Can You Treat Alcoholism Without the 12-step Program
When it comes to maintaining long-term sobriety outside of a rehabilitation treatment program, the oldest and probably most well-known organization is Alcoholics Anonymous (AA). Founded in 1935, AA and its 12-Step Program has been the go-to for treating alcoholism for decades, with many addiction treatment centers incorporating at least some version of the 12 Steps in their own treatment therapies.
AA is a faith-based program where, in order to succeed in their recovery and progress through the 12 steps, members are instructed to admit their lack of control over both alcohol and their own lives and turn themselves over to a higher power. While the foundations of AA are based in Christianity, the 12-Step program is meant to be nonspecific regarding religion and focus more on a spiritual awakening.
However, the religious undertones, as well as the idea of turning your will over to an external force, pose a problem to some and make completing the program difficult. People might be more likely to succeed in a more secular program or one with a different focus or structure.
But some people may feel pressured to join a 12-Step program because it’s the most well-known and they are under the impression that without it, real recovery isn’t possible.
But just like how recovery itself is not a “one-size-fits-all” process, the same holds true for recovery programs. It’s important to remember that AA and its 12-Step program is not the end-all-be-all when it comes to treating alcoholism.
In fact, in many cases, AA and the 12-Step program has been found to not be nearly as effective as people may think it is.
Does the 12-Step Program Work?
Trying to determine whether a program is effective can be a tricky business, in no small part because each person’s experience with any program is inevitably going to be different from someone else’s.
There’s also the fact that for many, if not all, of these support programs, you get out of it what you put in, and if someone is unable to fully commit, then they will probably not find success in not only the 12-Step program but in any program.
What we can look at to judge AA’s 12-Step program are some objective strengths and weaknesses that both substance abuse experts and those who have gone through the program have identified over the course of the many decades it has been in use.
There are indeed many elements that make the 12 Steps an effective program for treating alcoholism, including:
- There is an abundance of AA groups and meetings. Out of any alcoholism support groups and programs, AA is by far the most common, and it’s easy to find a group near you. Areas that are more rural or otherwise have less access to alcoholism treatment will still most likely have a local AA chapter to turn to.
- The support of a strong social network. In that same vein, since AA has been around for so long and is so widely instituted, its networks of support are both widespread and firmly rooted. Combined with that is the emphasis the 12-Step program places on having a sponsor to provide encouragement and motivation as well as regularly attending group meetings and finding strength through your peers.
- AA is established and well-organized. AA and the 12-Step program it is based around has had the benefit of more than 70 years to shape it. Alcoholics Anonymous is an institution and therefore is often more well-equipped and organized when it comes to structure, plans, and resources than other, newer groups might be.
- There are no dues or fees for members of AA. Prohibitive cost can be a major hurdle when it comes to sticking with a treatment program. Even if it’s working, someone might drop out if it becomes too expensive for them to stay with it. While a group might do a collection to cover expenses like rent or refreshments, there is no mandatory cost required to join AA.
However, while these facts speak to the strength of AA as an organization, when you shift the focus more to the actual 12 Steps themselves that the weaknesses of the program start to become more evident, such as:
- AA has remained mostly unchanged since it was founded. Obviously, the world is not the same as it was in 1935, as well as addiction, how we see it, and how we treat it. While newer sober support programs like SMART Recovery make it a point to keep up with the latest in the science of recovery treatment, AA and its 12 Steps have relied on the same “one-size-fits-all” techniques for almost 80 years, techniques that may no longer be as effective in today’s world.
- The program’s emphasis on negative feelings of powerlessness and guilt. Continuing in that train of thought, while the idea behind the 12 Steps may have been revolutionary at the time, for many they can feel outdated and even counterproductive. The 12-Step program demands that those in it break themselves down to be built back up, focusing on the notion that you are incapable of taking responsibility not just for your alcoholism but for yourself as well, that there is something wrong with you, and instilling what can feel more like shame than motivation.
- Prioritizing coping over healing. While AA obviously wants its members to avoid relapse and maintain sobriety, the means of doing so is heavily focused on using skills to cope with addictive behaviors rather than addressing the underlying issues that are causing them. Because of this, many people find the 12-Step program might help them stay sober, but leave them still struggling with the problems that led to becoming alcoholics in the first place.
- Issues with retention and completion rates. Despite how ingrained the 12-Step program is as the standard for alcoholism recovery, the hard numbers tell a different story. According to several studies, the 12-Step Program has been found to be effective for about 20 percent of those that try it, with the other 80 percent usually stopping after just one month. At any given time, only five percent of those still attending AA has been there for a year.
So there are many reasons why the 12-Step Program might not work for someone that are not the fault of the individual. But then, if not AA, what other recovery options are there?
Are There Alternatives to AA?
Luckily, if the 12-Step program has proven itself ineffective for you and your recovery needs, there are many alternatives to choose from. Even if they are not physically available to you, the majority of them have a strong Internet presence and can provide support with online forums for members to share their experiences in, which for some who are uncomfortable sharing in person may even find to be a preferable option.
- SMART Recovery: As previously mentioned, Self-Management and Recovery Training (SMART Recovery), is based on scientific research and is always evolving to match the latest knowledge in the field of addiction treatment. Like the 12 Steps, SMART Recovery is broken down into multiple stages, but focused on motivation, creating an overall positive atmosphere, and changing not just behaviors but also the emotions and thoughts behind them.
- Women For Sobriety: Founded in 1975 for the purpose of creating a recovery program that was explicitly geared towards women, the goal of Women For Sobriety is not to be anti-male but to address the specific psychological needs that many women have during recovery. WFS operates under the belief that many women are already struggling with low self-esteem or shame that has been culturally instilled in them and don’t need more of it from their recovery program. Instead of the 12 Steps, WFS’s treatment program is based around the 13 Affirmations that point toward positive goals rather than admitting negative faults, such as “Happiness is a habit I am developing,” “Enthusiasm is my daily exercise,” and “I am responsible for myself and for my actions.”
- LifeRing Secular Recovery: For people who would prefer a recovery program without the spiritual aspects of the AA and the 12-Step program, LifeRing is not based on any ideas of a higher power. Instead, they focus on the belief that each person has the power within them to control their alcoholism, having its member visualize themselves as two people: the Addict Self and the Sober Self, and work on weakening the former and strengthening the latter. LifeRing does this by connected Sober Selves through in-person and online group meetings to create a strong network of support without any kind of structured stages, steps, or sponsors. Instead, they emphasize that the best person to design an effective sobriety program is you since you will know what does and doesn’t work for you personally.
These are just a small sample of the variety of AA alternatives available for you to try until you find the one that is best suited to you and will give you what you need to manage your addiction and stay sober.
What Matters Most in Recovery
So hopefully, it’s clear now that choosing to recover without the 12 Steps is definitely possible, as the program, while well-established and certainly helpful for some, is not the guaranteed road to successful recovery that some might claim it is.
In fact, Anne Fletcher, award-winning medical writer and author of Inside Rehab: The Surprising Truth About Addiction Treatment, writes, “If nothing else, we know that people have better treatment outcomes when they’re offered choices and not coerced to accept one thing or another.”
Ultimately, the fact of it is, as previously stated, an alcoholism treatment program, even one that is tailored to your exact needs, is only going to be as effective as you make it. Whether you opt to join AA or to try recovery without the 12 Steps, it is still crucial that you do at least choose something.
Studies have shown that those who remain abstinent from alcohol for at least five years have a relapse rate of less than 15 percent, and recovery support programs are a big part of what makes that possible.
If you or someone you care about has been struggling with alcoholism or other substance addictions, Ocean Breeze Recovery can get you or your loved one on the path to a productive, drug-free life with the help of our professional, compassionate staff. Call (844) 789-2841 now to get more information from one of our addiction specialists.