Alternatives to AA and Other 12-Step Programs

The National Survey on Drug Use and Health (NSDUH) reports that more than 20 million American adults (aged 12 and older) struggle with a substance use disorder related to drug or alcohol abuse.
Addiction is considered a chronic disease with a high relapse rate of around 40-60 percent, the National Institute on Drug Abuse (NIDA) publishes. Aftercare services and support groups can help to promote sustained abstinence, which has been proven to decrease relapse rates. According to studies published in Psychology Today, individuals who remain abstinent from drugs and alcohol for five years relapse less than 15 percent of the time. Peer support and 12-Step programs can prove critical to that sustained abstinence.

AA and Standard 12-Step Approaches

treatment optionsPerhaps one of the most well-known 12-Step programs is Alcoholics Anonymous (AA). Essentially a support group for individuals in recovery from alcoholism, AA helps individuals to connect with others who also struggle with addiction to form a network of peers working toward the same goal: sustained sobriety in recovery. Individuals are able to work together to achieve this common goal and support each other through potential stressors, therefore helping to reduce episodes of relapse. It can be highly beneficial to have someone to lean on who has already been through there, who can offer insight, hope, and strength.
AA is based on the 12-Step doctrine that asks members to admit their lack of control over alcohol.  In order to recover, individuals are asked to turn themselves over to a higher power and find a spiritual awakening. While this concept may be very helpful for many people, for others, the spiritual aspect of AA may not ideal. Even though AA is not based on a specific religion, the 12-Step model does have religious, or at least spiritual, undertones.
Several alternatives to AA exist that are more secular in nature. These alternatives to traditional 12-Step programs generally ask individuals to find motivation within themselves and to learn internal control instead of seeking an external source of power. Alternatives to 12-Step programs also tend to evolve with new research, and they may be more flexible in their approaches than AA and other 12-Step groups.

Alternative groups still rely on peer support and provide tools for minimizing relapse. Most of these programs are free to join, with the only requirement being that individuals struggling with addiction wish to achieve and maintain abstinence. Some common alternatives to 12-Step programs include:

  • Self-Management and Recovery Training (SMART) Recovery
  • Women for Sobriety
  • Secular Organizations for Sobriety (S.O.S.)
  • LifeRing Secular Recovery
  • Moderation Management

A nonprofit organization that cultivates self-empowerment over addiction and addictive behaviors, SMART Recovery is a self-help support group for individuals who wish to remain abstinent from drugs and alcohol and/or other problem behaviors or activities. Offering face-to-face meetings with peers as well as daily online meetings, a chat room that runs 24/7, and an online message board, SMART Recovery is a research-based program that provides tools to help individuals change negative and defeating thoughts in order to enhance recovery from addiction. SMART Recovery follows a 4-Point Program. The four program points are:

  1. Obtaining and maintaining motivation
  2. Learning to manage urges
  3. Handling emotions, thoughts, and behaviors
  4. Finding and striking balance in life

With a variety of tools and homework exercises to help members work through these four points, SMART Recovery helps individuals to find the motivation within themselves to illicit and maintain positive change and therefore long-term sobriety. Face-to-face SMART Recovery meetings typically follow the same format worldwide in an effort to maintain consistency throughout the program. Meetings usually last about 1.5 hours and are run by a trained facilitator. Anyone who struggles with any kind of addiction is free to attend a SMART Recovery meeting.

Meetings typically begin with an introduction and check-in period where members can help to set the agenda for that day based on any pressing issues. If there aren’t any specific topics that come up during check-in, the facilitator will likely have a prepared topic to discuss and work through with the group. The bulk of the meeting is taken up by the working time, where the group works through one of the four program points, using some of the program’s provided tools and techniques. There is usually a donation plate passed around at some point, as the groups are self-sustaining and require donations to function. Meetings close with a closing dialogue to ensure all participants feel heard and understood.

Homework may be assigned between meetings, and there may be a social hour after the formal meeting concludes for individuals to get to know each other better. Meetings are kept confidential and provide a great space for people to share their experiences and gain support from peers in similar situations. Anyone can drop in to a meeting at any time. The SMART Recovery website provides tools to help people find local meetings.

The first self-help program to provide support strictly for women suffering from alcohol addiction nationwide, Women for Sobriety (WFS) is a nonprofit organization that was founded in 1976. Based on 13 acceptance statements that focus on positivity, responsibility for oneself, and emotional growth, the Women for Sobriety “New Life” Program helps women to positively change negative thought and behavior patterns in order to establish a healthier and happier life in recovery. The WFS doctrine postulates that a person’s actions directly follow their thoughts, and that by changing the thoughts for the better, the resulting behaviors can be changed. WFS encourages women to take control of their own thoughts, and therefore their actions, and learn not only to love themselves, but also to exercise self-control and potentially experience spiritual growth as well.

Women are encouraged to follow the program by consciously subscribing to the 13 statements each day. Members are asked to spend time each morning upon waking, and each night before bed, thinking through each statement, how it can be used, and its positive effects. WFS also uses meditation, healthy eating strategies, and other holistic healing forms to promote recovery as well. Meetings are run by a moderator who likely has been sober for a long time, and groups are usually 6-10 women. Meetings last about 90 minutes once a week, and new members are given literature at their first meeting. Beyond that, women are asked to have their own Program Booklet, to join the WFS online community, and to read the founder Dr. Jean Kirkpatrick’s book Turnabout: New Hope for the Woman Alcoholic.

At each meeting, women are asked to introduce themselves and give themselves a “stroke,” which is to say something positive about themselves. Membership is kept confidential, so women can share in private and with security. Discussions center around WFS literature. Meetings are closed by joining hands and reciting the WFS motto of competency, strength, and group support. For more information or to find a local meeting, contact WFS.


A secular addiction recovery support organization that is also a nonprofit with no ties to any outside organization, S.O.S. is open to anyone who wishes to be free from drug and alcohol abuse. The only requirement of members is continued abstinence. Membership is confidential and free, although donations are requested in order to keep the groups running, as no outside funding is permissible.

As an alternative to 12-Step programs, S.O.S. prides itself on being its own entity and not deriving from another secular or religious program. S.O.S. continues to evolve with new research and does not subscribe to any one theory surrounding addiction. Individuals are encouraged to use rational thought and take responsibility for themselves and their actions.

A typically S.O.S. meeting starts with announcements and the celebration of sobriety anniversaries. The bulk of the time is spent on discussion and group interactions. A collection plate will be passed around for donations at some point.

Sobriety, responsibility, and confidentiality are the overarching themes of S.O.S. Members work together as a group to hold each other accountable and improve their own quality of life through sustained sobriety enhanced by peer support. There are meetings around the world, and individuals can find one nearby by accessing the links on the S.O.S. “Find a Meeting” page.


LifeRing Secular Recovery

getting help from friendsBy believing that each individual has the power to control their addiction within them, and that each person battling addiction is made up of two people, the “Addict Self” and the “Sober Self,” LifeRing focuses on helping individuals to weaken the former by strengthening the latter. Unlike 12-Step programs, LifeRing does not rely on a higher power, sponsors, or certain steps to attain sobriety, but instead asks individuals to find strength and self-control within themselves. LifeRing is there to provide support as individuals find their own way to sustained sobriety and their own path in recovery. With face-to-face meetings and online support through a comprehensive online community, LifeRing is an international nonprofit organization.

Individuals can join a group and attend face-to-face meetings, or connect confidentially with a member via email through a service called ePals where questions can be answered, and a private a one-on-one dialogue can be opened up. The focus of a LifeRing meeting is on the present, and the past is meant to be left behind.

Meetings are generally about an hour and facilitated by a “convener” who keeps people on topic and lets the conversation flow informally throughout the time. Meetings are kept positive and encouraging, with members asking and answering questions, and offering advice and support. Meetings are free to attend and donations are requested but not required. Attendance is kept confidential.

Some meetings are considered “Study Meetings” where individuals work through the Recovery by Choice workbook together in the group. To find a local LifeRing meeting, individuals can use the tools on the “Find a Meeting” page.
Moderation Management

While almost all recovery support groups require complete abstinence as a condition of membership or even meeting attendance, Moderation Management (MM) is different. The National Institute on Alcoholism and Alcohol Abuse (NIAAA) reports that in 2013, more than 70 percent of Americans aged 18 and older drank alcohol and only about 7 percent of the population suffered from an alcohol use disorder. Many people can safely drink alcohol and not engage in problematic behaviors or suffer from addiction. MM is a program designed to target problem drinking early on and invites individuals who see alcohol becoming an issue in their lives to join. MM seeks to change risky drinking habits and problematic behaviors surrounding alcohol abuse by promoting a healthy lifestyle and more responsible habits, and not necessarily through complete abstinence.

MM doctrine states that alcohol abuse is a choice and a habit that can be changed with brief intervention strategies. MM allows its members to choose – alcohol in moderation or abstinence. That being said, MM reports that about 30 percent of its members do choose to continue on to abstinence-based programs.

Moderation Management asks its members to go through nine steps focused on taking responsibility for one’s actions, recognizing harmful drinking patterns, and addressing problem drinking. The second step asks members to remain sober for a full month. If after that point members can drink responsibly, and in moderation, that is allowable. If not, they should continue to remain abstinent and may continue with the MM program or move to an abstinent-only type group.

While members of MM are allowed to continue to drink, there are basic guidelines set forth by MM on this. They include: set drinking limits, don’t drink every day, have other interests and hobbies that do not include drinking, obey laws surrounding drinking and driving, do not put yourself in risky or dangerous situations when drinking, and keep blood alcohol concentration (BAC) below moderate drinking levels (around 0.055 percent). MM holds that alcohol may be a part of a person’s life without being the center of it.

MM meetings focus around finding balance in life and changing negative behavior patterns into healthier and more positive ones. This approach is enhanced by group and peer support and weekly in-person discussions.

MM may ask for donations at meetings to keep groups active. Information on finding a meeting can be found at their site.

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