Recently, I had a discussion with someone about treatment and whether 12-step programs are effective. He allowed me to quote him directly:
“I think 12-step works best for most, but is not universal. I do not think it is especially helpful for courts and professionals to send addicts/alcoholics to meetings without preparation, it yields more resistant clients. There is a place for harm reduction, and we are coming to a fork in the road with the legalization of marijuana. These are very interesting times as we try to deal with this burgeoning problem.”
So, the idea of preparing someone to enter into a 12-step program is, to me, a really good one. Really though, I am going to work on a program that would prepare someone to enter treatment. In thinking about the statement, there is both separation and grief for someone who’s entering treatment. Not because they’re “going away,” but because they’re entering into a program that is going to make them give up their best friend.
That request, or dependency, does build resistance. If someone told me that I had to give up my best friend (my wife) in order to achieve a program’s goal, you dang right I’d resist. Really, I wouldn’t enter the program. But, that’s what we ask someone when we try to get them to enter treatment: Leave your best friend behind. That request does cause anxiety that someone who’s already abusing substances probably can’t handle. Yet, we ask addicts to enter 12-step, or other treatment programs, without providing any tools with which they can counter the anxiety.
Another area of preparation I can see that is necessary for someone entering treatment is communication skills. If someone is naturally introverted and shy, having to stand in front a bunch of people would probably be petrifying. Yet again, we ask people to enter a 12-step program who probably aren’t suited for that type of environment.
The good news is that coping with anxiety and providing some exposure to the types of situations a person might encounter in a 12-step program are both solvable problems. However, the survey response did remind me that, while I and other treatment providers are quite familiar with treatment settings, most people aren’t. This awareness has awoken me to the needs and emotional challenges someone entering treatment may be facing.