Foundations of Addictions Counseling 3E David Capuzzi Mark

Foundations of Addictions Counseling, 3/E David Capuzzi & Mark D. Stauffer Chapter 12 12 -Step Facilitation of Treatment Updated by Melinda Haley, Walden University Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved

Twelve-Step Groups n n n 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, 3 e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved

History of 12 -Step Groups n Alcoholics Anonymous (1935) n n n 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, 3 e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved

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

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

Other Support Groups n Rational Recovery (1986) n n Alternative to AA and other 12 -step programs Cognitive-behavioral basis n n n 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, 3 e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved

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

More Self-Help Groups, n Rational Recovery (RR) – 1986 n n (continued) Founded by social worker, Jack Trimpey Designed as an alternative to AA groups Is cognitive-behaviorally based Secular Organizations of Sobriety (SOS)-1986 n n n 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, 3 e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved

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

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

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

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

Group Dynamics as Applied to 12 -Step Groups n 8 successful group characteristics n n n n 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, 3 e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved

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

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

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

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

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

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

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

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

Useful Web Sites n n n 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, 3 e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved