Based on the principles of Alcoholics Anonymous (AA) developed in the 1930s, the 12-step approach to recovery has since become a classic model for 12-step support groups and has been integrated into many addiction treatment programs.
Since its inception, AA has upheld its mission of providing free, confidential help to alcoholics and those struggling with other addictions who have a desire to stop drinking or using. Attendance at 12-step meetings is often required as part of a court-ordered drug or alcohol rehabilitation program.
But what if you’re opposed to the principles of 12-step recovery or you’re turned off by its spiritual focus?
Twelve-step recovery is not the only option for people who’ve made a commitment to stop using drugs or drinking. Although 12-step programs welcome atheists and agnostics – as well as people who identify with a religious faith – the 12-step approach simply doesn’t work for every individual. Non-12-step alternatives are indeed available for alcoholics and those struggling with other addictions who prefer a secular approach to rehabilitation.
What Is Non-12-Step Rehab?
Like 12-step rehabilitation programs, non-12-step rehab promotes abstinence from drugs and alcohol. However, many secular programs place less emphasis on relying on a higher power than 12-step programs. There also tends to be a stronger sense of self-empowerment in non-12-step programs, as many of these programs avoid labelling addiction as a “disease.”
Some treatment components of non-12-step rehab may include:
- Medically supervised detoxification from drugs or alcohol—both on an inpatient and outpatient basis.
- Medication therapy to minimize withdrawal symptoms and curb cravings.
- Dual diagnosis or additional treatment for any coexisting medical or psychological conditions you may have.
- Individual counseling with an emphasis on cognitive-behavioral therapy (CBT), rational emotive behavioral therapy (REBT), and other evidence-based therapeutic strategies.
- Family counseling or couples counseling for spouses or partners.
- Participation in non-12-step support groups like SMART Recovery, SOS (Save Our Selves), Women for Sobriety, or LifeRing Secular Recovery.
Why Choose Non-12-step Rehab?
For many people who have a problem with drugs or alcohol, rehabilitation based on the 12 steps may not be the right solution. A non-12-step program may be better for you if:2
- You object to the spiritual orientation of AA and prefer an approach to recovery that’s completely secular.
- You object to the idea that addiction is a disease that’s beyond your control.
Whatever your reasons for preferring another treatment model, you should have more than one option to choose from when it comes to planning your recovery.
Secular Rehabilitation Strategies
Programs like SMART Recovery and SOS empower their members by teaching them how to create healthy, sober lives. This approach to recovery is based on the premises of cognitive behavioral therapy, or CBT. CBT aims to modify the behaviors and thought patterns that cause alcoholics and those struggling with addiction to continue pursuing their drugs of choice, even in the face of destructive consequences.
Instead of encouraging members to surrender their will to a higher power, these secular programs give their members coping strategies that will help them overcome their addictive behavior and avoid relapses.
Overcoming Addiction Outside of the Disease Model: Cognitive Behavioral Therapy
Not all mental health professionals accept the idea that chemical dependence is an uncontrollable disease. CBT approaches alcoholism and drug addiction as learned behaviors that can be replaced with new strategies to achieve sobriety.
In a project funded by the Illinois Department of Human Services, Dr. Ronald Kadden identified the key elements of CBT treatment for addiction:3
- Coping skills training. Those struggling with addiction are taught new behaviors to help them handle high-risk triggers, such as stress or anger.
- Managing cravings. Clients are taught to challenge their cravings for drugs or alcohol with strategies like remembering bad experiences, reminding themselves of the benefits of sobriety or postponing the decision to drink.
- Managing emotional responses. Anger and other powerful emotions are common triggers for drinking or using drugs. In CBT, clients learn how to cope with these intense feelings without turning to these substances.
- Changing negative thought patterns. Those struggling with addiction often experience repetitive, negative thoughts that motivate them to keep using. In therapy, they learn how to substitute negative self-talk with positive messages.
Other elements of CBT also include:3
- Teaching individuals the techniques of distraction and relaxation.
- Encouraging individuals to engage in pleasant sober activities.
- Strengthening interpersonal relationships.
- Preventing future relapses.
Why Others Still Choose 12-Step Treatment
For thousands of alcoholics and those struggling from other addictions, however, 12-step programs have proven to be a lifeline to recovery. The 12 steps of AA provide a progressive framework for recovery, starting with the admission that you can’t control your substance abuse, and ending with your commitment to becoming a sponsor and sharing your experience, strength, and hope with other alcoholics or those struggling with addiction.
Scientific American reports that approximately 2 million people participate in AA throughout the world, taking part in over 100,000 12-step support groups.4
How did the 12-step approach come to dominate the world of drug and alcohol rehab? Among other reasons, many are drawn to 12-step programs for their emphasis on helping others and on depending on a higher power to recover.
Focus on Helping Others
According to the journal Addiction, the focus on helping others is one of the keys to the success of AA.5 As part of a member’s recovery, he or she is encouraged to assist other alcoholics or addicts who are seeking help. Participation in AA events and community service are also strongly encouraged in order to shift the individual’s focus to others and promote a sense of self-worth.
Spiritual Dependence for Recovery
AA and other 12-step programs perceive alcoholism and addiction as spiritual as well as physical diseases. The 12 steps require that the member admit that he or she is powerless over the addictive substance or activity, and that hope for recovery lies in turning to a higher power for help. For many members, the spiritual emphasis of AA is the key to sobriety and abstinence.
Other advantages of 12-step treatment include:
- The opportunity to seek support and learn coping skills from others struggling with addictions in group meetings at no cost.
- The opportunity to benefit from personalized teaching and motivation from a seasoned member or sponsor.
- The availability of face-to-face meetings throughout the United States and throughout the world.
- The opportunity to grow in recovery by serving as a positive example to other alcoholics or individuals struggling with other addictions.
- Alcoholics Anonymous. (n.d.). What Is A.A.?
- Alcoholics Anonymous (2018). Frequently Asked Questions About A.A.
- Kadden RM. (n.d.). Cognitive Behavior Therapy for Substance Dependence: Coping Skills Training. University of Connecticut School of Medicine.
- Lilienfield SO, Arkowitz H. (2011). Does Alcoholics Anonymous Work? Scientific American.
- Zemore, S.E., Kaskutas, L.A., Ammon, L.N. (2004). In 12-step groups, helping helps the helper. Addiction, 99(8),1015-23.