Alternatives to a twelve step treatment programme

non 12 step treatments


For whatever reason, some clients do not want to engage in a twelve step treatment model when they enter into treatment: This is their choice and, while the majority of centres use a traditional twelve step approach, there are those centres that offer an alternative. That is not to say that a twelve step approach has not help hundreds of thousands of people to overcome addiction and is ineffective, just (as with anything thing in life)people have choice: especially if someone is paying for it!

STRENGTH is a eight stage approach to drug and alcohol rehab treatment. It is done, alongside medically assisted withdrawal (where necessary) as soon as someone is physically able to participate. It is a general philosophy, quite rightly, that clients take control, ownership, of their recovery so it is important that a client engages in a treatment model that they feel will benefit them and one they feel  comfortable in.

The Strength model follows a eight stage approach. It is a systemic model where clients are able to map their progress from stage one: onwards. This has been shown to be important in the early stages of recovery as goals and recovery targets need to be bite size and achievable, in addition to being measurable.

Clients move on from one module to the next, once they have successfully completed it. Within each module are a number of worksheets to complete. Whilst it is a systemic model, it can be flexible.

The strength model follows what are known as core principles. These underpin the therapy model and process. The first core principle is that, when a client seeks treatment, it is an indication that their denial and rejection of acceptance of help has dropped to a level where therapy will assist them.

To recognise that someone is in denial is to recognise that denial is a defence against anxiety and also an expression of shame as it relates to the condition of addiction. The Strength model holds that recovery necessitates that a client feels enough hope and power to be able to take change on board: to embrace it and all it brings. This mode of treatment also holds that a client brings their own strengths and assets when entering treatment. This is known as recovery capital.  In order to deliver and measure outcomes, treatment goals, activities are broken down so that they can be small enough for a client to achieve, that outcomes are measurable and that also they are achievable. Overarching this, targets need to be realistic.

When a client enters into a STRENGTH model of therapy, there are some important milestones. The first of these is the clients life story. As this is the first stage of the STRENGTH programme it is designed to help a client to centre themselves. Often described as a road map, it can also be described as a “you are here” in their life and also in the environment. This document of also allowing peers, in treatment, to understand that person. As with the traditional twelve step model, this life story is read out during a group. Clearly, for some clients, it can be very challenging to read out: It can dredge up a lot of difficult and painful memories. However, as difficult as reading this out may be (and difficult for the audience to hear) it is vital to the client’s recovery and starts the “opening up” process. The second element is known as “addiction and me”. This works from the premise that those in addiction actually grieve the loss of their dependency, that this is normal and part of the recovery process. The STRENGTH model works from the premises that, at times, the addiction would have served the person well. The purpose of this module is to assist the client to track their past, the consequences of addiction and then to come to understand themselves better. This is done so that a client can then make positive choices and more informed decisions: moving forward.

Central to the STRENGTH model is where a client identifies their individual strengths. The thinking behind this is that, those in addiction, often experience very low self esteem and poor self worth. This module assists the client in moving away from this cluster of negative thinking and it’s consequences. It also demonstrates how, by embracing change, utilising their identified strengths, positive change can occur.

Addicts can often identify with the feeling that they are trapped or move in ever decreasing circles. It is these feelings that this module is designed to tackle. Using the SMART approach, a client can initiate making changes that are positive, using the skills of the therapy staff and the support of the other clients.

By clients going through the goal setting worksheets, it is anticipated that certain emotional issues (and potential blocks to recovery) will have been brought to the fore. The daily process groups will, by their very nature, also highlight certain areas of difficulty. Often, issues of fear will surface, which can be hinder a clients progression if not tackled.

Other therapy models sometimes foster a belief that clients do not need to address past behaviours. These past behaviours would also have had consequences, some of which may have been well meant, but can do the client a great disservice. Such an approach can foster a way of thinking where clients can be left thinking that “it was not your fault.” This can be seen to be unrealistic as a lot of clients think, constantly, about their past actions. A large number of addicts exist in a world of shame, guilt and anger, fear and remorse. The STRENGTH model believes that these emotions are a driving force behind active addiction.

The STRENGTH model works towards preparing clients for the future: post discharge. Within this philosophy there is a belief that, for a clients future, two rules should be kept in mind, firstly, that admitting you have an addiction, coming into treatment and having to acknowledge mistakes should not be all encompassing. In other words: do not let it kill you. It is important to be kind to one’s self , to allow sufficient time to rest and to allow space and time to reflect. Also, that it is very important not to set unrealistic targets, not to set unachievable goals and not to have unrealistic expectations. The final element is that clients are encouraged, when they leave treatment, to “start from where they find themselves” This means that not everything in a clients life needs to be changed. Sometimes very little actually needs attention.

A very important element, and one which can often be ignored by clients is that of how to ensure sobriety/abstinence is maintained (relapse prevention). This module is, clearly, something that gives the client ongoing work and is aimed at reflecting the maintenance stage. As with admission to hospital for surgery, it forms part of discharge planning. To simply present this element to a client on the last day would not assist. It is essential that clients become aware of the concept and practice of relapse prevention while they still have the support and structure of the support systems in a treatment centre.

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