Twelve Step

Education for Twelve Step Facilitation of alcoholism and addiction


  • Aggression and hostility in recovered alcoholics

    There is a long-recognized association between alcohol consumption and aggressive behavior. But does aggression and hostility continue into sobriety?

    This study was designed to examine aggression in a group of socially well-adapted recovered alcoholics.

    The question addressed was whether the treatment, together with long-term abstinence from alcohol, could reduce aggression and hostility in recovered alcoholics.

    Sixty four male stable alcoholics with at least 3 years sobriety were compared with 69 non-alcoholics. Neither group had any other psychological problems.

    Both groups were given a questionnaire on general characteristics as well as aggressive and hostility traits.

    After a 3-year abstinence, men from the recovering alcoholics group displayed greater signs of hostility and covert aggression. They were different from non-alcoholics on measures for indirect aggression, irritability, negativism, suspicion, resentment, and guilt.

    Research report; Ziherl S, Cebasek Travnik Z, Kores Plesnicar B, Tomori M, Zalar B. Trait aggression and hostility in recovered alcoholics. Eur Addict Res 2007; 13(2): 89-93.

    Posted in Adjunctive therapy, Alcohol, Alcoholism, Assessment, Disease of addiction, Men, Relapse prevention, Research, Stages of Change, Symptoms of addiction. Use this permalink for a bookmark.

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    AA and a social model of treatment


    Since the 1970s, much of the public treatment system in California has been based on a social model orientation to recovery for alcoholics, but there has been minimal research on program outcomes. This article reports on follow-up interviews conducted with a representative sample of 722 people who had entered treatment about a year earlier in public and private programs, including publicly-funded social model detoxification and residential programs, and clinical model programs in hospitals and HMO clinics.

    higher levels of 12-step program involvement during follow-up, which strongly predicted an absence of alcohol problems

    • Social model clients came to treatment with more severe legal and employment problems, whereas those seeking treatment at clinical programs reported more severe family problems.
    • At follow-up, clients at both types of programs reported attending a similar number of Alcoholics Anonymous (AA) meetings, but social model clients reported going to more Narcotics Anonymous (NA) meetings and being involved in more AA activities.
    • Social model clients were less likely than clinical model clients to report problems with alcohol or drugs at follow-up, but the odds of reporting other problems (e.g., medical, psychological, legal, family/social) were similar.

    The program effect for better alcohol outcomes at the social model programs was partially explained by their clients’ higher levels of 12-step program involvement during follow-up, which strongly predicted an absence of alcohol problems.

    • Social networks supportive of abstinence also were predictive of reporting no alcohol problems at follow-up.

    In contrast, subsequent detoxification treatment events between baseline and follow-up were associated with a higher odds of reporting alcohol, drug, psychiatric and family/social problems at follow-up.

    These findings are consistent with the growing body of literature reporting higher rates of abstinence among those who are able to construct more positive social networks, and who attend and become involved in 12-step programs during and following treatment.

    It is important that these results be replicated, as they suggest that social model programs are successful in engaging their clients in AA activities and in NA meeting attendance, and could represent for some an effective alternative to clinical model treatment programs.


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    Posted in 12-Step Groups, Alcohol, Alcoholism, Detoxification, Drugs, Research, Target populations. Use this permalink for a bookmark.

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    TSF and other models


    Most Similar Counseling Approaches

    TSF has its roots in the Minnesota Model first described by Daniel J. Anderson and as implemented in most AA-oriented treatment programs (e.g.,the Hazelden Foundation, the Betty Ford Foundation, the Sierra Tuscan Center, and others). These models assume addiction can be arrested but not cured, ascribe to the AA/NA philosophy as described in AA/NA literature that relies heavily on a combination of spirituality and pragmatism, and advocate peer support as the primary means for achieving sustained sobriety.

    Most Dissimilar Counseling Approaches

    Any approach that advocates controlled use of alcohol or other drugs (as compared with abstinence) is fundamentally dissimilar to TSF with respect to basic treatment goals. Cognitive-behavioural approaches that are based on the idea that problem drinking and other drug use stem primarily from inadequate stress management skills and that aim to enhance problem solving and coping skills differ from TSF with respect to the assumption of peer support as fundamental to recovery. TSF also assumes that alcoholism and other drug addiction are primary diagnoses and not symptoms of another diagnosis (e.g., depression, antisocial personality).

    Posted in Contrast to other models, Theory, TSF. Use this permalink for a bookmark.

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    Attitudes and Beliefs About 12-Step Groups

    Attitudes and Beliefs About 12-Step Groups Among Addiction Treatment Clients and Clinicians: Toward Identifying Obstacles to Participation.

    Abstract; Participation in 12-step groups during and after formal treatment has been associated with positive outcome among substance users. However, the effectiveness of 12-step groups may be limited by high attrition rates and by low participation, areas on which there has been little research.

    Clinicians play an important role in fostering 12-step participation, and the insights which they develop in their practice can greatly contribute to informing the research process. Yet, little is known about clinicians’ attitudes about 12-step groups or about their experiences in referring clients.

    This study surveyed clients (N = 101) and clinicians (N = 102) in outpatient treatment programs to examine 12-step-related attitudes and to identify potential obstacles to participation. Data collection was conducted between May 2001 and January 2002 in New York City.

    Both client and clinician samples were primarily African-American and Hispanic; 32% of clients reported substance use in the previous month, with crack and marijuana cited most frequently as the primary drug problem. On average, clinicians had worked in the treatment field for 8 years.

    Both staff and clients viewed 12-step groups as a helpful recovery resource.

    Major obstacles to participation centered on motivation and readiness for change and on perceived need for help, rather than on aspects of the 12-step program often cited as points of resistance (e.g., religious aspect and emphasis on powerlessness).

    Clinicians also frequently cited convenience and scheduling issues as possible obstacles to attending 12-step groups.

    Clinical implications of these findings are discussed, including

    • the importance of fostering motivation for change,
    • the need to assess clients’ beliefs about and experiences with 12-step groups on a case-by-case basis, and to
    • find a good fit between clients’ needs and inclinations on the one hand, and
    • the tools and support available within 12-step groups on the other.

    Research; Alexandre B. Laudet, Attitudes and Beliefs About 12-Step Groups Among Addiction Treatment Clients and Clinicians: Toward Identifying Obstacles to Participation, Substance Use & Misuse, Volume 38, Issue 14 December 2003, pages 2017 – 2047

    Posted in 12-Step Groups. Use this permalink for a bookmark.

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    Purpose in life in alcoholism recovery

    lanternSpirituality and purpose in life in alcoholism recovery.

    We examined the relationship between spirituality and recovery from alcoholism.

    Spirituality was defined as the extent of practice of Alcoholics Anonymous Steps 11 and 12 and was measured by a Step Questionnaire developed for this study.

    AA Step 11 suggests prayer and meditation, and Step 12 suggests assistance of other alcoholics. It was postulated that the extent to which Steps 11 and 12 were practiced would be positively correlated with the extent of purpose in life reported by 100 AA members.

    Positive correlations between practice of Step 11 and purpose in life scores and between Step 11 and length of sobriety were found.

    Number of AA meetings attended was significantly correlated with purpose in life scores and length of sobriety.

    Carroll, Stephanie. Journal of Studies on Alcohol, Vol 54(3), 297-301.

    Posted in 12-Step Groups, Alcoholics Anon, Alcoholism, Recovery, Spirituality and tagged , , , . Use this permalink for a bookmark.

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    Common Problems in Recovery

    Common Problems in Patients Recovering from Chemical Dependency

    Chemical dependency is a common, chronic disease that affects up to 25 percent of patients seen in primary care practices.

    The treatment goal for patients recovering from chemical dependency should be to avoid relapse.

    This requires physicians to have an open, nonjudgmental attitude and specific expertise about the implications of addiction for other health problems.

    Firstline treatment for chemical dependency should be nonpharmacologic, but when medication is necessary, physicians should avoid drugs that have the potential for abuse or addiction.

    Medications that sedate or otherwise impair judgment also should be avoided in the recovering patient.

    Psychiatric illnesses should be aggressively treated, because untreated symptoms increase the risk of relapse into chemical dependency.

    Selective serotonin reuptake inhibitors may help to lower alcohol consumption in depressed patients, and desipramine may help to facilitate abstinence in persons addicted to cocaine.

    If insomnia extends beyond the acute or postacute withdrawal period, trazodone may be an effective treatment.

    If nonpharmacologic management of pain is not possible, nonaddictive medications should be used.

    However, if nonaddictive medications fail, long-acting opiates used under strict supervision may be considered. Uncontrolled pain in itself is a relapse risk.

    Research; Fam Physician 2003;68:1971-8. Common Problems in Patients Recovering from Chemical Dependency. EDNA MARIE JONES, DOUG KNUTSON, and DANELL HAINES.

    Dual Disorders : Counseling Clients With Chemical Dependency and Mental Illness

    Posted in Addiction, Alcohol, Alcoholism, Drugs, Research. Use this permalink for a bookmark.

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    The Personality Traits of Alcoholics


    Psychopathological symptoms and personality traits in alcohol-dependent patients: a comparative study.

    Pensive The aim of this paper was to describe the psychopathological and personality profile associated with alcohol dependence and to compare it with those of non-addictive disorders and the normal population.

    The sample consisted of

    • 158 alcohol-dependent participants attending a psychiatric outpatient clinic,
    • 120 psychiatric patients with non-addictive disorders and
    • 103 participants from the general population chosen to match the patient samples for age, gender and socioeconomic level.

    All participants were assessed with different instruments related to


    • Impulsiveness Scale,
    • Sensation-Seeking Scale and
    • STAI,


    • SCL-90-R,
    • BDI and
    • Maladjustment Scale and

    personality disorders

    • MCMI-II.

    Patients from the clinical groups presented more symptoms of anxiety and depression than the healthy participants and had more problems adjusting to everyday life, but there were no differences between the two clinical groups.

    Alcohol-dependent patients were more impulsive and sensation-seeking than the other two groups.

    Histrionic, narcissistic and antisocial personality disorders were specific to the alcohol-dependent patients.

    The implications of this study for further research are discussed.

    Research report; Psychopathological symptoms and personality traits in alcohol-dependent patients: a comparative study. Adicciones. 2007;19(4):373-81. Bravo de Medina R, Echeburua E, Aizpiri J.

    See also;

                        Our Devilish Alcoholic Personalities.
    by Eddie Webster (The Author of the Little Red Book).

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    Posted in Alcoholism, Assessment, Research, Symptoms of addiction and tagged , , , , , , . Use this permalink for a bookmark.

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    AA and recovery from alcoholism

    Alcoholics Anonymous (AA) The recovery from alcoholism: Twelve steps of Alcoholics Anonymous.

    AA is a self-help, volunteer organization begun in the mid-1930s that views alcoholism as a disease, not a defect of will.

    Its founders, themselves alcoholics, maintained that persons with the disease should completely stop drinking, but they did not concern those who could handle alcohol. This position contrasted with the premises of most temperance advocates, who saw drinking as a moral choice and opposed any alcohol use by anyone.

    The Twelve Steps embody the wisdom of the founders of AA about pursuing ongoing recovery from alcoholism.

    The procedure they describe has evolved into one of the most successful programs for helping alcoholics.

    Many drug treatment programs also have based themselves on this twelve-step model.

    The abbreviated Twelve Steps are:

    1. admission of powerlessness;
    2. belief in a Higher Power;
    3. submission of one’s will to that Power;
    4. self-examination;
    5. admission of wrongs within self;
    6. readiness to have a Higher Power remove these faults;
    7. humble prayer for removal of these short-comings;
    8. list persons whom one has offended;
    9. make restitution to those whom one has offended;
    10. continue to take personal inventory;
    11. seek through prayer and meditation to improve conscious contact with God; and
    12. having realized a spiritual awakening, try to carry this message to alcoholics and practice these principles in all affairs.

    Research; Alcoholics Anonymous (AA) The recovery from alcoholism: Twelve steps of Alcoholics Anonymous. In: D.F. Musto, Drugs in America: A Documentary History, New York, NY: New York University Press, 2002. 574 p. (pp. 158-159)

    Alcoholics Anonymous: The Story of How Many Thousands of Men and Women Have Recovered from Alcoholism

    Posted in 12-Step Groups, Alcohol, Alcoholics Anon, Alcoholism, Higher Power, Research, Self-help. Use this permalink for a bookmark.

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    Prayer Cuts Alcohol Consumption?

    Rock with the word blessings on sandy beach uid 1180654Does Prayer Decrease Alcohol Consumption?

    Four methodologically diverse studies (N = 1,758) show that prayer frequency and alcohol consumption are negatively related.

    In Study 1 (n = 824), we used a cross-sectional design and found that higher prayer frequency was related to lower alcohol consumption and problematic drinking behavior.

    Study 2 (n = 702) used a longitudinal design and found that more frequent prayer at Time 1 predicted less alcohol consumption and problematic drinking behavior at Time 2, and this relationship held when controlling for baseline levels of drinking and prayer.

    In Study 3 (n = 117), we used an experimental design to test for a causal relationship between prayer frequency and alcohol consumption. Participants assigned to pray every day (either an undirected prayer or a prayer for a relationship partner) for 4 weeks drank about half as much alcohol at the conclusion of the study as control participants.

    Study 4 (n = 115) replicated the findings of Study 3, as prayer again reduced drinking by about half.

    Research; Nathaniel M. Lambert, Frank D. Fincham, Loren D. Marks and Tyler F. Stillman; Psychology of Addictive Behaviors; Volume 24, Issue 2, June 2010, Pages 209-219; Invocations and Intoxication: Does Prayer Decrease Alcohol Consumption?

    Prayer Steps to Serenity The Twelve Steps Journey: New Serenity Prayer Edition by L. G. Parkhurst Jr.

    Posted in Adjunctive therapy, Alcohol, Contrast to other models, Higher Power, Research, Spirituality and tagged , , . Use this permalink for a bookmark.

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    Alcoholism Drug Helps Gamblers

    Gambling urge medication Drug commonly used for alcoholism craving curbs urges of pathological gamblers

    A drug commonly used to treat alcohol addiction has a similar effect on pathological gamblers – it curbs the urge to gamble and participate in gambling-related behavior, according to a new research at the University of Minnesota.

    Seventy-seven people participated in the double-blind, placebo controlled study. Fifty-eight men and women took 50, 100, or 150 milligrams of naltrexone every day for 18 weeks.

    • Forty percent of the 49 participants who took the drug and completed the study, quit gambling for at least one month.
    • Their urge to gamble also significantly dropped in intensity and frequency.

    The other 19 participants took a placebo. But, only 10.5 percent of those who took the placebo were able to abstain from gambling.

    Study participants were aged 18 to 75 and reported gambling for 6 to 32 hours each week.

    Dosage did not have an impact on the results, naltrexone was generally well tolerated, and men and women reported similar results.

    “This is good news for people who have a gambling problem,” said Jon Grant, M.D., J.D., M.P.H., a University of Minnesota associate professor of psychiatry and principal investigator of the study. “This is the first time people have a proven medication that can help them get their behavior under control.”

    The research is published in the June 2008 issue of the Journal of Clinical Psychiatry.

    Compulsive gamblers are unable to control their behavior, and the habit often becomes a detriment in their lives, Grant said. He estimates between 1 to 3 percent of the population has a gambling problem.

    While the drug is not a cure for gambling, Grant said it offers hope to many who are suffering from addiction. He also said the drug would most likely work best in combination with individual therapy.

    “Medication can be helpful, but people with gambling addiction often have multiple other issues that should be addressed through therapy,” he said.

    See also;

              Counselling for Problem Gambling (Living Therapy)
    by Richard Bryant-Jeffries

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    Posted in Addiction, Alcohol, Alcoholism, Disease of addiction, Gamblers Anon, Loss of control, Research, Stages of Change, Symptoms of addiction and tagged , , , . Use this permalink for a bookmark.

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