12-Step Alternatives: CBT and REBT
The 12-step approach was started early in the 20th century before the medical community had any real understanding of what caused addiction, or how to treat it. The 12-step approach is a peer-based community support group…basically one addict or alcoholic helping another. It is a culture of recovery that is based in the personal opinions of those who attend meetings and does not take into account the science of addiction, the role of the mid-brain, or the overwhelming presence of co-occurring mental health issues for those who struggle with this vicious disease. Licensed professionals do not moderate the meetings themselves.
Although the 12-step approach certainly helped many people to achieve and sustain sobriety over the years, other alternative programs that can be equally or even more effective have been created since which contain the same fellowship and support. These alternatives to 12-step based rehab at often is made up of individuals seeking a holistic, therapeutic path to recovery.
Many facilities take a different approach when treating Dual Diagnosis substance abuse that don’t involve 12-step rehab. These include: cognitive behavioral therapy, (CBT), rational emotive behavioral therapy (REBT) which is a form of CBT. CBT and REBT are evidenced-based approaches (clinically proven and supported by SAMSHA) for dealing with affective and addictive disorders. Albert Ellis, who was awarded the distinction of being “the most influential psychologist” of the 20th Century by the American Psychological Association, first developed REBT.
CBT and more specifically, REBT, assume that people act the way they do because of their perceptions of reality, not because of reality itself. In other words, behaviors, emotions and thoughts are driven by beliefs that people hold about how things “should” be rather than how things actually are. REBT therapy is an alternative therapy to 12-step and is designed to help individuals discover underlying and often unconscious, inflexible and self-destructive beliefs about themselves, others and the world. Once these beliefs are identified, challenged and reframed, individuals are able to increasingly accept themselves and others without emotional distress. This resulting reduction in emotional distress allows them to reduce their overall stress and anxiety levels, to improve their mood and to gain control over self-destructive behaviors such as addiction. This differs from the 12-step approach in that a licensed and trained individual administers the therapy, and the therapy is specific and targets particular issues.
Many good things have come out of the 12-step addiction recovery programs. However, alternatives to 12-step based rehabs are also very successful and life changing – often more so.