Addictions Chapter 12

Narcotics Anonymous

In 1953, a self-help group patterned after AA was founded, and called itself Narcotics Anonymous (NA). Although this group honors its debt to AA, the members of NA feel that "Alcoholism" is too limited a term for us; our problem is not a specific substance, it is a disease called "addiction." To the members of NA, it is not the specific chemical that is the problem, but the common disease of addiction.

treatment programs include both group and individual counseling

Lawson et al. (2001) found that often it is in a group that the client makes the most progress toward significant therapeutic movement and suggests that as social beings, we are influenced more by a group of people than by just one person for any number of contextual, environmental, or personal reasons.

he primary purpose of AA is twofold

Members strive to "carry the message to the addict who still suffers" and the organization seeks to provide for its members a program for living without chemicals

AA is not officially associated with

any particular religious denomination, political affiliation, or organization, and notes that it "does not discriminate against any prospective member" including those with addictions other than alcohol. It thus welcomes nonalcoholics to open meetings unless it is a closed meeting.

AA groups

even if they do not regularly incorporate these groups into their counseling practice, should at least be familiar with them

Discussion meetings

focus on a topic discussed by those addicts in attendance.

National Association for Children of Alcoholics (NACoA)

formed in February 1983 in California, after two groups of professionals from across the country met twice during 1982 to share their concerns, knowledge, and experiences regarding children of alcoholics. One group included clinicians concerned with the needs of adults whose mental health problems stemmed from a childhood in an alcoholic family. The other group included counselors and social workers who primarily worked with young children experiencing a broad range of problems in families with parental alcoholism.

Big Book meetings

a chapter from Alcoholics Anonymous is read and discussed.

Goals

12-step addictions groups have established goals for members to work toward, which help them in their main goal of achieving addiction recovery the following treatment goals that share similarities with other treatment modalities were identified: Abstinence from alcohol and other drugs; Steady employment; Stable social relationships; Positive physical and emotional health; Improved spiritual strength; and Adherence to legal mandates/requirements as applicable.

Alateen21

By 1957, in response to the recognition that teenagers presented special needs and concerns, Alateen was established after modifications to Al-Anon. These members follow the same 12 Steps outlined in the Al-Anon program, but the goal of the program is to provide teenagers the opportunity to share experiences, discuss current problems, learn how to cope more effectively, and offer encouragement to each other

Co-Dependents Anonymous

founded in 1986 in Phoenix, Arizona, and is a 12-step program that strives for healthy relationships, from the point of departure of codependence on someone with an addiction. CoDA adheres to 12 steps and traditions similar to those of AA. Each group is allowed to function autonomously to meet its own needs, as long as it has no other affiliation except CoDA and does not affect other groups of CoDA as a whole. There are approximately 1,200 CoDA groups in the United States, and it is active in more than 40 countries.

affiliation with 12-step groups

has been consistently linked to the achievement of abstinence among persons experiencing alcohol and other drug problems

helping component

helping component relies on the exchange of dialogue, reinforcing behavior, and encouraging messages of recovery through efforts modeled by the leader, which then filter throughout the group, often resulting in a successful outcome.

Closed meetings

involve addicted individuals only

Open Meetings

involve one recovering person speaking to the group about his/her addiction and recovery story. Nonaddicts are invited to attend and listen, and these meetings are generally helpful for those who want to learn more about addiction.

Level I Sponsorship

is concerned with sobriety; the sponsor helps the sponsee to become or to stay sober.

sponsorship

is on two levels

AA

is the "most frequently consulted source of help for drinking problems" (p. 3). In fact, approximately 1 in every 10 adults in the United States has attended an AA meeting at least once

characteristics among group members are associated with the greatest long-term group retention, often leading to successful recovery:

older age; more lifetime arrests; more psychiatric symptoms but not taking psychiatric medication; being more troubled by substance abuse than by mental health; having a greater level of self-efficacy for recovery; residing in supported housing; and being enrolled in outpatient treatment at follow-up. Sponsorship is good for abstinence

speaker meetings,

one addicted person speaks to the audience about his or her addiction and recovery story, and the meeting may be open or closed.

six noted types of 12-step meetings

open, closed, discussion, speaker, step, and Big Book meetings.

Advantages to 12 step groups

personal growth, support for change, interpersonal relationships, explore socializing skills and experience similar stories with others, social outlet

participation in 12-step groups during and after formal treatment has been associated with

positive outcomes among substance users; reduced substance use and improved outcomes among alcohol- and cocaine-dependent individuals. a higher intensity of involvement has been associated with better drinking outcomes. individuals who are heavier substance users and have more substance-related problems are more likely to affiliate with 12-step self-help groups and less likely to drop out after treatment than less impaired clients

Twelve-step groups

re sometimes referred to as "self-help groups" because not all self-help groups have exactly 12 steps

internet self-help groups

recently, Internet self-help groups have become popular

Some studies suggest that AA and similar groups help individuals recover through common process mechanisms associated with enhancing

self-efficacy, coping skills, and motivation; and by facilitating adaptive social network changes

Eight characteristics of a successful group

shared experience with inability to control addiction, Education is the primary goal of AA membership; Self-help groups are self-governing; The group places emphasis on accepting responsibility for one's behavior; There is but a single purpose to the group; Membership is voluntary; The individual member must make a commitment to personal change; and The group places emphasis on anonymity and confidentiality.

Alcoholics Anonymous for Atheists and Agnostics (Quad A)

tends to draw heavily from the traditional Alcoholics Anonymous (Rand, 1995), but with one important distinction: Quad A tends to downplay the emphasis on religion inherent in the traditional AA foundation. In fact, this organization tends to remove the power given to a higher force than the members themselves, instead stressing the forces in the individual's life that support recovery

All AA groups are guided by

the Twelve Steps and Twelve Traditions, which serve as a basis for many other groups as well.

Level II Sponsorship

the sponsor counsels the sponsee through the Twelve Steps so that recovery can be achieved

step meetings

the topic for discussion is one of the 12 steps, and these meetings are typically for addicted individuals only.

primary focus of self-help groups

to provide emotional and practical support and an exchange of information

Secular Organizations of Sobriety

was also founded in 1986; Dorsman (1996) estimates that approximately 1,200 SOS groups meet each week in the United States. SOS emerged as a reaction to the heavy emphasis on spirituality found in AA and NA (Doweiko, 1999; "Groups Offer Self-Help," 1991); the guiding philosophy of SOS stresses personal responsibility and the role of critical thinking in recovery

Moderation Management (MM)

was established in 1994 as a free-of-charge, nonprofit support group that welcomes those concerned about their drinking, regardless of level of consumption. The founder, Shirley Kishline, states that the goal of MM is to "provide a supportive environment in which people who have made the decision to reduce their drinking can come together and to help each other change" (Kishline, 1996, p. 55). MM is a controversial group because moderation is the goal, not abstinence

Women for Sobriety

was founded in 1975 ("Groups Offer Self-Help," 1991), and McCrady and Delaney (1995) estimate that approximately 325 WFS groups meet in the United States. Doweiko (1999) states that this organization is specifically designed for and comprised of women, and is founded on the theory that the AA program fails to address the very real differences between the meaning of alcoholism for men and women. For this group, however, there are 13 statements, not 12.

Rational Recovery (RR)

was founded in 1986 by Jack Trimpey, a California licensed clinical social worker, and is a source of counseling, guidance, and direct instruction on self-recovery from addiction to alcohol and other drugs through planned, permanent abstinence. This concept is designed as an alternative to AA and other 12-step programs ("Groups Offer Self-Help," 1991). The program closely follows the cognitive-behavioral school of counseling, and views alcoholism as reflecting negative, self-defeating thought patterns (Ouimette, Finney, & Moos, 1997). While RR and AA promote abstinence, the programs use different strategies

Alcoholics Anonymous

was founded on June 10, 1935, when Dr. Robert Holbrook Smith, an alcoholic physician, had his last drink (Doweiko, 1999). His cofounder, Bill Wilson, a failed Wall Street stockbroker, had previously been affiliated with the New York Oxford Group, a nondenominational group of Christians committed to overcoming a common drinking problem. The two men met coincidentally in Ohio while Wilson was seeking support to stay sober during a business trip (Miller, 2005). The plan for the group was devised by the two men, with a shared aim to spread the supportive message of sobriety to other alcoholics.`

The first edition of Alcoholics Anonymous

was published in 1939, detailing the well-known Steps and Traditions that now serve as the established guide to addictions recovery and maintenance among group members. The organization took its name from the title of the book, which has since come to be known as the "Big Book" of AA (Twelve Steps and Twelve Traditions, 1981).

Al-Anon

wives would often wait while their husbands were at the early AA meetings. While they waited, they would talk about their problems and struggles. At some point, they decided to try applying the same 12 Steps that their husbands had found so helpful to their own lives, and the group known as Al-Anon was born

its early years, AA

worked to find a method that would support its members in their struggle to both achieve and maintain sobriety. Within 3 years of its founding, three AA groups were in existence, yet "it was hard to find two score of sure recoveries. The then-new organization was unable to establish exactly how and why the message of the group worked for some members, but not for all.