Frankly many people may not even realize that anything besides 12 Step programs for the treatment of substance abuse issues exist. Perhaps it is because in countless movies and TV shows if a character has an addiction problem they promptly go to a meeting, tell long heartfelt monologues and suddenly, are on the road to recovery. (Based on how many of these shows are broadcasted, screenwriters seem to be enamored with creating these scenarios). Hollywood besieges us with somber reaction shots and the appropriate musical accompaniment for an uplifting ending.
However, when you are deciding how to address your own substance abuse challenges, what works in the movies shouldn’t be your first criteria. While there are plenty of stories of successful individuals, there is no evidence that the program itself works better than simply a determination to change and having a support network. And in too many cases 12 Step programs result in numerous relapses followed by self-recrimination. The long term success rate of 12 step programs is surprisingly low given how many people try at least one meeting.
Thankfully, 12 step it is not the only choice, and you need to consider what is likely to work for your particular circumstances.
The National Institute on Alcohol Abuse and Alcoholism (NIAAA) reports, “Ultimately, choosing to get treatment may be more important than the approach used, as long as the approach avoids heavy confrontation and incorporates empathy, motivational support, and a focus on changing drinking behavior.” (Link)
Below is a chart that is helpful in making a decision. As you can see, there are many major differences between these approaches.
|12 Step Program||Non-12 Step Program
(as Practiced by Denise Hockley, LMFT)
|You must admit that you have an incurable, untreatable, disease called Alcoholism.||Alcohol Use Disorder is diagnosed on a scale, from mild to severe using criteria found in the DSM-V (Diagnostic and Statistical Manual of Mental Disorders). It can range from mildly interfering to serious behavioral and physical impacts. But at each severity level there are numerous treatment interventions available to attack it.|
|You are powerless to help yourself. Only by surrendering to a “higher power” can you hope to be helped.||Focused on empowering you to understand, recognize, and make the necessary changes to become in control of your life.|
|Focused on permanent total abstinence. One drink and your ‘number of days’ returns to zero. In other words one misstep means you have failed.||Focused on harm reduction. If you believe that your goal should be complete abstinence that is your choice, not an expectation of the program. Even if you decide that you want total abstinence one drink is a slip, not a fall.|
|There is a heavy emphasis on past harms. You must fully inventory every bad thing you have ever done as a result of alcohol, tell them to an untrained third party, and make amends with every person involved.||Minimal emphasis on the past. The past is used only as a way of understanding the situations, triggers, habits, etc. that must be addressed as part of your treatment.|
|Meetings, Meetings, Meetings. There is no requirement that anybody involved in the meeting have any formal training in addiction counseling.||One-on-one sessions with a licensed therapist. Your time will be spent working on your problems, not listening to somebody else talk on and on about theirs.|
|A strong culture of anonymity, but typically nobody is covered by therapist-client confidentiality laws.||Everything about your sessions is covered by therapist-client confidentiality laws. Moreover if you choose to be a private client, not even the insurance company will ever see the diagnosis.|
|Written in 1939 and expanded in 1953. Currently there is such an engrained culture in the myth of success that change to more effective treatment is essentially impossible. Despite the scientific research refuting the success of the AA programs, they continue to dominate individuals and institutions.||Treatment with this Non 12 step program is founded on the latest proven research-based results in physiology and the behavioral sciences. It is regularly revised based on new findings in these fields. The techniques used in your sessions will be based on what is most likely to work for your specific set of circumstances, not what the ‘Big Book’ says.|
Residential vs. Outpatient Treatment
Both Residential (“Rehab centers”) and Outpatient treatment at a therapist’s office are essential resources to recovery. If you are currently having physical symptoms due to the detoxification from alcohol, I recommend you seek medical care and perhaps hospitalization first, in order to prevent any permanent physiological problems.
If, however, you are not in immediate danger there are reasons to consider an outpatient approach. Primarily this is because Residential Centers’ greatest strength is also their weakness. At rehab you don’t have to walk past the liquor aisle at the grocery store, or drive past your favorite bar. You don’t have to walk through your kitchen where you have a bottle hidden on the upper pantry shelf. You don’t have to deal with the co-workers who urge you to have a few drinks to relax at the end of the day.
If you are in residential treatment, it is much easier not to drink because you are away from the usual situations that encourage you to do so in the first place. The flip side of this, of course, is what occurs when the ‘vacation’ is over and you return to your regular routine. Outpatient treatment teaches you how to cope when all the temptations are nearby.
Additionally, Outpatient treatment is substantially less expensive and less obvious (more confidential) than suddenly taking an unexpected ‘vacation’. The goal of Outpatient treatment is to empower you to face daily, real world situations while finding new ways to manage your symptoms and behavior and choose not to drink or at least in a manner that causes no harm.
Now that you understand the choices, the important thing is to take action on them. Don’t wait, give me a call at 760-822-7729 and I’ll be happy to answer any other questions you may have.