The Atlantic takes a turn at criticizing the approach drug and alcohol counseling of Alcoholics Anonymous
Last week I wrote about a Salon.com piece on drug and alcohol counseling and the ineffectiveness of AA (the article cited a 5-10% effectiveness rate for AA drug and alcohol counseling). This week the Atlantic weighs in with its own critique of the drug and alcohol counseling near-monopoly.
AA’s one-size fits all approach to drug and alcohol counseling
With greater depth than the Salon piece, the Atlantic criticizes the one-size-fits all approach of the AA model of drug and alcohol counseling, citing as well the “irrationality” of the 12-step approach and similar empirics demonstrating the ineffectiveness of AA as a model for drug and alcohol treatment.
Most concerning to me is the experience the Atlantic describes that I experience daily in conversations with therapy patients around the topic of drug and alcohol treatment in my NYC therapy office: Too many people believe AA is the only model for getting treatment for problematic drug and alcohol use. In this sense, the claim of a monopoly is effectively valid. There are other approaches and models of drug and alcohol treatment and failing to provide a real sense of options to a patient looking for help with drugs and alcohol violates the principle of informed consent, the idea that those seeking therapy be treated with a full understanding of the options available.
We need to support people’s choices for counseling, not demean them
Still, as I said in my previous article in response to the Salon piece, there’s an arrogant spitefulness in a blunt condemnation of AA and those who make use of it as part of their drug and alcohol treatment. The vitriol (which–I get it–is part of the internet these days) suggests that consumers of therapy and drug and alcohol treatment are too stupid to know any better. Similar claims have been thrown at Freudian psychoanalysis, a modality of treatment/ psychotherapy that I think is similarly worthy of critique.
But that character of the criticism of these therapies is what’s most concerning to me. For one, as I describe here in reference to this too true Onion article on the limits of psychology, it’s unclear to me that we truly know as much as we think we do, from a so-called scientific perspective, what constitutes “validity.” Further, I’m concerned about any institution (so-called scientific psychology) that purports to universally know more than ordinary people who are seeking help from therapy about what is and isn’t helpful to them. Is there a need for more informed consent in therapy, in the form of a better array of the options for treatment? Absolutely. Is there a need for therapy patients to be empowered to challenge the authority of their therapists’ expertise? You bet. I’m just not sure science and academic snobbery condemning the choices of people who are struggling with very real challenges such as drugs and alcohol is helping.