Self-help Meetings and Clinical Analysis - Research Paper Example

Self-help Meetings and Clinical Analysis Introduction Self-help meetings are one of the primary and effective forms of therapy for recovering substance abusers. These self-help meetings are often carried out in groups of individuals who have and are going through similar processes of substance abuse recovery. The main concept behind this form of therapy is the establishment of group support via shared experiences. Alcoholics Anonymous, which is the primary program initiated for recovering alcoholics, recommends a 12-step recovery process in order to guide alcoholics and other substance abusers in their recovery. This paper shall critically analyze the 12-steps of recovery adhered to in these self-help support groups. It will discuss the role that self-help support groups play in abstinence and long-term recovery. An initial overview of the steps shall be provided in this discussion, followed by a critical assessment of the steps and the impact of these steps on long-term recovery. A discussion on the rational recovery program will also be provided in an attempt to study its potential alongside the 12-step program. This paper is being carried out in order to provide a thorough assessment of the impact of the 12-step program in the hope of providing clear guidelines for the stronger application and support of the program. Body 12-step program overview The 12-step program includes an initial admission of one’s weakness in relation to alcohol (Borman and Dixon, 1998). It also includes the process of submission to a greater power, one which can restore one’s sanity. Turning towards such greater power is an important step towards recovery (Anonymous, 2001). Admitting to God, to other human beings, and to themselves the exact nature of their activities is also another element of the recovery, and humbly asking for God’s help in making the recovery is part of the recovery process. Making a list of individuals one has harmed and making amends to these people is also part of the 12-step program (Johnson, 2004). Continuing to make a personal assessment of one’s wrongdoing is also significant and seeking prayer and meditation as a means of improving communion with God formulates step 11 of this process, and after going through all the steps, sending the message to other alcoholics completes the recovery process (Borman and Dixon, 1998). Critical analysis In assessing the 12-step program, it is immediately apparent that the program has religious overtones and an initial criticism for the program would relate to such religious themes, especially as far as non-religious or non-believers or even non-Christians are concerned (Sandoz, 1999). How would this work for non-Christians or Atheists? There seems to be a presumption that the clients would be Christians. Under these conditions, issues on contextualization are already apparent (Sandoz, 1999). Nevertheless, religious considerations aside, strong support has been allocated to the program, especially in terms of the self-help it can indeed provide for patients (Stephenson and Zygouris, 2007). Among academics and scientists, support for the 12-step program has not always been forthcoming, mostly because these scientists seek numbers and figures before they would support the program, or any program for that matter (Bufe, 1998). For the AA, their support and belief in the viability of the program is not based on statistics, but is based on testimonials. In recent years, various researchers however have since extended their support for the AA and its self-help program. Project MATCH served to be one of the more important studies which provided support for the AA (Project MATCH Research Group, 1998). A study on the AA program was carried out and sought to establish ways to match individuals with the type of treatment which would fit them best (Project MATCH Research Group, 1998). This study therefore evaluated the client’s personal qualities, especially those which could predict how individuals would act when designated to specific types of treatment. In the project, three types of treatment were compared – 12-step program, cognitive-behavioral therapy, and motivational enhancement therapy (Project MATCH Research Group, 1998). Project MATCH soon revealed that the 12-step program was the only program which specifically supported individuals to reach out to other recovering substance abusers. Assisting clients in the 12-step program has become one of the main goals of the program, and this is very much opposed to the learning and coping skills which therapists often carry out with their clients. Project MATCH covered 806 clients in five outpatient centers and randomly assigned them to the three treatments discussed (Project MATCH Research Group, 1998). The study revealed that about 30% of the clients under the 12 step program abstained from alcohol three years after their treatment; and even those who drank, abstained from drinking about two-thirds of the time (Project MATCH Research Group, 1998). There were limited differences in the three treatments which all in all implied that the 12-step program more than held its own in relation to other forms of therapy. In fact, the 12-step program was actually more statistically significant in meeting its desired outcomes (Project MATCH Research Group, 1998). The 12-step program also had a major plus in terms of the social support that it was able to provide for recovering alcoholics. In a study by Longabaugh, et.al., (1998) from the Center for Alcohol and Addiction Studies at Brown University, the authors discussed that a high degree of social influence for drinking often spurred moments drinking. In the 12-step program, as discussed by Longabaugh, et.al., (1998) better outcomes for clients have been seen in terms of abstinence. They further established that respondents who had a high degree of support for drinking who then took part in the 12-step program declared about 83% abstinent days, those who underwent Motivational Enhancement Therapy only achieved 66% abstinent days (Longabaugh, et.al., 1998). Moreover, those who underwent Motivational Enhancement Therapy were able to gain more abstinent days when they attended the 12-step facilitation program. All in all, the study concluded that for drinkers with a high degree of social support for drinking, the 12-step program could work well for them, and those who had low social support for drinking should still consider the program because the program would take into consideration the larger context of their alcoholic problem (Longabaugh, et.al., 1998). In a study by Fiorentine and Hillhouse (2000), the authors were also able to establish that about two-thirds of the client/respondents were under the AA program and most of them opted to support global lifestyle change, not simply to change certain aspects of their life. More clients also stayed longer in the program, and were more likely to complete the program (Fiorentine and Hillhouse, 2000). In other words, this study was able to provide more numerical details on the application and efficacy of the 12-step program. Issues with the implementation of the 12-step self help AA program however have been apparent among other practitioners. Based on overview by Bufe (1998), the success rate for the 12-step program is only at 5% and these cases actually represent individuals who choose to quit drugs or alcohol, spontaneously choosing to end their damaging habit. These individuals did not have to attend the AA meetings, and regardless of what they heard in the AA meetings, they have chosen to quit. In effect, Bufe (1998) argues that the 12-step program is largely ineffective, and more proof is needed in order to secure widespread support for this program. Analytical assessments of efficacy vary based on particular fields of reference in assessing practices. Experimental studies on AA have been founded on results from individuals attending meetings under the larger AA program, or from the 12-step program which is run outside the AA organization (Bufe, 1998). Studies on the program have not established definitive conclusions for its efficacy (or inefficiency). Regardless of these issues on efficacy, it is important to note that AA has been able to maintain 26% of their clients after 12 months from the initial attendance (Arthur, Tom, and Glen, 2008). Due to the above issues on the efficacy of the AA 12-step program, the rational recovery program has been suggested as an alternative for recovering alcoholics. This program is based on the presumption that addicts desire and are capable of reaching permanent abstinence (Trimpey, 1998). However, it also acknowledges the fact that the addict also wants to persist in his addiction. This is due to the person’s belief in the impact of the substance to assuage his anxiety, such anxiety being also induced by the alcohol or the drugs (Penn and Brooks, 2000). There is a huge element of ambivalence in this type of therapy. This program is based on the process of recognizing the addictive voice; it also supports dissociation from the addictive proclivities (Polcin, 2000). It applies the Addictive Voice Recognition Technique in order to illustrate to the client that he is in control of the addictive voice, not the other way around. As soon as an individual is able to recognize the feelings and the images which may support such addictive voice, the compulsions of a person would likely be quelled (Penn and Brooks, 2000). Addiction is often a lifetime battle and it is often easier to say yes than to say no to the addictive voice, however, separating the rational self from the addictive voice would help the addicts become more aware of the impact of their actions should they give into the addictive voice (Penn and Brooks, 2000). In comparing Rational Recovery and AA, both programs do support and promote abstinence, however their concepts are very much different (Trimpey, 1995). The Rational Recovery program focuses on the fact that there is no better time to stop drinking than now; for AA, their principle is on taking it one day at a time (Trimpey, 1995). Rational Recovery counters that it does not alcoholism as a disease, but it views it as a voluntary act; it also does not support the fact that a person is forever recovering from alcoholism or substance addiction (Trimpey, 1998). This type of program also does not support groups, however meetings have been held under this program in the 1990s. The importance of self-efficacy was highlighted by this program and in stark contrast to the 12-step AA program, there are no religious considerations and concepts underlying its processes (Trimpey, 1998). Conclusion The self-help 12-step program of the AA provides one of the most popular forms of therapy against alcoholism and substance abuse, not just in the US, but in the world. It is a program which has been able to emphasize on the importance of group support, and of making certain changes and actions in one’s life in order to provide closure and to resolve issues. In resolving these issues, the recovery from one’s addiction is often made possible. The efficacy of the program however is still very much in dispute with more proof in its efficacy being demanded by various practitioners. For which reason, other programs, including the Rational Recovery program has been forwarded. This program has provided an alternative focus for recovery among substance abusers. Both of these programs have different points of focus, and their efficacy will likely need more substantiation from other meta-analytical and clinical studies. For the moment however, the importance of implementing and making these programs available based on patient preference must be the primary consideration. One program after all, may not fit all, and having a program which can fit the needs of clients is an important factor in truly ensuring recovery from substance abuse. References Anonymous. (2001). The Big Book of Alcoholics Anonymous (4th Edition ed.). New York: AA World Press. Arthur S., Tom E., Glenn C. (2008). Alcoholic Anonymous recovery outcome rates. Retrieved from http://www.hindsfoot.org/recout01.pdf Borman, P. & Dixon, D. (1998). Spirituality and the 12 steps of substance abuse recovery. Journal of Psychology & Theology, 26 (3), 287–291. Bufe, C. (1998). Alcoholics Anonymous, cult or cure? New York: Routledge. Fiorentine, R. & Hillhouse, M.P. (2000). Drug treatment and 12-step program participation: The additive effects of integrated recovery activities. Journal of Substance Abuse Treatment, 18, 65-74. Johnson, J. L. (2004). Fundamentals of substance abuse practice. Belmont, California, USA: Brooks / Cole. Longabaugh, R., Wirtz, P.W., Zweben, A, & Stout, R.L. (1998). Network support for drinking, Alcoholics Anonymous and long-term matching effects. Addiction, 93, 9, 1313-1333. Penn, P. & Brooks, A. (2000). Five years, twelve steps, and REBT in the treatment of dual diagnosis. Journal of Rational-Emotive & Cognitive Behavior Therapy, 18 (4): 197–208. Polcin, D. (2000). Professional counseling versus specialized programs for alcohol and drug abuse treatment. Journal of Addictions & Offender Counseling, 21 (1): 2–11. Project MATCH Research Group. (1998). Matching alcoholism treatment to client heterogeneity: Project MATCH three-year drinking outcomes. Alcoholism: Clinical and Experimental Research, 22, 6: 1300-1311. Sandoz, C. J. (1999). The spiritual experience in recovery: A closer look. Journal of Ministry in Addiction & Recovery, 6 (2): 53–59. Stephenson, G. & Zygouris, N. (2007). Effects of self reflection on engagement in a 12-step addiction treatment programme: A linguistic analysis of diary entries. Addictive Behaviors, 32 (2): 416–424. Trimpey, J. (1995). The small book: a revolutionary alternative for overcoming drug and alcohol abuse. New York: Dell. Trimpey, J. (1998). Rational recovery is an effective self-help program. In: Barbour, S. (Ed.). Alcohol. San Diego: Greenhaven Press Read More