Unlocking Therapeutic Success: The Integration of 12-Step-Concepts in My Practice

Alcoholics Anonymous has been a beacon of hope for millions, providing a path to break free from the grip of addiction. Those of us on the journey of recovery can attest to the efficacy of AA. Over time, its effectiveness has gained recognition and respect from hospitals, community agencies, rehabilitation centres, and even the judicial system.

My experience has taught me that the 12-Step principles are not just beneficial for substance abuse counselling, but also in the broader field of mental health. The essence of the 12-Steps is self-improvement, which aligns perfectly with the goal of therapy – to help individuals become better versions of themselves.

The synergy between 12-Step programs and therapy

The 12-Step concept, first introduced by Alcoholics Anonymous in 1935, was later adopted by Narcotics Anonymous in 1953 to address the use of all addictive substances, particularly heroin and other opiates. Since then, a variety of 12-Step programs have been developed, including:

• Co-Dependents Anonymous (CODA)
• Cocaine Anonymous
• Emotions Anonymous
• Gamblers Anonymous
• Heroin Anonymous
• Marijuana Anonymous
• Overeaters Anonymous
• Sex Addicts Anonymous

While many of these groups focus on specific substance addictions, several others do not. For instance, CODA aims to foster healthy and loving relationships, while Gamblers and Overeaters Anonymous address process addictions.

Over the years, the application of the 12-Step methodology has extended beyond addiction treatment.

The reason 12-Step principles are effective for other issues is that substance use and addiction, regardless of its form, often indicate deeper mental health issues. The process of working through the steps can help uncover and address these underlying problems.

Many contemporary counselling approaches employ cognitive-behavioural theory, which posits that our thoughts influence our feelings, which in turn impact our behaviours. To facilitate enduring change, therapists assist clients in identifying, challenging, and overcoming detrimental thought patterns.

These thought patterns are referred to as “cognitive distortions” by clinicians and “stinking thinking” by the 12-Step community. They are essentially the same thing. Consequently, the objectives of 12-Step programs align with those of psychotherapy.

12-Step programs offer a level of involvement that surpasses what an individual therapist can provide, primarily due to the significant amount of time a person spends in them compared to one-on-one therapy sessions. This doesn’t imply that one can replace the other, but rather that they complement each other and can be used in conjunction to treat both substance use disorders and mental illnesses.

Utilising 12-Step principles in mental health treatment

I invite my clients to adopt the “spiritual principles” that are considered by the 12-Step community to be the foundation for sustained recovery.

Spiritual principles are universal values that aid us in becoming better individuals. Each step is underpinned by several spiritual principles. Some of these include:

• Acceptance
• Awareness
• Fairness
• Faith
• Forgiveness
• Honesty
• Humility
• Love
• Open-mindedness
• Personal responsibility
• Service
• Tolerance
• Trust
• Willingness

Many individuals struggling with drug and alcohol addiction resort to unhealthy coping mechanisms, such as dishonesty and intolerance. During recovery, these harmful traits need to be unlearned and replaced with positive ones. For instance, dishonesty is replaced with honesty, denial with acceptance, and so on. This exploration of spiritual principles is the starting point for improvement.

When embarking on Step One, the spiritual principles of self-awareness, personal responsibility, acceptance, honesty, open-mindedness, and willingness are examined. As individuals progress through the steps, they encounter and delve into different spiritual principles. For instance, Step 5 is centered around the principle of trust, while Step 12 focuses on the principle of service.

These principles are not only beneficial for addressing addiction issues, but can also assist individuals on their journey to recovery from mental illness. With minor adjustments, we can tailor all the steps to meet our therapeutic needs.

An illustration

Let’s examine Step One:

“We admitted that we were powerless over X, that our lives had become unmanageable.”

In the context of AA, “X” represents “alcohol.” However, in therapy, it could be modified to represent something like clinical depression.

The first element of Step One is “powerlessness,” which pertains solely to the unsuccessful attempts to manage our condition without assistance. For alcoholics, this is often referred to as “hitting rock-bottom.” For someone with clinical depression, this sense of powerlessness is frequently what prompts them to seek help.

The second element involves assessing the impact of the problem on one’s life. It pertains to the repercussions we experience from our unsuccessful struggle with “X.” In recovery from substance use, we critically examine the havoc wreaked on our lives to understand and accept the extent of the problem. Similarly, when a person begins therapy, they must delve deep to articulate the symptoms they’re experiencing to receive an accurate diagnosis.

The subsequent element is assuming responsibility for the problem. As stated in the Basic Text of Narcotics Anonymous, “we aren’t responsible for our addiction, but we are responsible for our recovery.” This holds true for mental illness as well.

To clarify, responsibility is not about attributing blame or inducing guilt about symptoms. While no one chooses to have substance use disorders, clinical depression, social anxiety, or trauma, successful treatment for these conditions hinges on the individual taking ownership of their illness. Every clinician is familiar with the challenge of treating someone who refuses to do so, as well as the sense of victory when a person commits to recovery.

In recovery, comprehending Step One is crucial. It provides a sturdy foundation to build upon. If growth can be achieved from working Step One, imagine the potential growth from working all 12 steps.

While no one ever fully masters any of the spiritual principles, the aim is to strive to be a better version of ourselves than when we first embarked on the journey. The Steps offer a roadmap and direction, but it’s the spiritual principles that infuse the journey with a soul.