Ninety percent and upwards of American substance abuse treatment programs derive from AA' s 12 steps. We need to expand our options based on (a) the evidence, (b) the 12 steps' religious nature, (c) their shortcoming in not teaching coping or emotional management skills. I have created an alternative residential program built on my Life Process Program.

I'm not going to review the data showing that AA and 12-step programs are limited in their effectiveness, beyond repeating the summary from the respected Cochrane Collaboration's 2006 review: "The available experimental studies did not demonstrate the effectiveness of AA or other 12-step approaches in reducing alcohol use and achieving abstinence compared with other treatments."

And operating as though AA and the steps aren't religious can put you in legal danger. In a 2007 decision, the Ninth Circuit Court of Appeals declared in Inouye v. Kemna that a parole officer was not immune from liability for damages after he forced Inouye, a Buddhist, to attend AA meetings in violation of his First Amendment religious freedom. "This uncommonly well-settled case law (against coercing AA attendance). . .was sufficient to give notice to a reasonable parole officer."

Finally, AA meetings and 12-step treatment do little systematically to train people to cope with themselves, their urges, and their environments. They inspire some - evidence says a small minority - to quit drinking. The meetings do give people a place to go for human contact where drinking is not possible. But a ritual in which a group of laypeople or recovering counselors - many with obvious and persistent problems themselves - repeat the steps and tell their personal stories offers members little psychological basis for achieving sobriety.

In contrast to these empirical, civil rights, and clinical problems with AA, a body of evidence has developed that shows a number of psychological treatments -- motivational interviewing, the community reinforcement approach, brief interventions, skills training, and solution-focused psychotherapy -- to be effective for addressing substance abuse. As I have treated addicts in the decades since I wrote Love and Addiction, I have combined these techniques -- along with ones specific to my approach, like values-oriented and purpose-driven recovery -- to create the Life Process Program (c), which I tested through several years' use at a residential treatment prgram.

I now have a strongly validated, successfully aplied CBT and values program that I match with any program available for addiction, and certainly any based specifically on medications and the 12 steps.

You are reading

Addiction in Society

Ranking the Last 14 Presidential Marriages

Ranking presidents is old hat—what's interesting is their marriages.

Trump Won't Reduce the Ravages of Drug Addiction

His proposed recovery programs mean nothing while people are in despair.

Donald Trump and Addictive Behaviors, Part II

Vainglorious in victory, denying defeat, Donald uses strategies of the addicted.