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With an alarmingly increasing number of alcohol dependents, new approaches to alcoholism treatment are taking the stage. A twelve-step program rooted in Alcoholics Anonymous meetings is gaining particular interest for people suffering from alcohol abuse. The practice aims to improve interpersonal communication skills, adapt to the sober lifestyle, and enhance coping abilities (Kelly et al., 2020). Attendants share personal experiences during the meetings and aid each other by adhering to the twelve steps. These include admission, belief, decision, search, God, readiness, humility, making amends, direct amends, personal inventory, prayer, and awakening (Kelly et al., 2020). Despite some debates about the effectiveness of 12 steps programs in the long term, the latter can become a decent addition to other therapeutic approaches in creating a safe environment to develop a stable abstention from alcohol.
The twelve-step program is mainly exercised through a group treatment. Via trust building, sharing personal accounts, and group counseling, participants learn to adapt to the realities of a sober lifestyle and develop effective personalized strategies for abstaining from alcohol or drugs. Kelly et al. (2020) mention that “the observation of others who are sustaining recovery in AA can instill much-needed hope for a better future” (p. 15). Nevertheless, it is worth noting this practice is neither controlled nor designed by health professionals (Kelly et al., 2020). Mental health disorders that would benefit from the program are alcoholism, substance abuse, and other forms of addiction. In order to legitimize and further improve the efficacy of the approach, other methods of psychological treatment can be evoked.
Another method of intervention that might strengthen the positive effects of the twelve-step program is Cognitive Behavioral Therapy. As claimed by Ray et al. (2020), “Cognitive behavioral therapy is a time-limited, multisession intervention that … provides training in behavioral self-control skills to help an individual achieve and maintain abstinence or harm reduction” (p. 2). CBT is a first-line intervention measure utilized both on its own and in conjunction with other treatment methods. Ray et al. (2020) compared various combinations of CBT, usual care, and pharmacological treatment to assess the efficacy of the integrated approach. The authors concluded that CBT proves to be more effective than usual care practices and, as such, should be favored by clinicians in the pharmacological context (Ray et al., 2020). However, CBT showed no tangible advantage over “other evidence-based behavioral modalities” (Ray et al., 2020. p. 10). Based on the research, one can conclude that CBT might increase the efficacy of other rehabilitation routines, but it should not be considered a placebo.
To conclude, whether or not pairing CBT and the twelve steps will reduce recidivism for patients with substance abuse disorders is up for further research. As there is no definitive evidence on the subject, this discussion’s conclusion can only be speculative. However, CBT, known for its short- and long-term application, might provide additional lasting benefits if paired with a twelve-step program. Combining group and individualized training with the help of the two approaches might facilitate psychological well-being, ease adaptation to sobriety, and improve the ability to control addictive urges. AA is the most accessible rehabilitative service for people who struggle with substance abuse; therefore, researching the potential improvement of its practices in combination with evidence-based approaches such as CBT would be a worthwhile endeavor.
References
Kelly, J. F., Humphreys, K., & Ferri, M. (2020). Alcoholics Anonymous and other twelve-step programs for alcohol use disorder. Cochrane Database of Systematic Reviews. Web.
Ray, L. A., Meredith, L. R., Kiluk, B. D., Walthers, J., Carroll, K. M., & Magill, M. (2020). Combined pharmacotherapy and cognitive behavioral therapy for adults with alcohol or substance use disorders. JAMA Network Open, 3(6), e208279. Web.
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