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The Importance of Combining the 12-Steps and Therapy

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This content has been reviewed and fact-checked by a certified addiction therapist and a board-certified physician.

This content has been reviewed and fact-checked by a certified addiction therapist and a board-certified physician.

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The 12-Steps, typically associated with Alcoholics Anonymous (or Cocaine Anonymous), is a program to aid in recovery from addiction.  As addiction is often accompanied by mental illness, combining the 12-Steps with therapy can help an individual create an overall sense of well-being and recovery. 
Searching for help with drug and/or alcohol addiction? Call us now at (800) 643-2108.

What Are the 12-Steps?

The 12-Steps are a set of guiding principles in addiction treatment that outlines a course of action for tackling problems associated with substance use disorder (SUD).

The 12-Steps Are:

  1. We admitted that we were powerless over alcohol or drugs and that our lives had become unmanageable.
  2. We believed that a Power greater than ourselves could restore us to sanity.
  3. We decided to turn our will and lives over to God’s care as we understood Him.
  4. We made a searching and moral inventory of ourselves.
  5. We admitted to God, to ourselves, and to another human being the exact nature of our wrongs.
  6. We were entirely ready to have God remove all these defects of character.
  7. We humbly asked Him to remove our shortcomings.
  8. We made a list of all persons we harmed and became willing to make amends to them.
  9. We made direct amends to such people wherever possible, except when to do so would injure them or others.
  10. We continued to take a personal inventory and, when we were wrong, promptly admitted it.
  11. We sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out.
  12. Having had a spiritual awakening due to these steps, we tried this message to alcoholics or addicts to practice these principles in all our affairs.

Understanding The Concept of God in AA

Although the 12-Steps refer to God, Alcoholics Anonymous (AA) and Cocaine Anonymous (CA) are spiritual, not religious, programs.

The language emphasizes “God as we understood Him,” meaning that you can interpret the word God in any way you want.

You can also refer to God as a Higher Power if that language makes you more comfortable.

Typically, the only requirement for a Higher Power is that it be greater than yourself and loving.

Recovery is a lifelong process, meaning there is no right way to approach the Steps.

Most recovering addicts will revisit the 12-Steps as their recovery progresses and face new challenges.

However, Steps One, Two, and Three are considered the foundation of a 12-Step program and are recommended for daily practice.

Contrary to what people have said for a long time, 12-Step programs have significant outcomes.

A new study published by the medical journal Cochrane found that peer-led 12-step programs help people get sober and have higher rates of continuous sobriety than professional mental health therapy, such as cognitive behavioral therapy.

The study is significant because it dispels misinformation about the efficacy of the 12-step program, said lead author Dr. John Kelly, a professor of psychiatry and addiction medicine at Harvard Medical School.

“In the popular press, there have been reports of AA not working or even harmful for people,” he said. “So, we wanted to clarify the scientific picture to the highest scientific standard.”

The prominence of these programs and success stories from recovering substance users indicate that the 12-Steps are extremely effective in treating addiction. The 12-Step model provides support, encouragement, and accountability for people who want to overcome addiction.

What Is Therapy?

Therapy is a treatment used to relieve emotional distress and address mental health problems. Those who provide therapy are trained psychologists, psychiatrists, social workers, or licensed counselors.

Therapy involves examining and gaining insight into life choices and difficulties. The purpose of therapy is to explore feelings, behaviors, and thoughts to increase problem-solving skills or achieve higher levels of functioning. There are several different types of therapy, including:

  • Cognitive-behavioral therapy
  • Dialectical-behavioral therapy
  • Accelerated resolution therapy
  • Eye Movement Desensitization and Reprocessing (EMDR) therapy
  • Experiential therapy
  • Art therapy
  • Music therapy

The Link Between Mental Health and Addiction

Many people diagnosed with SUD are also diagnosed with mental health disorders. Even when both occur, it does not mean one caused the other.

Genetic vulnerabilities are common risk factors for developing mental health disorders and SUD. It is estimated that 40-60% of a person’s vulnerability to SUD is attributable to genetics.

It is also possible to pass down genes contributing to developing a mental illness. Both genetic predispositions can work hand-in-hand. For example, frequent marijuana use during adolescence is associated with an increased risk of psychosis in adulthood, specifically among individuals who carry a particular gene.

Certain mental health disorders are risk factors for developing SUD. Some people with mental illness may use substances as a form of self-medicating to relieve mental health symptoms.

When somebody develops a mental health disorder, the brain changes that occur increase the vulnerability for SUD. Substance use can lead to changes in brain parts associated with mental health disorders, such as schizophrenia, anxiety, mood, or impulse-control disorders.

Drug use that begins before the first symptoms of mental illness can cause brain structure changes that lead to a mental illness.

Treatment of both mental health disorders and SUD is essential to long-term recovery. In a 12-Step program, you may discuss traumatic experiences in the Fourth Step, but you may not have any coping strategies to help you deal with them.

The emergence of trauma may cause feelings exacerbated by mental health issues. When your mental health disorder symptoms arise, you may experience cravings to relieve your emotions.

The Importance of Getting Dual-Diagnosis Help in Treatment

If you treat your mental health disorder but not your addiction, uncomfortable feelings may surface in therapy, and you have your coping strategies. Still, you do not have the support system that a 12-Step program provides for you to talk about any cravings or urges caused by these emotions.

When you treat both disorders, you are ensuring a happy, healthy life and an abundance of solutions.

Treating both mental health disorders and substance use disorder (SUD) is essential to ensuring long-term recovery. The 12-Steps, as outlined in Alcoholics Anonymous or Narcotics Anonymous, are strategies to help you with a course of action to tackle addiction.

12-Step programs also offer a support system for people who struggle with the same disease and understand addiction’s problems. Therapy is a form of treatment typically used to treat mental health disorders.

In therapy, you will learn to explore feelings and behaviors to develop problem-solving skills and achieve a higher level of functioning. When mental health disorders and SUD co-occur, treating them with a combination of the 12-Steps and therapy is best.

At Cornerstone Healing Centers, we bring together science and spirituality to help you along this process. Our facilities offer an introduction to the 12-Steps and therapy to begin your recovery journey.

For more information on treating co-occurring mental health disorders and addiction, call Cornerstone Healing Centers at (800) 643-2108.

Let us help you start your journey to recovery.

Get compassionate evidence- based and trauma focused substance abuse treatment in Arizona.

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Lionel, a Licensed Independent Substance Abuse Counselor (LISAC) with over 4 years at Cornerstone. Passionate about helping those with addiction, he has trained as an EMDR therapist  adopting a trauma-informed approach to treat the underlying issues of addiction, providing an empathetic approach to addiction.

Articles written prior to August 2023 were also clinically reviewed by Karen Williams, LPC 

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