The 12-Step Program - Case Study Example

RUNNING HEADING: The 12-Step Program School Number The 12-Step Program Introduction The 12-step program is a set of principles intended to help an individual recover from alcoholism, though it can be used for other problems including compulsion, and behavioral problems. They are being considered as spiritual principles though is strongly based on evidences and literature. They were first proposed by the Alcoholics Anonymous and was published in one of their books in the year 1939. Slowly the method was being adopted for other types of programs. The American Psychological Association has developed a more concise version of the program that includes:- 1. acceptance of the problem 2. recognition of power to overcome this problem 3. Acceptance of past errors 4. Making corrections to these errors 5. Developing behavior and learning the same 6. Helping out others with similar problems (Trizio and Schlundt, 2006) The 12-step program goes beyond merely solving the problem, but involves understanding the mental and pharmacological causes of the problem and further using ones experience to solve the problems of others, or from learning from others experiences and problems. The first step of the 12-step program would be to accept ones insufficiency, accepting past errors and recognizing that a higher power which can give strength to resolve the problem (Alcohol Anonymous Worldwide Service, 2005). Steps Involved The 12 Steps as quoted are mentioned below:- Courtesy (Quoted from): Alcohol Anonymous (AA) Most of the alternatives to the above mentioned 12-steps involve modification primarily to step 1 and step 12, though, many of the modifications also involve combining or eliminating the steps in between. Along with the 12 steps, there are 12 traditions that are supplementary and provide means of group governance. Through the 12-step process, recovery occurs in the physical, mental, spiritual, religious and emotional domain. For addicts each of these domains are posing separate problems and for an alcoholic they involve:- Physical: compulsion to consume alcohol after the initial use Mental: powerlessness and lack of self-control to use the drug and control behavior Emotional: Unmanageable intention or compulsion to use the drug Spiritual (not tested scientifically): Self-centerpieces and lack of moral consciousness Religious (not tested scientifically): A road away from God (Trizio and Schlundt, 2006) History Bill Wilson and Bob Smith formed the Alcohol Anonymous organization in 1935 in Ohio and created the 12-step program through frequent meetings with the Oxford Group (a Christian organization that originated in the early part of the 20th century concerned with spiritual development). However, the Oxford Group did not intend the 12-step program for alcoholics, and was instead wanting to use the same to promote awareness and greater spiritualism. Based on the principles laid out with discussion with the Oxford group, Wilson and Smith developed the 12-step program, and used the same to solve alcohol-related problems with others. The 1939 book titled “Alcoholics Anonymous: The Story of How More Than One Hundred Men Have Recovered from Alcoholism” aimed at establishing the theory behind the 12-steps (Trizio and Schlundt, 2006). Following the initial publication, the book has been edited and version-ed several times, in order to update the concepts proposed by Wilson and Smith. However, both of them realized the book was not enough and hence they established the 12-step program as a package along with the book to promote recovery from alcoholism. When the steps were initially developed, the word “God” was used several times, and in order to make the steps more universal and secular, Wilson reduced the number of times it appeared. However, once they were revised by Wilson, the steps have hardly been edited anymore and what we see today is more or less what Wilson had proposed (12-Step,com, 2012). When the alcohol anonymous group was created, during the sessions of the 12-step programs, most of the people interacted with their first name only (such as Bob and Bill) when they spoke on radio, TV or the press. Following the creation of the 12-step program, the Alcohol Anonymous organization went further and created the 12 traditions which supplement the 12-steps and help in group governance when the 12-steps are implemented. The 12-traditions basically help to resolve conflicts concerning finances and religion (12-Step,com, 2012). Evidences & Rationale Each step that is present in the program supports a different cause, and one of the first step that comes in is the acceptance that one has a problem. Once the first step is accepted, then following steps automatically come and are more or less personal and spiritual basis for change. However, the Alcohol Anonymous organization encourages its members not to follow the steps as if they are being forced into, but to also develop certain flexibilities with the program. In general, the principle used is that the patient should choose his/her road to recovery and the 12-steps are mere guides, though they are flexible enough to be changed based on ones choices and priorities. To ensure that ones experience is shared and would be invaluable to others even though they may not be effective, the Alcohol Anonymous organization support Group therapy, wherein experiences are shared and discussed (Trizio and Schlundt, 2006). Effectiveness One of the largest programs that uses the 12-step program is Alcohol Anonymous, followed by Narcotics Anonymous. The main goals of this program is to help individuals to develop a program to recover from drug or alcohol abuse. Other than alcohol or drugs, most other programs that use the 12-step program are for family and social counseling for substance abuse. One-fifth of the programs are actually for recovery from substance abuse, and four-fifths are from related or other problems such as depression, debt problems, etc. Though it may seem to be adaptable to other circumstances, the 12-step program can never assumed to be effective for other problems and hence it would be ideal to determine the effectiveness through group sessions. There are many studies conducted in the past where the 12-step program has been compared with other programs. Orford and Edwards (1977) found that in a 100 subject study in men between the age of 20 and 65 years, a year of 12-step program was not better than a few therapy sessions with the psychiatrist. However, the sample size in this study was small, and it would always be better to study effectiveness in a much larger sample size (Trizio and Schlundt, 2006). In another study conducted by Ferris et al (2006) to compare AA and other 12-step programs for aclohol dependence, a number of databases were searched including COCHRANE, MEDLINE, EMBASE and CINAHL, with the of limits till 2005. 8 trials were obtained involving 3500 people. AA had certain advantages over other programs as their treatment methods were more acceptable and the retention rates were higher. However, regarding the effectiveness, there was no conclusive evidence between the AA programs and other 12-step programs. Hence, according to Ferri, greater studies are needed to study the efficacy (Ferris, 2006). In a study conducted by Gilman et al (2001), the 12-step program was used for methadone heroin addicts (MA). The effectiveness of MA versus the standard methadone maintenance therapy was compared, and following the length of time spend at MA helped to lower use of drugs and alcohol. Compared to other therapies, the MA helped in recovery and hence its use has been further suggested (Gilman, 2001). Finney et al 2001 compared the 12-step program with cognitive behavioral therapy and found that patients improved faster compared with CBT. However, it was not found that either were good for certain types of patients, and patients with 12-step program were more likely to be drug-free than with CBT (Finney, 2001). Issues However, though the 12-step program may seem to be effective in certain cases, there are certain sue that need to be resolved with using this form of treatment. Often the emphasis on High Power is so great that people feel eluded and the efficacy of the same may not be universally similar. Though members during group meeting sessions are asked not to invade the privacy and confidentiality of other members, invariable there could be confidentiality issues arising as the 12-step program basically aims to learn by sharing experiences. Hence, often groups using 12-step programs teach the members of the legal and ethical issues involved. Another problem that is posed is that the 12-step program may itself become a separate cult and take into consideration very little religious or ethical issues. The program may not be as effective in one group compared to the other, and often cultural issues may hinder with the effectiveness of the program (Hillhouse & Fiorentine, 2001). Conclusion Though the 12-step program seems logical and may be more effective than several of the other programs, the effectiveness of the program on a large group needs to be identified. Besides, the program also needs to be tested out and have similar results across both genders and all clutter groups. Hence, whenever any kind of integration of a 12-step program with a traditional treatment mode has been chosen, the benefits of the same need to be discussed and calculated. Many of the results of 12-step programs across various problems and populations have been showing universal trends. Hence, it can be said that the program may not be meant for everyone, the results obtained after using the same across both genders or ethnic groups should never be overlooked or excluded. Another important consideration is that in general, the 12-steps should be ideally stuck to, but the usage of the program should promote certain flexibilities as here the patient undergoing the therapy should develop a course that suits him/her (Hillhouse & Fiorentine, 2001). Bibliography 12Step.com (2012). 12 Step History, Retrieved on February 24, 2012, from Web http://www.12step.com/history.html Alcohol Anonmyous Worldwide (2001). A Guide to Addiction Recovery and Healing, Retrieved on February 24, 2012, from Web http://www.providentliving.org/familyservices/AddicitonRecoveryManual_36764000.pdf Gilman, S. M. Et al (2001). Methadone Anonymous: A 12-Step Program for Methadone Maintained Heroin Addicts, Subst Abuse, 22(4): 247-256. http://www.ncbi.nlm.nih.gov/pubmed/12466684 Ferri, M. Et al (2006). Alcoholics Anonymous and other 12-step programmes for alcohol dependence. Cochrane Database Syst Rev, 3. http://www.ncbi.nlm.nih.gov/pubmed/16856072 Finney, J. W. Et al (2001). A comparative, process-effectiveness evaluation of VA substance abuse treatment. Recent Dev Alcohol, 15: 372-391. http://www.ncbi.nlm.nih.gov/pubmed/11449754 Hillhouse, M. P., & Fiorentine, R. (2001). 12-step program participation and effectiveness: Do gender and ethnic differences exist? Journal of Drug Issues, 31(3): 767-780. http://web.utk.edu/~dap/SA2003/AAGenderEthnic.html Trizio, D. D. & Schlundt, D. (2006). The 12-Step Program & Alcoholics Anonymous, Retrieved on February 24, 2012, from Web http://healthpsych.psy.vanderbilt.edu/12step.htm Read More