The Value of 12 Step Facilitation in Drug Rehab

When looking at drug rehabs, you may notice that while many programs introduce AA/NA meetings and step work as a core component, others do not – in fact, some rehabs promote themselves specifically as non-12 step treatment programs.

This means, when choosing a rehab, you’ll have to decide whether you want an introduction to the 12 steps or whether you’d rather focus your time and energy elsewhere.

To help you with this decision, read on and find out:

1. Why the 12 steps probably make sense for you – though not as the sole component of your treatment regimen.
2. About research evidence that demonstrates the effectiveness of 12 step programs as a component of addiction treatment programs.

So Should You Go 12 Steps or No Steps?

OK – despite passionate and sometimes vitriolic arguments from both the pro and anti AA camps, there’s no single right way to recover – there’s really just a right-for-you way.

The truth is, there are many different types of evidence-based addiction treatments, for example:

• Cognitive behavioral therapy (CBT) groups or individual CBT
• Substance abuse focused family or relationship therapy
• Motivational intervening and enhancement therapy
• Contingency reinforcement
• Substance abuse education programs
• 12 Step facilitation
• And many more

Experts often use the toolbox analogy to describe what happens in treatment and recovery.

1. You’ve got a problem and you need some tools to fix it.
2. You get addiction treatment to learn how to use different tools that you can keep in your toolbox – to be used when necessary as you work to overcome the challenges of recovery.
3. You may not use all the tools you have, but the more skills you learn and the more tools you have at the ready, the better your long term chances.
   

So you don’t have to decide whether the 12 steps are the best system for you (how could you know before you’d tried?) you simply have to decide whether they are worth adding as one tool of many into your recovery toolbox.

And to help you make up your mind on this point, here is an overview of some research studies which demonstrate how and why the 12 steps help in the addiction treatment process.

Research Demonstrating the Value of the 12 Steps

Though critics of 12 step programs will sometimes bash the program as unscientific or even cult-like, there is actually a wealth of research evidence demonstrating its usefulness.

The Value of 12 Step Facilitation during Treatment

Most formal addiction treatment programs include an introduction to the 12 steps and step work as one component of a comprehensive treatment approach. This introduction to AA or NA is known as 12 step facilitation.

Researchers at the State University of New York looked at whether getting 12 step facilitation therapy worked better than motivational enhancement therapy to encourage people to stick with AA after the end of treatment. They found that people who had received 12 step facilitation attended more post-treatment AA meetings and had more days of complete alcohol abstinence.¹

The Value of Attending AA during Outpatient Treatment

Researchers at Western Michigan University looked at data from Project MATCH (a large national data set on alcoholism treatment) to determine if attending AA meetings while also attending outpatient treatment sessions led to improved outcomes.

They found that AA attendance during outpatient treatment phases was strongly correlated with increased alcohol abstinence and decreased alcohol-related problems.²

The Value of NA/AA after Treatment

Researchers in London investigated how AA/NA participation after the end of residential treatment affected abstinence rates. They found that people who made use of 12 steps meetings were more likely to be abstinent at a 1,2 and 5 years post-treatment and that those who were more frequent attendees were more likely than those who attended infrequently to have maintained abstinence.³

Research Showing How AA Helps

Researchers at the Center for Addiction Medicine at Massachusetts General Hospital didn't bother investigating if AA worked (they decided that it did) they looked into how and why it worked.

• They found that for people with moderate alcohol addictions, AA was of most benefit in helping people develop more adaptive sober social networks and in increasing sobriety-related self-confidence.
  
• Among more severely addicted alcoholics, AA helped primarily by decreasing negative emotions and by increasing spirituality and religiosity.⁴

AA Reduces Depression Symptoms

In a separate study, researchers at the Center for Addiction Medicine at Massachusetts General looked at whether participation in AA led to decreased depression symptoms.

1. At the start of their study, alcoholic participants had a higher incidence of depression symptoms than is seen in the general population.
   
2. Over the duration of the 15 month study, those that participated more heavily in AA experienced greater reductions in drinking and greater reductions in depressive symptoms.

The study authors postulate that reduced depression occurs as a consequences of reduced drinking. Improved emotional well-being then leads people to make further positive changes which can lead to even greater decreases in alcohol use.⁵

AA Decreases Risk of Suicide

Japanese researchers found that among a group of alcohol dependent people at-risk of suicide (had expressed suicidal thoughts or plans, previous suicide attempts, etc.) participation in AA significantly decreased the risk of suicidal phenomena.⁶

Long-Term Effectiveness

A 10 year study conducted by researchers at Case Western Reserve University School of Medicine showed that even after 10 years, there was a direct relationship between increased meeting attendance/increased AA-related helping behaviors and increased abstinence rates. Increased helping behaviors were also correlated, over the long-term, with improvements in other areas of life.⁷

The 12 Steps Add Value

If you get involved with the 12 steps during treatment and continue on with meetings years into recovery – and particularly if you get involved with helping others through AA/NA – your odds of a positive outcome go up substantially.

Once done with treatment you can attend meetings or rest at home, but since research shows how much some people get from 12 steps participation, it makes sense to at least give the program a try, and to choose a drug rehab that introduces you to this valid system of recovery.