addition, regular attendance at meetings can give structure to a person’s life in newfound recovery that can greatly aid ongoing sobriety.

Vs.

Non-12-Step Treatment Programs

While 12-Step programs are a popular choice when attempting to overcome an addiction, many treatment programs exist that do not follow this model. Some people find the spiritual aspect of traditional 12-Step meetings off-putting. Even though programs encourage a belief in any “higher power” rather than just a traditional Christian view of God, groups in the 12-Step model are often viewed in light of religious undertones.

Treatment Structure

Non-12-Step programs are generally groups that see the value of peer support but wish to get away from the reliance on a higher power associated with most 12-Step organizations. Alternatives to 12-Step programs include SMART Recovery and Secular Organizations for Sobriety (SOS). Alternatives to 12-Step programs simply base care on different principles. These principles vary somewhat between specific organizations, but they generally include:

  • Motivation: finding personal motivation to change, often based on the detrimental effects of substance abuse in a person’s life
  • Personal responsibility: accepting personal responsibility for recovery and ongoing sobriety rather than giving up power to someone or something else
  • Balance: establishing balance in life via overall wellness and active participation in peer support meetings

The main difference between non-12-Step treatment and 12-Step treatment comes down to self-reliance. Whereas the 12-Step model emphasizes that individuals are powerless to control their addictions, and stresses giving all control over to a higher power, 12-Step alternatives focus on personal responsibility, believing that individuals have the power to control their addictions themselves.

Treatment Efficacy

The effectiveness of non-12-Step programs will vary according to the specific program and the individual’s needs in recovery. Similar to 12-Step programs, the power of these programs lies in the peer support dynamic.

Due to the prevalence of 12-Step-based models, such as AA and NA, many in recovery think these types of programs are their only options for easy-to-access, ongoing peer support. According to a study published in Alcoholism Treatment Quarterly, over 40 percent of people in recovery from alcoholism who weren’t religious or who were unsure about religion still participated in AA. The same study found that about 75 percent of secular individuals did not participate in AA at all in the prior 12 months, and this lack of participation is likely due to the religious undertones of the 12-Step model. It’s likely that these individuals may be more likely to participate in non-12-Step models, such as SMART Recovery, SOS, Women for Sobriety, and LifeRing Secular Recovery.

The philosophies of each non-12-step program are somewhat different; however, all advocate self-reliance and peer support. Like any form of treatment and aftercare, ongoing participation is key to the success of these programs.

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Choosing a Treatment Model

The appropriateness of a 12-Step or non-12-Step treatment program is largely based on individual preference and circumstance. The most effective treatment for substance use disorders is tailored to the individual. Choosing a program that fits your lifestyle and your needs – regardless of the program type – is the most important factor in recovery from addiction.

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