There are many approaches to the
treatment of addictive disorders, but two stand out. In North America most
treatment programs for addictive disorders are based on the 12-Steps of Alcoholics
Anonymous. Oddly, most of the empirical research is
based on a very different understanding of addiction and its treatment: the bio-psycho-social model. These two orientations are contrasted below:
- According to the 12-Step model, alcohol abuse is the product of a disease.
Treatment emphasizes admitting powerlessness over alcohol, and adopting the norms and
values of a new social group, the AA self-help group, in order to achieve total
abstinence, which is the only acceptable outcome goal. There are many excellent 12-Step
treatment programs. In most communities virtually all treatment programs are based
on this orientation. These programs will provide the best match for persons
with the following attributes: physically dependent on alcohol, benefit from the support
of a self-help group, and have a religious orientation.
- The bio-psycho-social model is based on research in neural science, cognitive
psychology, and social learning theory. According to this view, alcohol abuse is the
product of biological, psychological, and social factors. In contrast to the AA
view, the individual accepts responsibility for changing behaviors that are excessively
costly to self and others. Individuals who do not feel comfortable with the
12-step philosophy, or those who have attempted 12-step programs without success, often
find that cognitive and behavior change techniques are practical and direct.
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Liberty means responsibility. That is why most men dread it.
-
G. B. Shaw
The true purpose of education is to teach you to do the thing that needs to be
done, when it needs to be done, whether you feel like it or not.
- Thomas Huxley
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