Since their start in 1939, 12-step programs have become one of the most utilised recovery methods from substance use and addiction. One of the best well-known, Alcoholics Anonymous (AA), has had more than 3 million members since 2017.
For some people, however, these programs may not always be the right approach. Understanding why 12-step programs don’t work for everyone – and what alternatives might work better for you or your loved one – can help you make an informed decision about how to move forward with recovery.
Why 12 step programs don’t always work
The structured simplicity of 12-step programs can come as a great comfort to those struggling with the ups and downs of addiction recovery. By following each of these steps one by one, you will recover. Or so that’s what these types of programs seem to promise. While this is one of the many benefits people find from them, many also say that it can feel like the problem lies with them. Rather than with the program itself. This can feel as if it’s their fault for not following instructions and guidelines appropriately.
If you or a loved one has devoted time and effort to a 12-step program only to fall back into addictive patterns and habits, it isn’t an indication of a personal fault. Instead, it is a sign that something more is needed in terms of treatment to support the recovery process. Any of the following may be a factor contributing to a lack of progress:
The spiritual aspect of AA, amongst other 12-step programs, can be a significant barrier for many seeking treatment. After all, the founders were Christians. The fifth step of AA explicitly prescribes confiding in a higher power, in many cases, God. For others who don’t belong to Christian faiths or don’t identify with a religion, it may be unsettling to attend 12-step meetings. Even though the doors may be open to people of all beliefs.
Many people struggling with addiction may not drive themselves to meetings, meaning they will rely on others or public transportation. This can become difficult if the nearest AA or 12 step group is an hour away. Or meets at a time that does not work with your schedule (or that of the person giving you a lift).
12-step programs have one focus: addiction. They are not a suitable method for addressing any underlying issues. These issues may be driving or exacerbating your addiction, such as trauma, co-occurring mental health disorders, or chronic physical illnesses.
Lack Of Structure
Even if none of the above apply, the reason a 12-step program may not work for you or a loved one may be that a higher level of structure, and more intensive treatment, may be necessary. While 12-step programs can provide some structure to your life, you may spend only about an hour a week in the meetings themselves. And they typically provide little to no framework for what to do with the rest of your time. For some, inpatient or residential treatment can provide a much-needed sense of structure and clarity. And aftercare programs can help create that structure in everyday life following treatment as well.
It can be tempting to give up after an initial attempt at rehab hasn’t worked. But just because a 12-step program hasn’t helped you or your loved one doesn’t make it a hopeless case. There are many other options for treatment—any of which may provide the way forward that you’ve been searching for.
Other Addiction Treatment Alternatives
There are numerous support groups and alternative options to a 12 step recovery program to help you or a loved one overcome addiction. Each program has value, and the best outcome happens when someone selects a program that best suits their needs. In some cases, people may find a combination of programs more helpful, such as dual diagnosis.
These therapies may be used singularly or in conjunction with one another as part of a larger treatment plan in one of the following types of care:
This is often a solid first step in establishing long-term recovery. Inpatient treatment includes an extended stay of days or, in some cases, weeks, in a hospital or rehab facility, where round-the-clock care is available, as well as multiple therapeutic approaches. This type of treatment provides the highest support and structure. Offering a safe, drug-free environment to make stabilisation easier and the recovery process smoother.
Partial Hospitalisation Programs (PHPs)
These are often less intensive than inpatient or residential programs. PHP can still include living in the facility or nearby housing and participating in therapy daily; however, there may be fewer sessions scheduled, and there may be more time to yourself on evenings and weekends.
This may be offered as a standalone approach or as part of an aftercare program following inpatient treatment. Outpatient typically offers many therapeutic modalities as inpatient does, but patients don’t stay on the premises. They’re asked to attend regularly scheduled therapy appointments and sessions while creating positive and healthy habits and relationships in their lives outside of treatment.
This type of care typically is less structured than inpatient or PHP and emphasizes fostering independence to build a sustainable lifestyle that supports recovery.
Unlike 12-step programs, all of the above programs typically include therapeutic approaches that address both addictions and other mental health conditions.
Working with licensed psychiatrists, counselors, and social workers offers the additional benefit of medications for these issues that can be prescribed to enhance the recovery process with careful monitoring and guidance from medical professionals.
Finding An Addiction Treatment That Works For You
When it comes to deciding what type of treatment is best, keep in mind that the most effective programs will likely include multiple therapeutic approaches as well as flexibility in your treatment plan that can adapt to you or your loved one’s unique recovery needs. There isn’t a one size fits all approach to addiction (one reason why the rigid structure of 12-step programs does not work for everyone), but rather, the most effective type of treatment plan is one that’s designed to treat addiction and substance use on an individual, personalised scale.
If 12-step programs haven’t worked for you, don’t give up on recovery just yet—there are alternatives available that may better suit your needs and your life. And if you’d still like your 12-step program to be a part of your recovery journey, you may need to combine it with another approach to create a system that will work better for you than relying on a 12-step program alone.
SMART Recovery SMART (Self Management and Recovery Training) is the leading self-empowering addiction support group. Unlike AA and other 12 step programs, SMART participants can learn tools and strategies for recovery based on evidence-based practices and research.
SMART provides a 4-Point Program:
Building and Maintaining Motivation
Coping with Urges
Managing Thoughts, Feelings, and Behaviors
Living a Balanced Life
In comparing a sponsor and a recovery coach, a sponsor is someone who:
Is a non-paid peer advocate who is associated with a particular 12-Step organization. They act as a mentor or guide and have been through the steps themselves. A sponsor sees their service work as a way of giving back for the life they’ve gained from the 12 step program.
A recovery coach is someone who:
Is like a life coach who specialises in guiding you throughout your recovery process. They’re a professional who is employed by you and can be there 24/7. Unlike a 12-Step Sponsor, a Recovery Coach’s services are paid for. They can help you make a plan to achieve your short-term and long-term recovery goals. They’ll support you and hold you accountable for completing each goal.
Attending & Participating In DBT Therapy Alongside A 12 Step Program
Developed by Dr. Marsha M. Linehan, DBT is a comprehensive treatment program with an ultimate goal to aid patients in building a life worth living. DBT has become one of the most popular and well-established treatment options for those struggling with dual diagnosis, substance abuse because many patients have substance use disorders. DBT for substance abuse incorporates concepts and modalities designed to promote abstinence and reduce the length and adverse impact of relapses.
In fact, from our own experience we have found that many of our clients hugely benefit from attending DBT Therapy alongside their 12 step program. The skills, concepts and ways of thinking taught in DBT provide a practical and actionable method that can supplement living their recovery using the principles of a 12 step program.
The Bottom Line
Addiction can create immense health, legal as well as personal obstacles for those afflicted. The good news is that there are many roads and treatment options to recovery, and everyone deserves to discover what works best for them.
If you or a loved on is suffering from the affliction of addiction, our professional therapists are here to help. We’re available for free phone consultations where you can discuss your concerns in confidence. It will also be an opportunity to learn how our addiction specialists can help you or your loved one move forward into recovery from addiction.
Lorna has worked extensively in a therapeutic setting for the last 18 years and throughout this time worked with many conditions and client groups including Depression, Anxiety, Personality Disorders, Autism & PDA, Eating disorders, Complex Addiction, PTSD, and Emotional and Social disorders in Young Children and Adolescents.