Twelve-Step Groups Also called self-help groups Not all groups have 12 steps In-person and on internet Members gain knowledge, obtain and provide support Affiliation with 12-step groups is consistently linked with achievement of abstinence Counselors should be familiar with them Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved

History of 12-Step Groups Alcoholics Anonymous (1935) Most widely used 1 in 10 adults in the US has attended an AA meeting More than 2 million membership worldwide Alcoholics Anonymous first published in 1939 12 steps and 12 traditions Purpose is to achieve and maintain sobriety Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved

History of 12-Step Groups, (continued) Al-Anon Borrowed and modified AA’s twelve steps and twelve traditions Applicable to the needs of families Co-Dependents Anonymous (CoDA) Founded 1986 Strives for healthy relationships Autonomous groups in the US and 40 other countries Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved

History of 12-Step Groups, (continued) Narcotics Anonymous (1953) Patterned after AA All inclusive—the disease called “addiction” Any mood-changing, mind altering substances Alateen (1957) Modified Al-Anon for teenagers Goals: Share experiences Learn to cope effectively Encouragement each other Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved

Other Support Groups Rational Recovery (1986) Alternative to AA and other 12-step programs Cognitive-behavioral basis Does not regard alcoholism as a disease Negative, self-defeating thought patterns Discourages the ever “recovering” drunk persona NO RR groups Emphasis on self-efficacy No steps and no religious overtones Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved

More Self-Help Groups Secular Organizations of Sobriety (SOS) Founded 1986 Personal responsibility and critical thinking Women For Sobriety (WFS) – 1975 13 Statements, Not 12 AA for Atheists and Agnostics (Quad A) Downplays emphasis on religion Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved

More Self-Help Groups, (continued) Rational Recovery (RR) – 1986 Founded by social worker, Jack Trimpey Designed as an alternative to AA groups Is cognitive-behaviorally based Secular Organizations of Sobriety (SOS)-1986 1,200 groups meet each week Emerged as a reaction to the heavy emphasis on spirituality in AA and NA. Stresses personal responsibility Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved

More Self-Help Groups, (continued) Women for Sobriety (WFS) – 1975 Founded by women, for women Founded on the theory that AA programs fail women Alcoholics Anonymous for Atheists and Agnostics (Quad A)-1994 Downplays the role of religion Members have the power themselves Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved

More Self-Help Groups, (continued) Moderation Management (MM) – 1994 Goals chosen by the individual Controlled drinking programs National Association for Children of Alcoholics (NACoA) - 1983 Founded by professionals Support and information Confidential phone, website, correspondence Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved

More Self-Help Groups, (continued) Moderation Management (MM) – 1994 Goals chosen by the individual Controlled drinking programs National Association for Children of Alcoholics (NACoA) - 1983 Founded by professionals Support and information Confidential phone, website, correspondence Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved

The Group Process: How 12-Step Groups Work Alcoholics Anonymous The Twelve Steps and Twelve Traditions Open and closed meetings Discussion/Participation meetings Speaker meetings Step meetings “Big Book” meetings Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved

Group Dynamics as Applied to 12-Step Groups 8 successful group characteristics Members have shared experience Education is the primary goal of AA Self-help groups are self-governing Accepting responsibility Single purpose for the group Voluntary membership Commitment to personal change Anonymity and confidentiality Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved

The Role of Sponsors in Recovery Two levels of sponsorship Sponsor helps the sponsee to become or stay sober Counsels the sponsee through the 12 steps Guide and facilitator through recovery process Provide consistent guidance and support Supports sponsor’s own sobriety as well Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved

Do 12-Step Programs Really Work? Participation associated with positive outcomes Self-selection may account for high rate of success Very little research has been done Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved

Advantages of 12-Step Groups Predictability Consistency Universality Building social skills without chemicals Coping skills Accessibility Economical (free) Multiple locations Multiple days and times Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved

Disadvantages Inconsistent empirical support May become overly dependent May get bad advice from other members Risks of Boundary violations Structure may be lacking Lack of appropriate modeling Christian foundation Lack of cultural sensitivity (maybe) Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved

Using the 12-Step Program as Part of Treatment Combining with other treatment modalities maximizes success Supports counseling Help clients Develop self-regulation Reduce isolation Process and reflect Generalize new skills and values Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved

The Role of the Counselor Key to treatment outcome Encouraging outside support of groups Educating clients about self-help groups Addressing misconceptions and concerns Making appropriate referrals Understand potential barriers Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved

The Role of the Counselor: Referrals to Groups Stay current on 12-step programs Substance and process addiction groups Keep a list of meetings in the area Information to have: Type of addiction Transportation Desire for anonymity Background: gender, culture, religion Personal characteristics Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved

How Can I Learn More About Groups? Consult Colleagues are a valuable source Research Stay current Get involved Contact organizations Request literature Attend various groups Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved

Useful Web Sites Alcoholics Anonymous (www.aa.org) Narcotics Anonymous (www.na.org) Al-Anon (www.al-anon.org) Rational Recovery (www.rational.org) Secular Organization for Sobriety (www.sossobriety.org) Women for Sobriety, Inc. (www.womenforsobriety.org) Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved