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’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 (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
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