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the chaplain

Great interview about an important topic. Thank you.

efrique

He completely convinced me to be extremely suspicious of even an atheist-oriented 12-step program, by not actually answering the "evidence"-related questions:

The first: One of the criticisms of 12-Step is that so many of its proponents are so resistant to having it rigorously tested, to see how effective it really is. If alcoholism/ drug addiction really is an illness, the argument goes, then any treatment of it should be subjected to the same kind of careful scientific testing that any other medical treatment of any illness gets. Otherwise, you just have a lot of anecdotal evidence, and confirmation bias, and counting the hits while ignoring the misses. But many 12-Step proponents are strongly resistant to this, and carefully- gathered statistics about what percentage of people who go into 12-Step stay clean and sober are lacking. What are your thoughts about that?

Okay. So one more in a similar vein: Another criticism of 12-Step that I've seen a lot in the skeptical community is how resistant so many 12-Step proponents are to the idea that any other treatment might be effective. What are your thoughts about that? Do you think 12-Step is the one best technique for recovery, or do you think different recovery techniques might work for different people?

I mean, he completely talked around those. That really worries me, because either he chose not to answer them or he was unable to see that he didn't answer them.

Seth Manapio

Actually, the evidence is extremely clear and convincing: 12 step programs do not work for the vast majority of people.

That's the truth if you do any research, and look at evidence. 12 step programs suck at helping people get off drugs.

Let me put it this way: its less effective than exercise. And exercise is also free, and you meet better looking people.

Greta Christina
He completely convinced me to be extremely suspicious of even an atheist-oriented 12-step program, by not actually answering the "evidence"-related questions.

I don't think that's fair, efrique. He said he supported research into drugs that would reduce physical cravings for drugs. He said he supports clinical rehabilitation in addition to 12-step. In other words, he said that he thinks 12-step isn't the only answer, and that there should be research into other alternatives.

I think Bucky's approach to 12-step is very down to earth and skeptic- friendly. He doesn't view it as a magic bullet that will fix everything. He views it as generally good advice for everybody, but that alcoholics and addicts need a support structure to follow.

Donna Gore

Hi Greta, there are secular alternatives to the 12 step programs now. SOS (Secular Organizations for Sobriety) is one of them. They are affiliated with the Center for Inquiry West.

You might also be interested to know about the legal challenges to court mandated AA as being unconstitutional. There is a good review of cases in the Duke Law Journal here:

http://www.law.duke.edu/shell/cite.pl?47+Duke+L.+J.+785

the author is Derek Apanovitch.

mathyoo

I'm working a 12 step program for sex addiction, and one of the problems I've seen and heard about from others is that many of the people who go through a 12 step program don't actually work the program. They think that they just need to stop their behavior (get sober) and attend meetings and everything will be fine. Those are the people who ultimately fail in their sobriety because they are not addressing their core issues that led to the addiction(s) in the first place. I do think that they are effective when a person works the steps completely, and especially if they can afford to combine that with individual therapy. At it's core, much of a 12 step program is really cognitive therapy (which I also use, and have found it tremendously effective). The problem is that most addicts don't want to actually do the steps because it brings up a whole lot of very painful stuff, and we become addicts specifically to avoid dealing with that painful stuff.

I'm fortunate in that I'm working through the 12 steps not with the traditional SA group, but with my therapist (who is also a recovering sex addict who's been through all the steps), but I'm doing it completely without any gods being involved.

I have a feeling that the main reason that 12 step groups are resistant to having statistics is that factor of how many people are actually working the steps, vs. how many people just show up at meetings.

Donna Gore

The traditional 12-S sobriety surveys come from the ranks of their own membership, so you have a sample that's biased, to say the least. The number of people who drop out do not get counted. I have read some analyses of shrinks who gave different groups of patients different types of follow up therapies and then compared the rates of recovery, length of sobriety. Cognitive behavioral therapy seemed to fare best, as I recall. The only way anyone could do a truly scientific study on the effectiveness of 12 step groups would be to get the name and contact info of every single person who walked through the door and then check up on them every day for the next year to see who drank and who didn't. And that's impossible because it's supposed to be anonymous! Not to mention the manpower involved in spying on everyone constantly! But come to think of it, it's pretty hard to gauge the effectiveness of any recovery program, because you have to rely on what the subjects SAY. And people who abuse drugs generally are not truthful. They will look you right in the face, smile, and swear they are sober. (I know, I was one of them.)

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