12-Step, or the set of guiding principles for self-help groups and addiction recovery first outlined by Alcoholics Anonymous in 1939, is the most popular and common addiction treatment guideline in the world. Today, as many as 75%-95% of all inpatient treatment centers (rehab) in the United States offer some form of 12 step as a primary or secondary (and possibly optional) treatment solution. 12 Step is so ingrained in American culture that it’s seen as the de facto standard, utilized by even state-standardized and funded programs.
At the same time, 12 Step uses a set of principles which are rapidly being left behind by millennials and younger generations. With an increasing rise in secularization (21% of the American population has no religious affiliation) as well as increasing numbers of Muslim, Buddhist, and other religions, the intensely Christian-based principles of 12-Step often clash with the beliefs and ideals of those going into recovery.
If you’ve either gone into treatment and are considering a 12-step program or have attended 12-Step meetings and are unsure whether it works for you or not, there are options. What do you do if 12 Step doesn’t work for you?
Does 12 Step Actually Work?
12 Step, whether Alcoholics Anonymous (AA) or any of its numerous spin-offs has been reviewed, criticized, and analyzed almost since its conception in the 1930s. Today, it’s the most popular treatment option in the United States, but is it effective? Data shows that AA has anywhere from a tiny 10% to a high 75% success rate depending on the demographic, study, and treatment group.
However, studies going into why AA is or is not effective typically highlight specific factors contributing to its success. These primarily include:
Social Accountability – Individuals are forced to be socially accountable, sharing their progress or lack of it with a group. This creates a sense of moral responsibility, pushing many into resisting substance use when they would otherwise have used. Here, social accountability is akin to peer pressure in that individuals feel like outsiders or as though they are not respected or part of their group when they do use.
Group Support – AA and other 12-Step programs create a strong focus on group support, where individuals are able to share experiences with others who have gone through similar things and hear stories from people they relate to. Being able to relate to and share problems with others, especially in a nonjudgmental situation, helps many people to cope with those problems more readily, which can work to prevent a relapse.
Individual Support – Most 12-Step groups create a sponsorship program, where individuals are paired with more experienced persons who have gone through recovery in the past. They can then mentor and coach the person newly in recovery to help them navigate cravings, triggers, and difficult situations. Simply having someone to talk to in a setting of being able to ask for help and receive it with social accountability can be a powerful factor in staying clean or sober.
Each of these factors contributes to the success of 12-Step and are often more important than the actual process of the 12 Steps or any material used in the program. However, this is important for two reasons, because literature analysis and review suggests that the primary reasons 12-Step groups are effective at all is social support and accountability. This means that as someone in recovery, you could benefit just as much from any group or social-based recovery model but could also benefit from AA.
What to Do if 12 Step Doesn’t Work for You?
With millions of Americans seeking out drug and alcohol addiction treatment, it makes sense that the same therapy options don’t and cannot work for all of them. If 12 Step doesn’t work for you, there are plenty of options and you can review them and choose based on your situation and what you’ve tried in the past.
Keep Trying – Most people go into a 12-Step group with the idea that it won’t work for them and many don’t give themselves the opportunity to adapt to 12 Step. For example, as many as 81% of patients never make it past the third group meeting, which isn’t enough time to become accustomed to the treatment option. If this is you, most recommend that you continue to attend meetings to determine if it will work for you later. While not the only option for treatment, 12 Step is the most readily available and therefore a very good solution if you can make it work for you. Most people struggle with the social model of discussing problems and issues, may be uncomfortable with concepts of higher power and powerlessness, and may not like feeling accountable to what are essentially strangers. However, each of these factors only requires that you adjust to it and work with your sponsor to translate it into something that works for you. For example, while 12 Step is inherently Christian-based, many chapters will allow individuals to interpret their higher power into anything they want, including their own sense of smallness in the universe.
Try Another Group Therapy Option – While 12-Step is the most common group-therapy option, it’s not your only solution. Other group therapy options including Self-Management and Recovery Training (SMART Recovery), Secular Organizations for Sobriety (S.O.S.), LifeRing Secular Recovery, Moderation Management, Women for Sobriety, and many others. Unfortunately, without the very wide adoption seen by 12-Step, you won’t be able to find every option in every area, but there are many options available, especially in larger cities.
See a Private Therapist – Most rehabilitation clinics will offer you recommendations or referrals to private or group therapy outside of their own treatment options. Here, you can likely seek out group or private therapy, which will offer many of the same benefits as a traditional group or self-help group therapy solution.
While 12-Step doesn’t work for everyone, the important part of seeking out treatment is that you do so. 12-Step programs are most effective because of their social model of support and less because of their focus on reaching out to a higher power, which means that you can look elsewhere for social and group support or you can take part in a 12-Step program without focusing on the aspects that don’t work for you. At the same time, 12-Step programs are the most commonly available and may be the only option in your area, if you need support and help in recovery and only have 12 Step available, it may be a good idea to discuss your options with your counselor or therapist or discuss options with the group to determine a solution that would allow 12 Step to work for you.
Most rehabilitation and treatment programs will offer both 12-Step and non-12-Step options, so you will have a choice when seeking out traditional recovery programs. With evidence-based treatment including behavioral therapy and training, as well as support for co-occurring disorders and trauma, modern recovery centers take a much more varied and inclusive approach to recovery than in the past. You can easily discuss your options and your preferences with your counselor before going into treatment to ensure that your recovery program meets your specific needs and preferences. Once you leave, your treatment center can likely help you find a support group or even sober home that continues to support those preferences.
If you or a loved one is looking for a support group or would like to know more about the 12-step program, please contact Beginnings Treatment Centers today and speak with one of our experienced and professional intake advisors, we’re here to help you.