Getting sober is one of the most challenging things one can do. It requires commitment, time, personal inner strength, money, stepping outside of your comfort zone and humility. Many treatment options can help in this challenging process. The 12-step program is a spiritually based guidance program used by addicts who are trying to recover from alcohol abuse, drug use and compulsive behaviors like gambling. The most commonly used program for sobriety in the world, the 12-step program has been around for decades. Founded in 1938, Alcoholics Anonymous was the original fellowship group that adapted the 12-step program.
The 12-step program
Twelve-step literature routinely stresses the importance of service, encouraging its members to give of themselves to others through sponsoring fellow alcoholics. The pillars of the 12-step program center around the belief of a higher power and accepting the fact that people are powerless. Without this higher power, sobriety cannot be obtained.
Alcoholics Anonymous and other 12-step programs have an all-or-nothing approach. People either are completely sober or an addict; there is no middle ground. This places unbearable pressure on people who cannot live up to this high standard.
For decades, only a few studies documented the effectiveness of 12-step-based treatment and, for the 65 years of its existence, AA has grown by anecdotal accounts of recovery among its members, not by the results of research published in peer-reviewed medical journals. This has led to many controversial arguments about whether this method of treatment is the best approach to get clean. After all, not everyone believes in a higher power nor has the willpower to practice abstinence.
Of note, the 12-step program is the only addiction help program that requires a sponsor throughout the process to help the recovering addict have someone to call, meet with and relate to especially in times of potential relapse. This is a great benefit of the 12-step program.
In 1994, another recovery program, known as SMART Recovery, was founded and today is widely accepted. SMART Recovery, also known Self-Management And Recovery Training, is a secular program designed to help addicts discover and act on their personal reasons for staying sober. Having a very different approach from the 12-step program, SMART Recovery does not focus on a higher power, but rather centers its philosophy on cognitive and scientifically based methods to treat addictions.
SMART Recovery is a self-empowering program. In contrast to the 12-step approach, self-empowering groups encourage individuals to take charge of their lives, rather than accept powerlessness and turn to a higher power. Motivational enhancement therapists help people move through six specific stages of change: precontemplation (not considering a behavior change), contemplation (considering a change), preparation, action, maintaining the change and coping with relapse.
SMART Recovery refrains from using the term “addict” or “alcoholic,” accepts the validity of appropriately prescribed addiction and psychiatric medication, allows for truly anonymous participation via a screen name on the website, and allows participants their own perspective on whether addiction is a disease. The SMART Recovery can be solely online based through the website and chat rooms. The program also offers face-to-face meetings, but the program is not centered around them as many people desire to remain anonymous. Many people in SMART Recovery also attend 12-step meetings to have a sufficient face-to-face component or because they find aspects of both programs helpful.
Cognitive Behavioral Therapy
Cognitive Behavioral Therapy, is an alternative avenue to 12-step programs that helps people master skills that are essential to maintaining their sobriety, in particular, relapse prevention. Specific techniques and skills include exploring the positive and negative consequences of continued drug or alcohol use, self-monitoring to recognize cravings early and learning to respond to those cravings in ways other than drinking. Some of those skills also include challenging the thoughts used to rationalize drinking and avoiding the people, places, and things linked to alcohol or other drug use.
The skills individuals learn through cognitive behavioral approaches remain after the completion of treatment, helping people to abstain from relapsing. Cognitive behavioral therapy does not focus on a higher power, does not have any steps to follow and does not include a sponsor. The 12-step program is the only program that requires a sponsor.
Treatment of choice
Many addicts have a drink or drug of choice, whereas many recovering addicts have a sobriety program of choice. Many professionals and scientists argue for or against each of these treatment programs. They each have their own pros and cons and they all have been proven beneficial to those who have needed them. Regardless of the arguments, it is important to know that multiple treatment plans are out there. Each person might require a different approach and could even use all three of the modalities. The bottom line is whichever program works for that particular addict should be the treatment of choice for that addict.