Choice In Addiction Recovery Approaches; Powerless Vs. Self-Empowering

cut from same cloth

Alcoholics Anonymous (AA) and other 12-step groups are the leading U.S. approach to addiction recovery. Millions have attended these meetings and “worked the steps.” Popular media include countless references to AA-oriented recovery. Many scientific studies show that attending these meetings is associated with recovery.

However, many individuals will not attend these meetings, or will not attend them long enough to solidify change. Their reasons include not wanting to accept the labels “addict” or “alcoholic,” not wanting to attend groups of any kind, not wanting to consider oneself powerless, not thinking of oneself as having a disease, or not wanting an approach that encourages lifelong attendance.

Perhaps we should encourage these individuals to set aside their objections and attend AA anyway? When such strong encouragement is given it probably works in some cases. However, the reality is that only a small percentage of those who have addiction problems attend AA. We need to have additional approaches.

Actually, other approaches already exist, but they are not well-known. There is a range of mutual aid groups in addition to 12-step groups, as well as a range of treatments in addition to 12-step-based treatment. The non-12-step mutual aid groups include SMART Recovery, Moderation Management, Women for Sobriety, LifeRing Secular Recovery and Secular Organizations for Sobriety. Each group has an active presence on the Internet. Through their websites, one can also find information about non-12-step based treatments.

Why do we need choices? Because we are not all cut from the same cloth!cut from same cloth

These non-12-step groups can be more positively defined as self-empowering groups. Self-empowering groups encourage individuals to take charge of their lives and leave addiction (and eventually recovery) behind. In contrast to the 12-step approach, self-empowering groups support individuals in taking charge of their lives rather than accepting powerlessness and turning their lives over to a higher power.

The Serenity Prayer, often used at AA meetings, provides a framework for understanding a fundamental difference between powerlessness and self-empowering recovery:

“God, grant me the serenity to accept the things I cannot change,
Courage to change the things I can,
And wisdom to know the difference.”

The 12-step approach is a serenity approach to recovery. The self-empowering approach is a courage approach. As the Serenity Prayer suggests, we all need both serenity and courage. However, most of us prefer one approach to the other. To use the language of scientific psychology, some of us tend toward external locus of control (serenity) and others tend toward internal locus of control (courage). Locus of control refers to our expectation about what in the future will shape our lives more (e.g., what controls us, or who is in charge): What happens to us, or what we do about it.

Self-empowering approaches to addiction recovery are well-suited for individuals who have an internal locus of control. Rather than thinking they have lost control of their lives because they have a disease, these individuals want to learn how to build motivation, control craving, resolve their underlying problems, and move on with creating meaningful and purposeful lives.

Two addiction treatment facilities I am aware of offered both the powerlessness and self-empowering approach. Clients were allowed to choose the approach they preferred. The choice was about 50/50 in each facility (one outpatient, one residential).

SMART Recovery is the best-known and most widely available of the self-empowering recovery groups. With fewer than 1,000 meetings, it is about 100 times smaller than AA. The SMART Recovery website and its activities and community could be a substitute for face-to-face meetings for many individuals and locations. Many SMART Recovery participants include 12-step meetings in their recovery plans, either to have a sufficient face-to-face component, or because they find aspects of both programs helpful.

Consistent with the overarching self-empowering perspective, SMART Recovery:

Teaches tools for recovery based on evidence-based addiction treatment

Does not use the labels “addict” or “alcoholic”

Encourages participation only for as long as it is perceived to be useful,

Allows for truly anonymous participation via a screen name on the website

Allows participants their own perspective on whether addiction is a disease

Teaches tools for recovery that are useful regardless of what the participant believes (or not) about God

Accepts the validity of appropriately prescribed addiction and psychiatric medication.

In addition to providing free, science-based, self-empowering addiction recovery mutual aid groups, SMART Recovery advocates for choice in recovery. All individuals seeking recovery support or treatment should be informed of the full range of options available, and be free to choose among them.


October 13, 2015

Comments

4 responses to “Choice In Addiction Recovery Approaches; Powerless Vs. Self-Empowering”

  1. Everything listed in the non-12 step groups is in fact covered by the 12 step groups. Lack of education and understanding of 12 step programs seem to be what’s missing here. 12 step programs advocate choice immensely, courage to face their addiction head on, and ultimately find freedom from addiction and it’s accompanied symptoms. Freedom to choose whatever higher power you want is fiercely defended and encouraged, and even spiritual principles (which who could argue ever hurt anyone? I.e. compassion, love, honesty, fogiveness) can be a form of a higher power. 12 step programs are def empowering, which a completely realistic view that most (NOT ALL) people that used alcohol and drugs for any length of time, is in fact sick, at the very least left with a disorder, that scientists have in fact proven happens as a result of drug use. The negative affects of using substances for an extended period of time is well documented. Just to clarify some of the contradiction inn this article. Lastly, I totally agree that there are in fact many different ways to approach this deadly disease, and I personally support whatever works. There are aspects of 12 step programs that are priceless, and the information is vital to recovery, but I’m sure the same is said about these other programs. Just don’t be confused, powerlessness leads to power, acceptance of being am addict or alcoholic leads to freedom, and working the steps beings about change and miracles you will never understand unless you have done them. You must study the information of 12 step programs before you try to understand what it’s saying or doing. Misinformation does in fact kill the sick and suffering. Godbless and keep the options open for everyone, everyone deserves a chance to escape the horrors of addiction.

  2. Interesting artical. I suppose culture, religion and regional availability of group based interventions for compulsive repetitive behaviours. Those that follow the Minnesdota Model (12-step), which fits a disease model, with free (although can donate) world wide availability. Not suitable for all people, but has strong fellowship and enables gruaduates from residential MM treatment programmes to find familiar after-care support never too far away. For me in the United Kingdom, I’m more familiar with the resdidential non-MM Therapeutic Communites operating within correctional and commity based programmes, together with ad-hoc Peer Support Groups and aware of a range of group formats used within local community based Drug and Alcohol Services following a Recovery Model. Some of these programs enable access to alternative therapies e.g. accupuncture, yoga, mindfulness, relaxation, meditation, life skills etc; all of which appears to assist overall treatment efficacy. Dialectical Behavioursl Therapy has extended their treatment focus into substance use, and is accepted by some as providing evidenced based methodolog; although based significantly within a behavioural psyvhology framework. Yes alternatives to the MM do exist, but any individual need to find the most appropriate intervention for themselves; although realistically, funding and availability may be the deciding factors in the end.

  3. Emory Young says:

    The 12 Steps of Narcotics Anonymous does not endorse powerlessness. The most important words in Step 1 are past tense ( we’re and had). We admitted we were powerless and our lives had become unmanageable. There is a paradoxacle phenomenon that occurs when embracing this step. When we embrace this step we are no longer powerless and our lives are no longer unmanageable. As we continue to live the following eleven steps our lives improve and we flourish in society. Powerlessness therefore becomes part of the past

  4. Dave Ockey says:

    Thank you Mr. Bennet, I could not have said it better. I worked with this population for over 40 years. People would get hung up on you have to believe in God in the twelve steps. To them I talked about the man who used a door nob as his higher power and 10 years later he is still sober. To me the major key is believing in your self that you can overcome your addiction. If you don’t believe in your self, it is almost impossible to suceed.

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