Psychotherapy and 12-Step Recovery Programs
Working Together
Dana Backstrom, LMFT. LPCC
Counseling to You
March, 2015
Have you ever attended professional counseling or psychotherapy sessions to help you recover from an addictive behavior? If so, the therapist may have recommended that you also participate in a 12-step program.
Likewise, if you’ve ever attended Alcoholics Anonymous (AA) you may you may have heard members encourage each other to get “Outside help” when needed. The 12 & 12 Step Five, p. 59 states, “We’d have to have outside help if we were surely to know and admit the truth about ourselves—the help of God and another human being.”
Concurrent participation in psychotherapy and 12-Step programs only deepens recovery and personal growth. For people who struggle with addiction-related issues, the integration of psychotherapy and the 12 steps is often the best approach.
The Basics of the 12-Steps
And, while many believe 12-step programs such as Alcoholics Anonymous (AA) and professional counseling and psychotherapy are at odds with one another,
Many therapists refer clients with addiction-related issues to 12-step programs, and many 12-step program participants seek professional counseling and psychotherapy as an adjunct to their work on the 12 steps.
So, if you’re struggling with an addiction, the important thing is not where you start to get help but that you get started!
12-step programs and psychotherapy, both separately and in conjunction, have been proven effective in the treatment of numerous addiction disorders.
There are more than 80 12-step programs encompassing over 125,000 chapters and involving millions of Americans.
The original 12-step program, Alcoholics Anonymous (AA), was founded in 1934 by Dr. Bob and Bill Wilson and all other 12-step programs are based on the 12-step traditions of AA. These “12 steps and 12 traditions” are practical and spiritual steps that are “worked,” often with a sponsor, over a period of time.
So, whether you’re attending Codependents Anonymous, Adult Children of Alcoholics, Overeaters Anonymous, Gambler’s Anonymous or any one of the over 80 other 12-Step programs, the basic tenets of all of these 12-step programs are the same.
Without getting specifically into each of the 12 steps, in 12-step-based programs individuals are encouraged to attend meetings to share their problems with others who have direct experience, work the 12 steps, and be of service.
The disease of addiction affects the physical, the mental, and the spiritual aspects of the addict’s life, as well as impacting the lives of those in relationships with the addict, and a major focus of all 12-step programs is using the 12 steps to facilitate recovery through spiritual understanding.
To be clear, this does not mean that 12-step programs are affiliated or aligned with any particular religion or religious group (though some are). Acknowledgement of and connection to a power greater than our selves need not be tied to any faith. In fact, Carl Jung noted that many of his patients who spontaneously overcame their alcoholism did so thanks to spiritual conversions.
Along these lines, one can view 12-step programs such as AA as a method of intentionally inducing a genuine spiritual transformation. But such a spiritual transformation involves not only awareness but also the process of living in accordance with spiritual principles.
Thus, 12-step programs offer a group-oriented, spiritually-focused path to recovery, which can differ greatly from professional counseling and psychotherapy’s focus on individual awareness and understanding the underlying causes of one’s addictive behaviors.
The 12-steps are not therapy, nor were they ever intended to be. But this doesn’t mean they’re mutually exclusive!
Counseling and Therapy with the 12 Steps
People commonly turn to professional counseling and psychotherapy to better cope with and overcome day-to-day difficulties that are affecting their professional and personal lives.
Although there are many different therapeutic orientations and styles, psychotherapists all offer a safe, confidential, contained space and their sole purpose is to help clients heal from whatever is troubling them.
Because intense emotional reactions in the present often have their origins in difficult emotional experiences from the past, psychotherapy often explores family histories as a potential source of present difficulties.
Successful psychotherapy hinges on the effectiveness of the relationship developed between the client and the therapist. It’s this relationship that allows people, over time, to share intimate details and openly discuss their feelings, which is what allows healing to occur.
In psychotherapy, healing occurs when clients are able to acknowledge past emotional wounds and learn to integrate new and more helpful beliefs, and ways of thinking, reacting, and behaving.
So, where does this fit with 12-step programs?
Well, first of all, the recovery process often brings up a host of old beliefs, behavior patterns, ways of interacting with the world, and relationship dynamics that are often best dealt with in the more individualized setting of professional counseling and psychotherapy.
In fact, abstinence often results in numerous emotions surfacing that otherwise might be suppressed or avoided through intoxication.
Psychotherapy is, by its nature, less programmatic than 12-step programs, and thus can lead to a greater awareness of individual patterns of experiencing the world and relating to others.
Additionally, many people who struggle with addictions also suffer other mental disorders and vice versa. As an example, it’s been shown that people struggling with a drug addiction are almost twice as likely as the general population to suffer from some type of anxiety or mood disorder.
If someone attending a 12-step program continues to relapse, it’s often because of a co-occurring and untreated mental health issue and it’s been well established that professional counseling and psychotherapy in conjunction with some type of 12-step program is the best means of treating both.
It’s also important to note that if you’ve experienced any form of victimization in your childhood or any serious trauma, then professional counseling and psychotherapy is often the best place to work through these experiences. Whereas a 12-step inventory focuses on your part in contributing to negative situations in your life, it can be destructive to look for “your part” in situations where you have in fact been victimized, and had no responsibility.
Lastly, while psychotherapy is not typically focused on spiritual transformation per se, it can be very helpful in supporting you in your process of spiritual discovery and recovery from addictive patterns of behavior.
There are those for whom psychotherapy is not enough. But if your therapist understands the principles of 12-step programs, he or she can better understand your struggles and be supportive around an important part of your life.
In Conclusion
Psychotherapy and 12-Step programs are a highly effective combination for knocking out addiction. While 12-step programs can be tremendously effective in supporting one’s recovery from addiction, we need to remember that 12-step programs are not treatment and can’t effectively replace the expertise of a professional trained in helping people like you cope with and overcome all the various issues surrounding your addiction.
Likewise, counseling and psychotherapy can’t provide the sense of belonging to a group and the feeling of being accepted that 12-step programs offer.
Overcoming addiction requires you to develop a sober social network as an alternative to the people, places and things that trigger the addictive behaviors you are working so hard to set aside.
For these reasons, an integrated, holistic approach to addiction recovery that takes into account the physical, emotional and spiritual effects of addiction on the individual and his or her family is your best bet.
12-step programs and professional counseling and psychotherapy are both important components of effective addiction recovery and, when combined, they work together to create the spiritual, emotional, social, and behavioral foundation you need to have the best chance of avoiding relapse, achieving a lasting recovery, and moving forward in your relationship and your life with confidence and optimism.
Counseling to You
March, 2015
Have you ever attended professional counseling or psychotherapy sessions to help you recover from an addictive behavior? If so, the therapist may have recommended that you also participate in a 12-step program.
Likewise, if you’ve ever attended Alcoholics Anonymous (AA) you may you may have heard members encourage each other to get “Outside help” when needed. The 12 & 12 Step Five, p. 59 states, “We’d have to have outside help if we were surely to know and admit the truth about ourselves—the help of God and another human being.”
Concurrent participation in psychotherapy and 12-Step programs only deepens recovery and personal growth. For people who struggle with addiction-related issues, the integration of psychotherapy and the 12 steps is often the best approach.
The Basics of the 12-Steps
And, while many believe 12-step programs such as Alcoholics Anonymous (AA) and professional counseling and psychotherapy are at odds with one another,
Many therapists refer clients with addiction-related issues to 12-step programs, and many 12-step program participants seek professional counseling and psychotherapy as an adjunct to their work on the 12 steps.
So, if you’re struggling with an addiction, the important thing is not where you start to get help but that you get started!
12-step programs and psychotherapy, both separately and in conjunction, have been proven effective in the treatment of numerous addiction disorders.
There are more than 80 12-step programs encompassing over 125,000 chapters and involving millions of Americans.
The original 12-step program, Alcoholics Anonymous (AA), was founded in 1934 by Dr. Bob and Bill Wilson and all other 12-step programs are based on the 12-step traditions of AA. These “12 steps and 12 traditions” are practical and spiritual steps that are “worked,” often with a sponsor, over a period of time.
So, whether you’re attending Codependents Anonymous, Adult Children of Alcoholics, Overeaters Anonymous, Gambler’s Anonymous or any one of the over 80 other 12-Step programs, the basic tenets of all of these 12-step programs are the same.
Without getting specifically into each of the 12 steps, in 12-step-based programs individuals are encouraged to attend meetings to share their problems with others who have direct experience, work the 12 steps, and be of service.
The disease of addiction affects the physical, the mental, and the spiritual aspects of the addict’s life, as well as impacting the lives of those in relationships with the addict, and a major focus of all 12-step programs is using the 12 steps to facilitate recovery through spiritual understanding.
To be clear, this does not mean that 12-step programs are affiliated or aligned with any particular religion or religious group (though some are). Acknowledgement of and connection to a power greater than our selves need not be tied to any faith. In fact, Carl Jung noted that many of his patients who spontaneously overcame their alcoholism did so thanks to spiritual conversions.
Along these lines, one can view 12-step programs such as AA as a method of intentionally inducing a genuine spiritual transformation. But such a spiritual transformation involves not only awareness but also the process of living in accordance with spiritual principles.
Thus, 12-step programs offer a group-oriented, spiritually-focused path to recovery, which can differ greatly from professional counseling and psychotherapy’s focus on individual awareness and understanding the underlying causes of one’s addictive behaviors.
The 12-steps are not therapy, nor were they ever intended to be. But this doesn’t mean they’re mutually exclusive!
Counseling and Therapy with the 12 Steps
People commonly turn to professional counseling and psychotherapy to better cope with and overcome day-to-day difficulties that are affecting their professional and personal lives.
Although there are many different therapeutic orientations and styles, psychotherapists all offer a safe, confidential, contained space and their sole purpose is to help clients heal from whatever is troubling them.
Because intense emotional reactions in the present often have their origins in difficult emotional experiences from the past, psychotherapy often explores family histories as a potential source of present difficulties.
Successful psychotherapy hinges on the effectiveness of the relationship developed between the client and the therapist. It’s this relationship that allows people, over time, to share intimate details and openly discuss their feelings, which is what allows healing to occur.
In psychotherapy, healing occurs when clients are able to acknowledge past emotional wounds and learn to integrate new and more helpful beliefs, and ways of thinking, reacting, and behaving.
So, where does this fit with 12-step programs?
Well, first of all, the recovery process often brings up a host of old beliefs, behavior patterns, ways of interacting with the world, and relationship dynamics that are often best dealt with in the more individualized setting of professional counseling and psychotherapy.
In fact, abstinence often results in numerous emotions surfacing that otherwise might be suppressed or avoided through intoxication.
Psychotherapy is, by its nature, less programmatic than 12-step programs, and thus can lead to a greater awareness of individual patterns of experiencing the world and relating to others.
Additionally, many people who struggle with addictions also suffer other mental disorders and vice versa. As an example, it’s been shown that people struggling with a drug addiction are almost twice as likely as the general population to suffer from some type of anxiety or mood disorder.
If someone attending a 12-step program continues to relapse, it’s often because of a co-occurring and untreated mental health issue and it’s been well established that professional counseling and psychotherapy in conjunction with some type of 12-step program is the best means of treating both.
It’s also important to note that if you’ve experienced any form of victimization in your childhood or any serious trauma, then professional counseling and psychotherapy is often the best place to work through these experiences. Whereas a 12-step inventory focuses on your part in contributing to negative situations in your life, it can be destructive to look for “your part” in situations where you have in fact been victimized, and had no responsibility.
Lastly, while psychotherapy is not typically focused on spiritual transformation per se, it can be very helpful in supporting you in your process of spiritual discovery and recovery from addictive patterns of behavior.
There are those for whom psychotherapy is not enough. But if your therapist understands the principles of 12-step programs, he or she can better understand your struggles and be supportive around an important part of your life.
In Conclusion
Psychotherapy and 12-Step programs are a highly effective combination for knocking out addiction. While 12-step programs can be tremendously effective in supporting one’s recovery from addiction, we need to remember that 12-step programs are not treatment and can’t effectively replace the expertise of a professional trained in helping people like you cope with and overcome all the various issues surrounding your addiction.
Likewise, counseling and psychotherapy can’t provide the sense of belonging to a group and the feeling of being accepted that 12-step programs offer.
Overcoming addiction requires you to develop a sober social network as an alternative to the people, places and things that trigger the addictive behaviors you are working so hard to set aside.
For these reasons, an integrated, holistic approach to addiction recovery that takes into account the physical, emotional and spiritual effects of addiction on the individual and his or her family is your best bet.
12-step programs and professional counseling and psychotherapy are both important components of effective addiction recovery and, when combined, they work together to create the spiritual, emotional, social, and behavioral foundation you need to have the best chance of avoiding relapse, achieving a lasting recovery, and moving forward in your relationship and your life with confidence and optimism.