Non-12-Step Rehabs for Addiction Treatment

From the well-known recovery program of Alcoholics Anonymous, the 12 steps focus on self-awareness, community support, and individual spirituality to help people with the desire to stop using alcohol or drugs. 12-step fellowships have free support groups all over the world, and many treatment centers use the 12-step model in their programs.

But, the 12 steps aren’t the only path to recovery, and there are plenty of non-12-step treatment options.

Some people want a treatment center that focuses on underlying causes of addiction—like mental illness or behavioral disorders. You may be interested in spiritual wellness, but equally want to focus on your mind and body in a holistic rehab. The open-ended spirituality in 12-step programs may make people of particular religious faiths feel uncomfortable, so there are faith-based treatment centers. And, although the 12-steps are in no way religious, spirituality in general may deter some atheists and agnostics.

The right addiction treatment center is the one where an individual feels safe, comfortable, and willing to listen to suggestions. There's no need to put off treatment if you or your loved one is resistant to the 12 steps.

What Happens in a Non-12-Step Rehab?

Just like 12-step treatment centers, non-12-step rehabs focus on helping addicts and alcoholics stay sober by giving them a set of useful tools. For this reason, many of the core components are the same.

There are both inpatient and outpatient options for non-12-step treatment. Depending on an individual's needs, medical detoxification may be necessary to safely remove all alcohol and drugs from the body. The facility will do an intake assessment, with physical exams and a medical history report. Using this information, the facility will create an individualized treatment plan.

Addiction treatment offers resources that can’t be found on one’s own. Some recovering people need medication for cravings, withdrawal symptoms, stabilization, as well as co-occurring mental illnesses or behavioral disorders. Treatment also provides intensive addiction therapy with licensed professionals. Emotional wounds may play a part in addiction, or occur in the wake of an addiction. Therapy sessions seek to process these difficult feelings and teach healthy coping mechanisms.

Although non-12-step treatment centers do not adhere to the Alcoholics Anonymous program, clients can still experience a community of support. Most facilities provide opportunities for clients to go to non-12-step support groups and recovery meetings.

How is Non-12-Step Treatment Different?

Though many treatment centers adopt the 12-step recovery model, it isn’t right for everyone. Here are some differences between 12-step and non-12-step treatment:

Support Groups

12-step support groups include Alcoholics Anonymous, Narcotics Anonymous, Cocaine Anonymous, and many more. Some groups are geared towards behavioral addictions, like Gamblers Anonymous and Sex Addicts Anonymous. A few of the popular non-12-step support groups are SMART Recovery, Women for Sobriety, SOS (Save Our Selves), and Lifelong Secular Recovery.

Therapy Structure

Though both kinds of treatment involve group therapy, 12-step treatment tends to have more group therapy while non-12-step focuses more on individual counseling.

Language of Addiction

The philosophy of 12 step programs labels addiction as a “disease” and describes addiction as “powerlessness,” Most non-12-step programs avoid these labels.

Reliance & Empowerment

12-step programs teach reliance upon a higher power of one’s own choosing. Non-12-step programs tend to focus on self-empowerment as a recovery tool.

Overcoming Addictive Behaviors

In a 12-step program, addicts and alcoholics surrender their will to their higher power, to guide them in their recovery. Non-12-step programs focus on coping strategies and relapse prevention

Cognitive-Behavioral Therapy

Most treatment centers—both 12-step and non-12-step—use cognitive-behavioral therapy (CBT) to change unhealthy thought patterns and behaviors that lead to substance abuse. 12-step treatment centers teach CBT coping skills alongside a reliance upon a higher power. Non-12-step facilities focus largely on CBT strategies:

• Learning healthier behaviors, to cope with powerful emotions and relapse triggers
• Managing drug and alcohol cravings
• Substituting negative though patterns with positive self-talk
• Finding healthy outlets in sobriety
• Building strong relationships and a support network

What if a Loved One is Resistant to Treatment?

When a loved one is resistant to treatment for their drug or alcohol problem, it can be both terrifying and frustrating. Try talking to your loved one, expressing your concerns about their addiction alongside how much they mean to you.

If your loved one has rejected or become resistant to 12-step programs in the past, let them know about non-12-step treatment options. If they’re skeptical, you can show them the program differences listed above.

If a loved one is resistant because they are in denial about their substance abuse problem, it may be time to stage a professional intervention. It’s difficult to reason with a loved one in the midst of addiction, but even more difficult to watch as their problems progress.

Do You Need Inpatient or Outpatient Treatment?

There are non-12-step inpatient rehabs, where you or your loved one will live at the facility. Inpatient treatment offers round-the-clock care from the treatment staff, as well as a safe environment that’s separated from possible relapse triggers at home. An inpatient stay can range from 30 to 90 days.

There are also non-12-step options for outpatient treatment. Clients attend scheduled therapy sessions and groups, but have the freedom to carry on with their daily lives. For the best chances of long-term recovery, most people enroll in outpatient treatment after they’ve completed an inpatient stay. However, if you or your loved one are unable to attend inpatient treatment because of family, work, or money constraints, outpatient treatment can still help.

The Cost of Treatment

Addiction treatment can be costly, but it doesn’t have to stop you from seeking the help you need. Most insurance companies will help with the cost of treatment services, treatment centers accept a variety of insurance policies, and some facilities even offer financial packages based on need.

Is Non-12-Step Treatment Better or Worse Than 12-Step Treatment?

The 12 steps of AA have become an accepted and trusted framework for recovery because they’ve helped millions of people worldwide. Because 12-step programs are not religious, they've become safe places for a variety of people with open-ended spiritual beliefs. The program and its meetings are free and wide-spread—making AA a readily accessible resource. These communities tend to be very supportive and tight-knit.

The philosophies at non-12-step treatment centers will be more varied, but they still provide clients with tools for staying sober and access to support groups. There will be differences in the quality of care among different treatment centers, but there’s no way to say whether 12-step or non-12-step treatment is better or worse. No matter which treatment philosophy you choose, it's important to do your research before selecting a facility.

Why People Look for Non-12-Step Treatment, and Questions to Ask

The reasons people give tend to fall into three groups. Some reject the idea of powerlessness at the center of the first step and want a program that treats them as capable of directing their own change. Some do not want a higher power in their recovery, or want to keep their spiritual life separate from their treatment. And some simply cannot give the time: a 12-step-oriented program can expect daily meetings, step work, and service on top of treatment, and for people with jobs and families that is the deciding factor. None of these is a wrong reason, and none means 12-step programs are bad; it means fit matters.

What a non-12-step facility offers is mostly the same as any other: medical detox where needed, individual and group counseling, and life skills work. Two differences tend to stand out. Individual counseling gets more weight, which suits people who are uncomfortable sharing in groups or worried about privacy because of their profession. And peer support comes through groups such as SMART Recovery, which runs free in-person and online meetings around its 4-Point Program of building motivation, coping with urges, managing thoughts, feelings, and behaviors, and living a balanced life, and states that participants can combine it with therapy, medication, or other groups.

Questions to ask before you choose:

• What structure does treatment follow day to day, and how much of it is individual versus group?
• Does the program treat addiction as a disease, and does that framing matter to you?
• Are the therapies evidence-based, such as cognitive behavioral therapy, motivational interviewing, and contingency management?
• Does the program support medication for opioid or alcohol use disorder?
• What peer support groups are available, and what does aftercare look like?