Understanding and Implementing the 12 Steps into Your Program: Court Accountability and Spiritual Development 2010 Drug, DUI, and Mental Health Court Conference Atlanta GA Bob King, MSW, LCSW Dawson County Treatment Court
A Blend In Dawson County s Treatment Court Program we blend court accountability, clinical treatment, and 12 step recovery support (through mandated meetings) to promote long term recovery outcomes (not just abstinence). The story of Misty P
Blending 12 Step & Clinical Treatment Professionals need to understand the 12-steps of AA and AA members need to understand what professional counseling are all about, because it is the interaction between these two programs that brings about the powerful result of recovery. Terence Gorski
Why Bother? Old playgrounds Old playmates Lifestyle Change Breaking through Cognitive Defense Mechanisms (Denial) Defense mechanism that people survive by using so we must replace with coping skills We won t be there forever Long-term recovery support
Is AA the only way? Absolutely not! Faith-based support groups such as Celebrate Recovery Secular Organization for Sobriety Rational Recovery Church/Religion External Support System needs to be developed
Then why AA/NA? Prevalence Number of available groups Availability of clubhouse settings Process Addiction affects thinking and actions, 12-step focuses on action which changes thinking over time 12-step is a blueprint for a selfless vs. selfish lifestyle (regardless of the saying it s a selfish program applies to the first year of recovery. You must have recovery to give it away)
Spirituality outside of Religion Attitudes Spiritual in nature. Foster what is the creative purpose of my life vs self centeredness and loss of potential. Beliefs Religious beliefs Personal beliefs esteem issues, Self Efficacy Scale scores Core beliefs about life Value System Morality set as chosen by the person Effects Attitude/Belief sets Enhances or detracts from recovery
12 Steps 1. We admitted we were powerless over alcohol - that our lives had become unmanageable. 2. Came to believe that a power greater than ourselves could restore us to sanity. 3. Made a decision to turn our will and our lives over to the care of God as we understood Him. 4. Made a searching and fearless moral inventory of ourselves. 5. Admitted to God, to ourselves, and to another human being the exact nature of our wrongs. 6. Were entirely ready to have God remove all these defects of character.
12 Steps 7. Humbly asked Him to remove our shortcomings. 8. Made a list of all persons we had harmed, and became willing to make amends to them all. 9. Made direct amends to such people wherever possible, except when to do so would injure them or others. 10. Continued to take personal inventory and when we were wrong, promptly admitted it. 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. 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. (REPEAT)
How many times is Alcohol Exactly ONE TIME mentioned? Steps are about lifestyle change that supports recovery Steps are also about giving to others instead of keeping your recovery (once achieved) to yourself. Principle of step 12 is service. Selfish?
Lifestyle Change 1 & 2 Reflection 3 Decision 4 thru 11 Action 12 True Faith 1 thru 9 Process of Recovery ( The Promises which are read at meetings is hidden in the Big Book after Step 9) 10 thru 12 Daily Maintenance After looking at my past in Steps 4-9, I have looked at The Victim part of me. After that, I m no longer a victim but a volunteer
So, why do some established groups struggle with court mandated programs? Relations With Outside Agencies The Fellowship has adopted a policy of cooperation but not affiliation with other organizations concerned with the problem of alcoholism. We have no opinion on issues outside A.A. and neither endorse nor oppose any causes. from A.A. at a Glance Each group should be autonomous except in matters affecting other groups or A.A. as a whole. 4 th Tradition
12 Traditions 1. Our common welfare should come first; personal recovery depends upon A.A. unity. 2. For our group purpose there is but one ultimate authority - a loving God as He may express Himself in our group conscience. Our leaders are but trusted servants; they do not govern. 3. The only requirement for A.A. membership is a desire to stop drinking. 4. Each group should be autonomous except in matters affecting other groups or A.A. as a whole. 5. Each group has but one primary purpose - to carry its message to the alcoholic who still suffers. 6. An A.A. group ought never endorse, finance or lend the A.A. name to any related facility or outside enterprise, lest problems of money, property and prestige divert us from our primary purpose.
12 Traditions 7. Every A.A. group ought to be fully self-supporting, declining outside contributions. 8. Alcoholics Anonymous should remain forever non-professional, but our service centers may employ special workers. 9. A.A., as such, ought never be organized; but we may create service boards or committees directly responsible to those they serve. 10. Alcoholics Anonymous has no opinion on outside issues; hence the A.A. name ought never be drawn into public controversy. 11. Our public relations policy is based on attraction rather than promotion; we need always maintain personal anonymity at the level of press, radio and films. 12. Anonymity is the spiritual foundation of all our traditions, ever reminding us to place principles before personalities.
Implementing 12 Steps into your program enhancing recovery, a supplement to AA/NA Step Work 1 st Step Phase 1 Using the Steps in Treatment 2 nd & 3 rd Step Phase 1 (1&2 are reflection, 3 a decision) Phase 2 (notice no Step Work) 4 th & 5 th Step Phase 3 (clinical) 6 th & 7 th Step Phase 3 8 th & 9 th Step Phase 4 (starting volunteer projects) 1 thru 9 process of recovery (Promises) 10 th -12 th Step Phase 5 Daily Maintenance Volunteer projects and a group project
Principles behind the Steps Step 1: Honesty After many years of denial, recovery can begin when with one simple admission of being powerless over alcohol -- for alcoholics and their friends and family. Step 2: Hope It seems to be a spiritual truth, that before a higher power can begin to operate, you must first believe that it can. Step 3: Surrender/Faith A lifetime of self-will run riot can come to a screeching halt, and change forever, by making a simple decision to turn it all over to a higher power. Step 4: Courage/Soul Searching There is a saying in the 12-step programs that recovery is a process, not an event. The same can be said for this step -- more will surely be revealed. (Moral inventory but focus is on immoral Step 5: Integrity Probably the most difficult of all the steps to face, Step 5 is also the one that provides the greatest opportunity for growth. Step 6: Willingness/Acceptance The key to Step 6 is acceptance -- accepting character defects exactly as they are and becoming entirely willing to let them go. If prayer worked to relieve the obsessive thought to drink it will work on defects also
Principles behind the Steps Step 7: Humility The spiritual focus of Step 7 is humility, asking a higher power to do something that cannot be done by self-will or mere determination. Random acts of kindness Step 8: Justice/Brotherly Love Making a list of those harmed before coming into recovery may sound simple. Becoming willing to actually make those amends is the difficult part. Step 9: Discipline/Forgiveness Making amends may seem like a bitter pill to swallow, but for those serious about recovery it can be great medicine for the spirit and soul. Purpose NOT to say I m sorry but a commitment to act differently in recovery Step 10: Perseverance/Maintenance Nobody likes to admit to being wrong. But it is absolutely necessary to maintain spiritual progress in recovery. Step 11: Awareness The purpose of Step 11 is to discover the plan God as you understand Him has for your life. Step 12: Love & Service For those in recovery programs, practicing Step 12 is simply "how it works." Loss of personal will vs alignment of will
Verification of Meeting Attendance Problems Falsification of documents Sheets must be signed by someone whose signature is verifiable Autonomy of Groups in AA/NA means that some groups may choose NOT to sign them Lack of details on specific meetings can lead to problems in verification
Last Presentation-Verification of Meeting Attendance Solutions Develop detailed sign-in form Include date, time, meeting name Choose a designated signer for your documents; i.e. only meeting chairperson or meeting secretary Include brief description by participant of meeting topic and what they learned Develop your own meetings in-house Allows you to have a sign-in attendance sheet Supervision can be done by staff Supervision can be done by senior participants or alumni
This year s CONTROVERSY Mandating meetings: Church & State. To better understand what we are mandating let s look at the early history of AA. We use AA because it is the mother of all 12 step programs. Some of the original members of AA belonged to the Oxford group (also known as a First Century Christian Fellowship). The following quote (p. 39)and an outstanding history of AA can be found in AA Comes of Age: Early AA got its ideas of self examination, acknowledgement of character defects, restitution for harm done, and working with others straight from the Oxford groups (Bill W)
AA s Transformation The first 100 realized AA needed to be inclusive, not exclusive, so they moved from Christian roots to a more generic approach leading to the phrase a Higher Power of your own understanding. This is credited to an agnostic Jimmy Burwell, and is illustrated in depth in Chapter 4 of the Big Book, titled We Agnostics
Spirituality Yes, Religion No As Bill Sees It (p. 95) When the Big Book was being planned, some members thought that it ought to be Christian in the doctrinal sense. Others had no objection to the use of the word God, but wanted to avoid doctrinal issues. Spirituality yes, religion no. Still others wanted a psychological book, to lure the alcoholic in. Once in, he could take God or leave Him alone, as he wished. To the rest of us this was shocking, but happily we listened. Our group conscience was at work to construct the most acceptable and effective book possible. Every voice was playing its appointed part. Our atheists and agnostics widened our gateway so that all who suffer might pass through, regardless of their belief or lack of belief.
The Problem & Solution as defined in AA AA s definition of the alcoholic, suggested solution, and it s rigorous plan of action states you may be suffering from an illness that only a spiritual solution can conquer Big Book p. 44 We think it is no concern of ours what religious bodies our members identify themselves with as individuals. This should be entirely a personal; affair p.28 Heal the spirit, the mind and body will follow
A New Paradigm Removing the symptom The outside fix and other behaviors Fixing the hole in the soul to combat the disease of MORE! Through adaptation of 12 new principles the shift from self-centeredness and the ensuing loss of potential to service to others
Spiritual Kindergarten We are only operating a spiritual kindergarten in which people are enabled to get over drinking and find the grace to go on living to better effect. Each man s theology has to be his own quest, his own affair. (As Bill Sees It p. 95)
Truth Truth is easily observed in the results. As early AA folks stated if you are not sure go out and try controlled drinking. If you want our results you need to do what we did. As a truth that AA works beyond religious affiliation let s look at a research study published in the Journal of Addictive Diseases. The population in question were substance abusers of the Jewish faith. By far the recovery ratings showed 12 step support as the most helpful to long term recovery in a group of seven modes of recovery. (The mean length of recovery in this study was 9.2 years) This is demonstrated on the following graph:
Ratings of Recovery Modes for Chemical Dependency 350 300 250 200 150 Very Helpful Somewhat Helpful Not Helpful 100 50 0 AA/NA/CA Short-term Long-term Outpatient Psychotherapy Rabbinical Other
Summary Mandating participants to 12 step Recovery meetings is the right thing to do for long term recovery results, developing a support network that will be in place post graduation. From the AA perspective, spirituality yes, religion no
Fatally Progressive We all understand the the disease of addiction is a fatal progression, no one shows up in the revolving door doing better. Recovery is also progressive!!!!
DISCUSSION
Suggested Reading: Alcoholics Anonymous 3 rd edition, Alcoholics Anonymous World Services Inc, N.Y. N.Y. 1976 12 Steps & 12 Traditions, Anonymous World Services Inc, N.Y. N.Y. 1992 Understanding the 12-Steps: A Guide for Counselors, Therapists, and Recovering People, Terence Gorski, Independence Press Independence MO 1989 Characteristics of a Population of Chemically Dependent Jewish Men and Women Journal of Addictive Diseases, Vol. 20 (4) Hawthorne press 2001 PP 71-89 Internet The Oxford Group Connection Submitted by Bill C. www.winternet.com/~terrym/oxford jimmy B.- The Agnostic and Author of the Vicious Cycle www./barefootsworld.net/aaburwell