Differences Between Na And Cbt

[sgunn65]

I have read (and participated) in many of the debates about the 12 step model as opposed to the Social Learning/CBT Model and before I am shot down in flames let me say clearly that if it works for you, fine. I am not out to attack someones method of getting, and remaining, clean.

However I do think that CBT offers something extra. Unfortunately because the NA model is free and CBT is not there will never be a level playing field to compare. But this is not about that. It is great that there is free treatment available, I just wish it were possible for a network of CBT meetings to be made freely available.

You might find the following interesting (or be ready to abuse me ):

The choice is yours, the outcome is yours, the power is yours to decide.

12-Step Programmes: Disease based model

Social Learning/Cognitive Behavioural Therapy

Labels you an addict for life, beaten by addictions, no self control, needing lifetime membership

VS

Optimistic outlook, you CAN become a new and better person

Empowering you to transform your perception of addiction

Culture of fear of failure and certainty of failure if you do not attend

VS

Culture of confidence in an individual's ability to succeed

If progress is not made, client is forced to repeat the same 12 steps over and over...

"Insanity: doing the same thing over and over again and expecting different results."

--Albert Einstein

"If you do what you've always done, you'll get what you've always got"

VS

Using evidence based tools

Learning how to find new tools to apply differently in each new situation

Supporting lifelong positive growth through continued learning

Focused only on addictions

VS

Provides a broad spectrum of life tools

Uses cognitive therapy

Originally based on a Christian/Religious approach. Nowadays more emphasis on spirituality

VS

Common sense based approach applicable for everyone

Lifetime attendance required

VS

Producing quick results

Focuses on programmes for a singular drug or type of addiction, such as cocaine, alcohol, gambling

VS

Covers any addiction, overlapping addictions and conditions

Addresses underlying erroneous thinking and poor life skills

One problem, one solution one approach

VS

Holistic approach, mind and body, nutrition, exercise, recreation, communication, relaxation, school/work life, social life/skills

Testimonial based

VS

Research based

The differences between Disease model and Social Learning Model

Morals Based 12-Step Programmes

Cognitive / Problem Based Therapy (these are not steps)

1 We admitted we were powerless over alcohol - that our lives had become unmanageable.

Since you chose to drink or use drugs you can chose not to, therefore, you are in control and powerful.

2 Came to believe that a power greater than ourselves could restore us to sanity.

Problem focused strategies are used in cognitive therapies to help the individual transform their perception of the problem.

3 Made a decision to turn our will and our lives over to the care of God as we understood Him.

We choose to take control of our lives. This includes choosing not to use.

4 Made a searching and fearless moral inventory of ourselves.

Problem focused strategies help you to identify a specific problem(s).

5 Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.

You identify the responses that you typically used to reduce distress in the situation such as drinking.

6 Were entirely ready to have God remove all these defects of character.

You are encouraged to evaluate your typical responses for their effectiveness, lack of effectiveness, and cost, such as wife leaving me because I drink.

7 Humbly asked Him to remove our shortcomings.

You then develop alternative responses or other ways that you can handle the situation in a more effective and positive way.

8 Made a list of all persons we had harmed, and became willing to make amends to them all.

You make conscious choices about how you choose to respond to stressful situations.

9 Made direct amends to such people wherever possible, except when to do so would injure them or others.

You develop the cognitive skills needed to deal with social pressures, interpersonal conflict, and negative emotions.

10 Continued to take personal inventory and when we were wrong, promptly admitted it.

This leads to you developing a greater sense of control and empowerment, which serve to enhance self-esteem, and wellbeing.

11 Sought though 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.

Cognitive therapy is very effective at treating clients who also suffer from depression, anxiety, or other mental health issues.

12 Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics and to practice these principles in all our affairs.

Once the techniques taught in cognitive therapy are mastered, you can apply them to any area of your life where you experience distress

I am off to hide under the nearest rock!!!

Edited April 7, 2008 by sgunn65

[Sheryl]

I haven't had any exposure to NA specifically but unless it is quite different from other 12 step programs, then I think some of your statements about it may be incorrect.

More importanly, tho, I think this is a false dichotomy. Plenty of people in 12 step programs also receivev CBT -- at the same time -- and find they benefit from it without any conflict withy the 12 step approach and vice versa. It's not an either-or situation. The two approaches work differently and address different, but complementary, needs.

CBT, like other individual therapies, helps illuminate individual patterns of behavior and thought which are unproductive and increase the person's awareness of same as well as understanding of how their own personal history and conditioning has affected them. 12 step programs on the other hand provide more in the way of community and spiritual/ moral support, and help put the individual and their problems into a larger context.

I'm a little doubtful that anyone truly addicted could achieve permanent sobriety through CBT alone but if someone can, that's great. Certainly CBT can help develop insight into negative thoughts and behavior patterns which have contributed to the development of addiction. It would therefore be a shame if people choosing a 12 step approach were to think that this means they cannot also be in therapy, CBT or other, because the 2 approraches are somehow opposed to each other. They go at the problem from different angkles but they aren't in opposition and people do not need to chhose one vs the other.

[garro]

Can this method not stand on its own value without the need to try and debunk another method which is already proven to work? Perhaps if you put more effort into describing what is on offer with this method and leave off criticising other methods it would seem more reputable. I did not use a 12 step system to get sober but my method was not in competition with AA either.

Cognitive therapies are nothing new. I remember seeing them at work in the 1990s through the Alcohol Recovery Project in London. My experience was that these had poor outcomes. Maybe your method has more to offer. If it can work for somebody then that is good. It has just been my experience, and it is good to remember, that their are plenty of people out there trying to make money off the back of the addict. It is a big business. So of course there is resentment against free treatments like AA.

If you are going to mention research it might be helpful if you reference this with some studies. Research in the recovery field is notoriously bad and not very reliable.

[sgunn65]

I don't feel I am debunking or rubbishing alternatives rather looking at the differences. CBT can work in conjunction with NA as long as you understand that they start from a completely different perspective.

There are some aspects of the 12 step programme that are similar to CBT and I am more than happy to recognise this.

Whatever works works. And I love the idea of free treatment being available as I understand that many addicts cannot afford treatment and many countries do not offer free treatment.

I am one of the people "making money off the backs of addicts" and do not apologise for it. I have to eat too. However very few people in the substance use world make big money, in fact most workers are on quite poor wages but do it because they feel they are doing something worthwhile. After 15 years in this field I still wake up in the mornings excited by the day ahead and the rewards I get are not financial given that, for the same amount of studying I could have been a lawyer !!!

CBT has developed enormously and offers very good results especially in shorter programmes. Given that in the UK the emphasis is on shorter programmes there are now many more day programmes and residentials offering this kind of treatment.

To each their own and may all who seek treatment find the programme that is right for them and succeed. If you believe you can, or if you believe you're right; you are.

[Chris Lawrence]

Why pay the big bucks for CBT when you can get something for free.

If you need therapy, I would suggest get along to a 12 step fellowship don't take everything as gospel but listen to how people struggled. Some people will still be struggling but only they know there own struggle as most cant work out what the <deleted> they are talking about. But then again some people are sicker than others. Dont be too judgmental, don't look to hard for the differences, try and understand what is being said.

Then again some people may not need a 12 step fellowship. Shop around for a good person that listens. There are a lot of wanke_rs out there that say they will offer you a service but cant back up their words. If you find this wanke_r move on. They are not worth any money and can cause more damage. Shop around. I have been doing drug and alcohol work for some 15 years. I don't recommend a particular course of therapy but would be more inclined to recommend a certain practitioner.

I just know that the people I saw, at the end of one of their many roads, they didn't have the money to pay someone for this very expensive work. Usually what I saw was they were not ready for that in depth therapy for about 2-4 years.

People with a D&A problem want a quick fix; therefore if someone say's they can fix you in six weeks, I would tend to move onto some one that is very honest with you. But this could scare you more?

CBT is a very good form of therapy. There are others out there that will give similar results. I suggest shop around, but if your are at the stage where you got no options then the one that costs nothing may work.

Just my thoughts for what they are worth