Why Should I pay for Addiction Therapy When AA Is Free?

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Who can resist saving a buck -- especially when the price difference is hundreds, if not thousands of dollars? Here’s some info to help you decide.

Isn’t AA really just therapy by another name?

If you want to spark an argument, get an Alcoholics Anonymous cheerleader to comment on the value of therapy. If they’ve been successful with AA, the quick response is, “You don’t need it.”

And honestly, they might be right. Some do remain abstinent with AA alone. For a long time, it was the only really focused way to confront alcoholism directly. But that time has passed. We aren’t in the 1930s or 40s anymore.

The major difference between AA and therapy is that AA is a self-help organization. Members are expected to follow a standardized recipe, the 12 steps, with the encouragement and guidance of other members. The other members, by definition, are also alcoholics (some groups allow drug users as well). This isn’t all bad. There’s great power in hearing others’ experiences, and there is a shared bond. But, as much as group support is valued, it’s still self-help.

A good analogy

There are as many support groups available as there are serious life issues. We find them for cancer survivors, parents who have lost children and veterans. All consist of those with shared experiences telling their stories and encouraging others. But just as the cancer survivor needed a doctor to treat the disease, so too does an alcoholic benefit from professional advice and care.

AA can and does provide support. But there are no psychologists or psychiatrists involved. These professionals have trained in the latest addiction treatment techniques and are able to offer specific, targeted advice and even medications. This isn’t something available from a book published 50 years ago.

Why the fight?

Therapists usually do not think of AA as competition. Rather, they often recommend it as an extension of treatment. They believe AA has therapeutic value and can help reinforce what the professional offers. Some AA proponents, however, react badly to the idea of formal treatment for alcoholism, either because they personally had a bad experience or because of the use of medications by medical personnel.

AA’s position on drugs is mentioned in their pamphlet, The AA Member – Medications and Other Drugs:

”Experience suggests that while some prescribed medications may be safe for most non-alcoholics when taken according to a doctor’s instructions, it is possible that they may affect the alcoholic in a different way. It is often true these substances create dependence as devastating as dependence on alcohol.”

That isn’t a rousing endorsement. Through the carefully worded text (it doesn’t actually say, “No prescriptions”) you get a sense of distrust and fear. Perhaps it’s a worry about staying relevant, perhaps it’s just a restatement of the credo, “This is what works for us.”

Apples and oranges

Professional addiction and alcoholism therapy takes into consideration the person seeing the therapist as an individual with unique needs, concerns and relationships. Therapists may delve into other conditions, like depression or anxiety, when they feel there is an impact on drinking. AA is a “one size fits all” opportunity. When there is a good fit, good things result. When the fit isn’t quite as good, the results reflect that as well.

The two options are not equivalent, and considering cost alone is a mistake. Because AA is free to attend, there is no reason not to see what a meeting is like or reading the literature. However, understand that self-help may not be enough help.

To read what a nationally certified addiction specialist has to say on this issue, check out a short blog by Dr. Alicen.

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