If Not AA, Then What? Five 12-Step Group Alternatives

Most of us know someone who was saved from a serious drinking or drug problem by Alcoholics Anonymous (AA) or a group based on its 12 steps such as Narcotics Anonymous. And that’s where most minds go when we think “recovery” from addiction. Yet AA and similar groups are not treatment – rather, they’re support groups or what professionals call mutual help groups because participants (usually peers) support and help each other without professional therapy or guidance. However, such groups existed long before AA was established in 1935, as noted by William White, author of Slaying the Dragon: the History of Addiction Treatment and Recovery in America, who documented the existence of native American recovery “circles” a century earlier.

Today, although most people have heard only of AA and similar 12-step mutual help groups – and this approach is included in some fashion in programming of the majority of U.S. treatment facilities – it’s well-documented in the scientific literature that most people who go to AA don’t stick with it.

…studies suggest that just 25 to 35 percent of those who attend one AA meeting go on to become active participants.-Anne Fletcher

According to renowned addiction treatment researcher Thomas McLellan, Ph.D., CEO and Cofounder of Philadelphia’s Treatment Research Institute, studies suggest that just 25 to 35 percent of those who attend one AA meeting go on to become active participants. Of course, attendees do commonly go to meetings for a few months, drop out, and then come back at some later time. But many never “get hooked” and don’t realize (nor are they told in treatment programs) that there are alternative support groups with very different philosophies that might appeal to them. There are more than a few longstanding choices with very different philosophies that exist nationwide.

Some AA Alternatives Support Groups

Faces and Voices of Recovery offers a comprehensive, easy-to-use listing directory, from 12-step to secular to youth-focused. (Note that in addition to face-to-face meetings, many of these groups hold meetings in jails and prisons, and a good number have on-line meetings.) The following are some longstanding national abstinence-based groups (statistics are included for those that shared numbers of face-to-face meetings).

Women for Sobriety

Women for Sobriety (WFS) was founded in the mid-1970s by Jean Kirkpatrick, a woman with a doctorate in sociology who had a severe alcohol problem that she ultimately overcame herself by changing her thoughts when she was lonely or depressed. Kirkpatrick felt that women with drinking problems require different approaches than men and began this abstinence-based program for women, taking the position that drinking begins as a way of dealing with emotional issues and then evolves into addiction.

Designed to bolster women’s sense of self-value, the WFS philosophy stands in contrast with AA’s focus on humility and limiting self-centeredness, working from a position of empowerment.-Anne Fletcher Designed to bolster women’s sense of self-value, the WFS philosophy stands in contrast with AA’s focus on humility and limiting self-centeredness, working from a position of empowerment. Members are encouraged to learn how to better manage their issues by sharing with and encouraging one another. A major emphasis is on substituting negative, self-destructive thoughts with positive, self-affirming ones. WFS uses 13 statements or affirmations that emphasize increased self-worth, emotional and spiritual growth, not focusing on the past, personal responsibility, problem solving, and attending to physical health.

Latest stats: WFS averages 100 U.S. groups and a dozen in Canada. womenforsobriety.org

SMART Recovery

SMART Recovery’s cornerstone is cognitive-behavioral approaches that help members recognize environmental and emotional factors for alcohol and other drug use (as well as other “addictive” behaviors) and then to respond to them in new, more productive ways. It also incorporates motivational interviewing concepts. Unlike some support groups whose principles remain static, SMART Recovery maintains a philosophy of evolving as scientific knowledge evolves.

Although it is an abstinence-based program, SMART Recovery welcomes those who are ambivalent about quitting substance use.-Anne Fletcher

SMART Recovery tools can help you regardless of whether or not you believe addiction is a disease. Working from empowerment, it encourages individuals to recover from addiction (as opposed to being “in recovery” or seeing themselves as having a lifelong “disease”) and is a recognized resource by multiple professional organizations, including the National Institute on Drug Abuse and the American Society of Addiction Medicine.

Although it is an abstinence-based program, SMART Recovery welcomes those who are ambivalent about quitting substance use. Its 4-point program guides participants in the following areas: (1) building and maintaining motivation; (2) coping with urges; (3) managing thoughts, feelings and behaviors; and (4) living a balanced life. SMART Recovery president and clinical psychologist, Tom Horvath, Ph.D., told me, “SMART is good for people who take lots of responsibility for their lives — those who feel they’re in control of events rather than the other way around.”

Latest stats: 635 U.S. groups; 613 international groups. SMART Recovery also has a youth program and a Family & Friends program. smartrecovery.org

Secular Organizations for Sobriety

[SOS] advocates taking responsibility for problem drinking and handling it as a separate issue, distinct from any religious or spiritual beliefs.-Anne Fletcher

Secular Organizations for Sobriety (SOS) was founded by former serious problem drinker, James Christopher, in the mid-1980s. He tried AA but felt uncomfortable with the notion of turning one’s life over to a “higher power,” finding that focusing on self-reliance and personal responsibility were more helpful in dealing with his alcohol problem on his own. He used these tenets in founding SOS, which advocates taking responsibility for problem drinking and handling it as a separate issue, distinct from any religious or spiritual beliefs.

SOS has no structured program, but it has some suggested guidelines for sobriety. The centerpiece is the “sobriety priority” which works from the standpoint that, when using, alcohol or other drugs become the main focus in life. Therefore, to become free of substance, SOS maintains that sobriety has to become your priority, and you “cannot and do not use, no matter what.”

Latest stats: I was told, “SOS has well over 1000 meetings.” sossobriety.org

LifeRing Secular Recovery

LifeRing Secular Recovery (LSR) was formed more than a decade ago when a number of SOS groups changed their names and affiliated as LSR, a separate group that was formed because of differences of opinion about how the organization should be structured. LSR has three fundamental principles: sobriety, secularity, and self-help. For this organization, sobriety also always means abstinence from alcohol and other problem drugs, and they practice the sobriety priority, “we do not drink or use, no matter what.” Although people of all faiths or none are welcome, LifeRing supports methods relying “on human efforts rather than on divine intervention.” For them, self-help means that the key to recovery lies in the individual’s own motivation and effort, and the group is there to reinforce his or her own inner efforts.

Latest stats: 159 U.S. groups; 41 international groups. lifering.org

Celebrate Recovery

Celebrate Recovery (CR) was founded as a Christian support group in the early 1990s and is part of the Saddleback Church of Christopher Warren (author of mega bestseller, The Purpose Driven Life) fame. It has eight recovery principles based on the biblical beatitudes, each translated into a principle of personal recovery, and provides a Christ-centered, Bible-based recovery program. In an article on the program’s history, writer Elias Crim described CR as “Alcoholics Anonymous powered by Sermon on the Mount.” While CR does incorporate the 12 steps in some fashion, it is separate from AA, with its own steps designed for all types of “addictive behaviors” that aim to free people from “hurts, hang-ups, and habits.”

Here’s an example of how the first part of CR’s step one is similar to AA’s but the biblical quote is added by CR:

We admitted we were powerless over our addictions and compulsive behaviors. That our lives had become unmanageable. (“I know that nothing good lives in me, that is, in my sinful nature. For I have the desire to do what is good, but I cannot carry it out.” Romans 7:18)

Latest stats: The June 2009 article by Crim indicated that the Saddleback Church estimated that more than 10,000 churches – “almost all evangelical” – offered a CR group. However, the organization did not confirm this number or send any new data. celebraterecovery.com

Where’s the Evidence?

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.-Anne Fletcher

Although very little research has been conducted on non 12-step mutual help groups, psychologists and AA researchers Keith Humphreys and Lee Ann Kaskutas said of them at a 2007 conference at the Betty Ford Institute, “By analogy, one can reasonably argue that these organizations probably benefit participants because they share curative features (e.g., abstinent role models, social support) with organizations that have been shown effective in longitudinal research. For some organizations, like SMART Recovery, an even stronger argument through analogy can be made for effectiveness because the organization’s change technology is adopted from well-established treatment approaches.”

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. In 2012, a report on addiction treatment in the U.S. by the National Center on Addiction and Substance Abuse at Columbia stated, “The research evidence clearly demonstrates that a one-size-fits-all approach to addiction treatment typically is a recipe for failure.” As a case in point, for Inside Rehab, Rose T. said she felt that her relapse following her first treatment experience might have been prevented had she been told about Women for Sobriety at that time. Eventually, on her own, she explored alternatives to AA and found Women for Sobriety to be the best fit. She shared, “To sit in a room with others like me, makes me feel less alone. I’ve found such a beautiful community of sober sisters, and I’ve got such a strong support group standing behind me.”

It should be noted that it’s not uncommon for people who attend these non-12-step support groups to also attend AA, a relationship that is typically not discouraged. Note, too, that a mutual-help group called Moderation Management, which has 30 face-to-face groups, is available for people with drinking problems but who are not addicted to alcohol and want to reduce or stop their drinking and make other positive lifestyle changes.

Related: The Dual Citizenship Phenomenon by Tom Horvath

Photo Source: pixabay

The views and opinions expressed in this article are those of the authors and do not necessarily reflect the official policy or position of Rehabs.com. We do believe in healthy dialogue on all topics and we welcome the opinions of our professional contributors.

What Are Your Thoughts on this Topic?

  • LifeRing

    Thank you, Ms. Fletcher. for this useful overview of alternatives to AA. I remember back 15 or so years when I decided I needed help in order to quit drinking. In my town at the time, AA was the only support system available. But I had looked through their “Big Book” and knew I would never feel comfortable there. I turned to Google thinking there had to be alternatives, but boy, were they difficult to find! At last I stumbled upon LifeRing, joined one of their email support groups and felt immediately as though the “support” piece of the puzzle was firmly in place. It still took me awhile to “get it,” but the support I received from LifeRing never wavered. I’m still involved and highly recommend them to anyone seeking secular, supportive help in finding their way towards lasting sobriety.

    Craig Whalley

  • Shira Goldberg

    As an advocate that presents resources that are more aligned with each individual, I have found individuals are interested in learning more about alternatives besides the AA type fellowships. This curiosity has proven to be really beneficial to both clients and non clients alike. It is important to provide information in way that is useful to someone, not it in a way that is based on anecdotal evidence, since it was useful to you it must be the way to go for everyone, type logic. I have seen a shift, maybe because of more awareness, that these self help support groups really are ideal for those that have once felt hopeless, now feel hopeful, once powerless, now powerful. As we see more examples of evidence and strength based options integrated in treatment centers and communities, there can only be more people that feel connected and more a part of their own recovery. WIth more knowledge of such alternatives, they will continue to grow in communities and prove to be vibrant and viable options, people just have to know such options are available.

    Shira Goldberg, BSc., RRW, Master Recovery Coach GoldbergSoberCoaching.com, SMART Recovery facilitator, LifeRing participant and host of The Addiction Show

  • http://www.chaplainmike.com/ Mike Hansen

    Here in the Denver area Step Seven Ministries is a very effective and growing Christian alternative to AA. I’ve seen many, many lives saved and changed. http://www.StepSeven.org

    • abn12

      don’t forget to sleep with the pastor

  • BobbyBlunt

    SOS assured you they now have 1,000 meetings? Wow, after viewing their meeting directory that would mean over 900 of them are super-secret unlisted meetings. Thanks for the time you put into researching this article. Having the facts on alternatives to AA so handy is a great service.

  • massive

    We need National PSA that promote and educate that there are 6 free options to AA self support groups. Many have no idea.

  • Jon S

    Hi Anne. This is an excellent resource. I also really like your book. Recently I saw the independent documentary movie One Little Pill (available on Vimeo) which is an extremely convincing discussion of The Sinclair Method. Amazingly this has been available since the mid-1990s but hardly used outside of Finland. How many alcoholics who could not find abstinence have died in that time? If AA really cared for the suffering alcoholic they would produce literature that outlined such alternatives in the interests of openness and transparency. I recently left AA after 14 years and my site “Leaving AA, Staying Sober” at http://jonsleeper.wordpress.com also includes commentary on all the resources you’ve listed here. JS

  • abn12

    I have almost 17 years of sobriety in AA. What I am about to say is only from my experience. I am an alcoholic – I can never use alcohol in any way, shape, or form. I am an alcoholic. I am upset but understand how AA is not for everyone, not everyone who drinks heavy is an alcoholic. I tried just about every way imaginable to get sober and nothing but AA worked. I love people who bash AA. They only read a portion of the big book and then claim it is a cult or it is guilt and shame based etc. That is ok. I love how this family in California is trying to sue AA because their “court ordered” daughter was killed by a “court ordered” asshole. They should be suing the court who ordered this guy there. AA today is no longer AA. It is simply an extension of the judicial system, clean and sober housing system and treatment programs. I am a member of AA and do not believe AA is the only way for folks to get sober. Bill Wilson stated in 1950, “If AA proposes to have a cure for all of the worlds ills then it is no longer AA.” Today AA has become just that a cure for all the worlds ills. There are sponsors, much like parents, who want to be your friend. Then there are those with time who do not stand up and say anything about predation both male and female predators. I have started new meetings where court slips, treatment slips or housing slips are not signed.

    • Sean Syrek

      That is awesome! Good for you. AA and the like are at their core peer run VOLUNTARY programs. What is so hard to understand about that? These judges and lawyers are supposed to be super smart right? Forcing people to participate in a VOLUNTARY program? Ridiculous.

      • abn12

        The collective AA ego was stoked when the judges said, “you can help when no one else can.” That was all that was needed. Now we have pedophiles, murderers, serial rapists etc sitting in meetings and praying on victims – male and female. No wonder people talk crap about AA. AA does not propose to have the cure for all of the worlds ills if it did it would not be AA. The steps and the program saved my life but it is not for everyone!! Thanks for your reply Sean

    • blimpalot

      I’ve read all of the big book and am anti-AA.

      • abn12

        wow you read it huh? Hey different strokes for different folks it worked and works for me

      • abn12

        it does state in the big book “if a man can find another way to get sober our hats are off to him.”

  • Mike Orr

    In AA, they say, “rarely have we seen a person fail who has thoroughly followed this path”. But in argument, I say rarely have AA people seen one succeed who hasn’t followed this path, because the people who recover from addiction without AA aren’t in their close little social circle.

  • Darrell B.

    I have been a member of AA and “secular” groups for over 30 years. I have noticed that those groups who embrace judeo-christian values , to be far kinder to their fellow members than the secular ones, in general. Being just “dry” is not equal to reaping the benefits of a sober life. Furthermore, I have noticed that many secular members are also radical Leftists who transfer their addictive energy, to dislike of those who are in disagreement with their life-philosophy. Please beware of the negative energy of many of those group-members. Darrell.

    • blimpalot

      Sounds like the religious have morals and Atheists do not argument.

    • challenger1

      Hear hear

  • Anne T

    Thank-you! Unfortunately in Sac.CA, where I live there are no WFS Group. Why doesn’t this program have more meetings on the West Coast?

  • Lilarose Davis

    There seems to be a lot of help for drug addicts but not for alcoholics. If I were in jail, I would be offered some kind of help as a drug addict. I can’t afford a program like we have in Oregon (Serenity Lane). I live remotely and just to get to the facilities is difficult. I wish there was something on Facebook besides AA groups, and particularly for women.

    • Jon M

      You might be interested in SMART Recovery. You can visit their website at smartrecovery.org. They have online meetings and ones also broken down for just women, youths, etc.

      • jt

        SMART Recovery costs lots of money. You don’t get to see anything unless you sign up for $89 bucks for 3 months. Yes less than doing drugs or drinking for a couple days but that is a lot of money.

        • http://mylifeas3d.blogspot.com/ DeanDD

          Hi, jt. I’m 99.99% sure that the SMART Recovery program is free. You may have to purchase reading materials, but those are optional. AA does the same. I suppose I could be wrong, but I’m pretty sure anyone can attend SMART Recovery meetings absolutely free of charge.

          • Jon M

            No you are 100% right. It is free, they just ask for a small donation to pay for the rent. By small I mean 1 or 2 dollars. And yes you can buy literature for around $10. It’s the same as a 12 step meeting. I’m a certified SMART Recovery Facilitator, I have no idea where “jt” came up with those numbers.

        • Jon M

          It is 100% free. I have no idea where you came up with those numbers. Anyone can go to a meeting and the room rent is paid for by passing a hat around and asking for small donations (like 1 or 2 dollars). Exactly like any 12 step meeting. The literature costs around $10, once again the same as any 12 step meeting. On top of that they also have FREE online meetings if you don’t feel comfortable going to an actual sit down one.

  • Beth C

    Dr Stanton Peele has developed his Life Process Program into an online based program, link to lifeprocessprogram.com. To quote a recent sign-up to the program: “I really like the idea of following a structured program without having to spend thousands of dollars and trying to explain my 4 weeks absence from my home. I also like that I can conduct this without having to leave my home and that I am available to my family and my business as usual”

  • Skeptic

    I have tried to get clean and sober for years……

    I have tried NA and AA for years…..

    I’m an atheist and anti-group think……

    12 Steps doesn’t work for me….

    It never will…..

    It’s based on Judeo-Christian Moral Principles and Theology…..

    No rehabs based on 12 Steps should supported by Tax Dollars….

    I hope to get clean and sober…..

    But, I’d rather die than be brainwashed in sobriety…..

    I will never accept or believe something to help me go along and get along….

    Integrity or Survival?

    • Grateful

      That’s too bad your not willing to go to any length to get sober. The fact that you would die rather than be brainwashed is probably whats gonna happen. I don’t know about you but I needed a good brainwashing. You don’t have to believe in the actions, just do them. You might be amazed by what happens. Have you ever tried working the steps? They only work if you try. Ill be praying for you.

      • mw

        don’t listen to this idiot. the choices are not so black and white. 12 step programs do not help all or even most people. don’t let people like Grateful shame you into thinking you will die if you don’t accept 12 step recovery. think about it: if you had depression or diabetes, would you tell someone that the only way to fix themselves is by making up a god; and accepting the stupid sayings that 12 steppers have, which are mindless slogans, coming from a book written 100 years ago. think for yourself

      • Rodney

        I’m a sober atheist who goes to AA meetings several times each week. I have gone to secular AA meetings and those that read the regular 12 Steps that have God in them. In working the steps, I use a secular version, and they have kept me sober. I have many friends in AA. Some of them believe in some sort of higher power and some of them don’t. We all respect each other’s beliefs or lack thereof. The most important thing I get out of the meetings is the relationships I develop with other people in recovery. I feel supported, understood, and loved. And I get to be helpful to others seeking recovery. That is an awesome experience.

        • John Citizen

          When I hear that AA is working for someone, I’m thrilled. But, if you believe in a “Higher Power” you might not be an atheist. If you are spending a few evenings every week reciting teachings about God, you might not be an atheist.

        • Zeus

          There is no such thing as a “secular” AA. Removing “God” from the big book and exchanging it for the eumphemism, “Higher Power,” does not remove the spiritual foundation which makes it an inherently non-secular organization and non-secular philosophy.

      • challenger1

        Excellent i agree

      • Cassondra Sue Duffy

        Judgemental much? Just because a 12 step program worked for you doesn’t mean everyone should be forced to do it if they’re an addict. Any idea what goes through a gay or bisexual ex Christians mind everytime “higher power” is said at na or aa? We think “yeahhhh right. The same God that I prayed to asking to either save me from homosexuality or kill me and end this cycle of never-ending sin that I can’t stop no matter how hard I try, who didn’t do either, is really gunna care about me NOW? REALLY? i’m like an ant to God. Or worse a poisonous spider. He doesn’t care. Why should I ask him for help? If he didn’t save me from sin before then why will he save me from slow suicide through drug use? ” and then it makes us feel guilty for our “sins” of being gay-something that cannot be helped. Which then can be a trigger. Guilt can be a trigger. So for gay/bi/trans ex Christians (or most other religions for that matter) a religious 12 step program is more of a problem than a help. And don’t say I didn’t try hard enough to “turn straight”. I was 14. On my 14th Birthday when I realized I had a crush on someone of the same sex. I was suicidal. For a year. I tried so hard to “turn straight” and I prayed EVERY DAY for a year for God to save me or kill me. I stayed away from the same sex. Tried dating the opposite sex. Nothing could stop my feelings.

    • Skeptic 2

      I am an atheist as well. I was put in a in patient twelve step program for a month. I regularly attend as meetings. Even though I think it’s all shit I have heard before and the lessons they teach seem to me like common f***ing sense. It helps to have a support group, that’s the only reason I keep attending. When I help people It helps me stay sober. Hearing other people tell there stories even though sometimes I roll my eyes and think they are exaggerating or whatever. No matter how much your against the principles of you let it help you it will help.

      • Lou

        I feel the same fucking way,, I have been fighting alcohol for 30 yrs and i always fail to stay sober, But i do not want god chubbed down my throat so i can stay sober.. theres gotta be another way, another support group..

  • http://shryve.webs.com/ William

    Below is the Charitable Choice Act. It clearly states that Government Funds should not be expended on religious activities like the 12 Steps. I have seen plenty of Rehabs where the staff would teach the Steps during Group Therapy time.

    The Charitable Choice Act link to gpo.gov

    This is a statement from the White House that says it best:

    1. No funds provided directly from SAMHSA or the relevant State or local government to organizations participating in applicable programs may be expended for inherently religious activities, such as worship, religious instruction, or proselytization (42 USC 300x – 65 and 42 USC 290kk; 42 CFR section 54.4)

    Page 283 of PDF File link to whitehouse.gov

    AA Groups can still come into Gov funded Rehabs but time and space also has to made available for nonreligious self-help groups.

    I hope this helps cancels the unhealthy favoritism that Substance Abuse Workers who are AA members give to AA.

    • challenger1

      I think youre out to lunch the 12 steps do not have to include religion. It says higher power.

      • http://shryve.webs.com/ William

        It does not matter what you or I think, the fact is that every time the issue reaches the courts the verdict is that AA and the 12 Steps are religious in nature and some provider or state agency has to pay out large damage payments.

  • nacron

    It says in the big book of alchoholics anonymous, and I’m paraphrasing, that we ‘don’t hold a monopoly on sobriety’. Also it says that science may one day acomplish what we have So far failed to do. So in conclusion, my two cents is that all these alternatives are wonderful. What marvelous times we live in were people are so devoted to helping others achieve a better life, free of drugs and alcohol. I’m not christian, or even christian based, and I’ve often felt that it must be really hard on atheist people who kind of get show horned into AA. It’s not about being all knowing, all encompinsg and right. It’s about being a functioning ‘recovered’ (yes we do recover) individual. My hat is off to all these great people helping each other.

  • Sunni

    Thank you for sharing this article and insights to other self help groups that offer alternative solutions to addiction – hoping and believing for a better world. Peace & Love

  • CJ Plourde

    Wise words. As a Tibetan practitioner and monk, I’ve never believed in a god concept. As such, I remember an older woman chasing me in an AA meeting when I first sobered up. She grabbed her cross around her neck and said, “So, have you found God yet?” Her belief was that unless I surrendered myself to her understanding of a H.P. I would never stay sober. Well, I’ve been sober for more than 30 years and I never surrendered my life over to the care of an H.P.

    The idea you mentioned, that mono-theism is relatively new, is so true. In fact, December 25th was a day that actually celebrated the birthday of an Egyptian deity, Maimonides, if I am spelling that/remembering that correctly. I doubt many Christians are even aware of that.

    The things that kept me sober was compassionate help for myself and for others. More so the latter than the former. As a Buddhist, that worked well for me. You don’t have to believe in a god to be sober, you just have to want to be sober.