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Alternatives to 12-Step Recovery

If clients are looking for alternatives to 12-step recovery programs like Alcoholics Anonymous (AA) or one of the 12-step spin-offs, there are other options. While millions have found them useful over the past decades, there’s no right path to recovery that works for everyone.

You may want to suggest individual counseling and/or group therapy. For psychotherapy, cognitive behavioral therapy (CBT) remains the leader in addiction treatment, but you may also want to try suggesting the BRENDA approach, a method that involves direct advice, counseling and the use of medication to help patients overcome addictive behaviors. Or SMART Recovery®, which teaches self-empowerment tools and uses mutual-help support groups. These two alternatives to 12-steps recovery offer a clinical approach, free of the 12 steps and spirituality.

  • BRENDABRENDA is an acronym. It stands for a method of counseling that’s used to treat any addiction or mental health issue. It includes six core components that a counselor focuses on with each client: Biopsychosocial evaluation; Report to the patients on assessment findings; Empathy; Needs identified by patient and treatment provider; Direct patient advice; and Assessing the patient’s reaction to advice and adjusting treatment when needed. BRENDA uses a type of psychotherapy called cognitive behavioral therapy (CBT) that focuses on questioning and changing negative and unproductive thoughts and beliefs in order to improve behavior and emotions that lead to using – whether that means drugs or alcohol or a compulsive behavior like sex, gambling or shopping – in combination with prescription medication, which helps to prevent cravings and relapse.

  • Rational Recovery®Rational Recovery® is a program of counseling, guidance and direct instruction to help individuals recover from addiction through permanent abstinence. It was founded in California by Jack Trimpey, a social worker, in 1986. The program is based on the premise that the addict wants to and is capable of sustained abstinence but still wants to use due to an inner “addictive voice.” Trimpey’s program aims to offer the mental tools needed for permanent abstinence. Rational Recovery views substance use as a voluntary choice, not a disease with a genetic component, and supports individual recovery rather than treatment in an addiction treatment center.

  • SMART Recovery®SMART Recovery®, which taps into a community of support to help people manage their own recovery, builds self-reliance through education and supportive meetings. (SMART is an acronym for Self-Management and Recovery Training.) This four-point plan focuses on being motivated, overcoming urges, managing feelings and living a balanced life. Created by physician Joseph Gerstein in 1992, it offers face-to-face and online meetings, as well as chat rooms and message boards to connect addicts with one another. The organization says it helps people recover from all types of addiction and addictive behaviors, including drug addiction, alcohol abuse, gambling addiction, prescription drug abuse, sexual addiction and problem use of other substances and behaviors.

Sources: Alcoholics Anonymous; The Journal of Clinical Psychiatry; LifeRing Secular Recovery; Moderation Management; Rational Recovery®; Secular Organizations for Sobriety; Greg Simpson, LCSW; SMART Recovery®; Substance Abuse and Mental Health Services Administration.

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