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Residential Rehab Needs a Real BioPsychoSpiritual Approach: 12 Steps Not Enough

 

Prior to 1949, addicts received residential care, supervision, and structure in jail or custodial asylums, often with minimal dignity and simplistic treatment until the Hazelden (Minnesota Model) opened, ushering a new era of addiction treatment. Their curriculum consisted of daily 12-Step lectures.

The 12 Steps were established in 1938 in Ohio by Bill Watson and Dr. Bob Smith to guide the first AA meeting as its purpose was to help alcoholics connect to the God of the Bible, then navigate stepping stones leading to sobriety, a spiritual awakening, and ultimately a transformed life. But according to their own 12 Traditions (principles and guidelines for AA), Tradition 8 states:

“AA should remain forever nonprofessional. We define professionalism as the occupation of counseling alcoholics for fees or hire. But our usual A.A. 12-Step work is never to be paid for.”

The 12-Step Program was designed to be a layperson led outpatient community support and encouragement group and was never designed or intended to be the primary intensive in-depth treatment curriculum of an inpatient or residential program. But having no other curriculum options, the Hazelden/Minnesota Model grabbed the 12 Steps program.

Addiction Knowledge Increases, But Treatment Falls Behind

Since Hazelden experienced success, when compared to asylums and jail, all subsequent addiction treatment lazily copied Hazelden using the 12 Steps as the core curriculum. Over the last 65 years, as our addiction understanding exponentially increased, sadly, that knowledge hasn’t been brought into addiction treatment methods and core curriculum. In fact, instead of building on the 12 Steps for stronger and deeper programming, the power of the 12 steps has actually been weakened by going politically correct, pushing God out by replacing God with “Higher Power” or “god as we know him.” Predictably, treatment success, after that initial improvement in the 50s, has stagnated, then actually worsened, as insurances realize current superficial treatment using misapplied 12 Steps curriculum is often a waste of money and as a result, refuses to pay for it.

Fueling this failing addiction model is the simplistic disease model developed in the 50s and used by most treaters. In its drilled-down form, it reduces addiction to a biochemical problem, minimizes the psychological and spiritual components, avoids the personal responsibility and decision-making aspect, and believes “once an addict, always an addict.” With this model, full healing is impossible and behavioral management through watered down 12 Steps, facilitated by ex-addicts with minimal psychological or spiritual integration training, is why recovery rates have stagnated for decades.

So why does almost every treatment program still use the 12-Step Model when it was not designed for intensive residential care? Curriculum change takes effort, a thorough understanding of addictions, clinical expertise of the staff, and a psychologically sound faith-based BioPsychoSpiritual approach. Let me explain.

Real Addiction Treatment Gets to the Root Cause

Most facilities believe addictions are the primary problem, but they never are. Addictions are always the result of a person having some inner stress, hurt, issue, or wound they can’t heal or fix, so they use the addiction object (substance) or behavior (process – think porn, gambling, eating, work) to achieve some relief or escape. In short, to bring some comfort or a temporary “cure,” which is where “self-medicating” comes from.

These underlying issues are the reasons why an addict mistakenly believes their addiction object has a reasonable purpose and provides adequate relief and continues to use it. The addiction is a maladaptive coping mechanism to manage their internal struggles. When internal struggles are healed and/or better coping mechanisms are learned, practiced, believed in, and confidently used, the addiction has no purpose and provides no advantageous relief.

Process addictions reveal this understanding so clearly. Since no biological substance is in play, realizing psychological and spiritual spheres are what’s broken and need attention is so much easier to see. Eating disorders are both a substance (food) and process (many behaviors around eating, weight, and body image management) addiction. Eating disorder treatment abandoned the 12 Steps as a core curriculum and moved to programming that uncovers wounds, hurts, and distorted thinking, teaches new PsychoSpiritual skills, and uses trained therapists. This approach is significantly more successful.

PsychoSpiritual Approach for Lasting Transformation and Freedom

Successful addiction treatment goes much deeper than 12 Steps (which is a great layperson led support group curriculum for many). Where addiction treatment needs to focus is recognizing addiction is not the primary disorder, then emphasizing the need to uncover, process, and heal the internal wounds. This essential firm foundation for sobriety and transformation can be built by using skilled therapists that guide a patient’s psychological exploration of the why’s, how’s, and distorted thinking of their addiction. 12 Steps doesn’t go this deep.

But most importantly, combining this psychological equipping with the divine power of God through Jesus, then teaching the life management principles of The Holy B.I.B.L.E. (Best Instruction Book for Living Everyday) is what brings light, truth, and healing into those core wounds and baggage that generate addiction decisions. Facilities providing this combination are not just managing, but really healing the addiction so addicts will truly be free from the bondage of addiction, achieve their God-given potential, and live the abundant life full of peace Jesus offers all of us.

John 10:10 “The thief comes to steal, kill, and destroy, but I came that you might have abundant (full and satisfying) life.”

Isaiah 61:1 “He will heal the brokenhearted and set the captives free.”

by HIS grace,

Karl Benzio, MD

Founder and Clinical Director, Lighthouse Network


“Karl-BenzioDr. Karl Benzio is a Christian psychiatrist, writer, speaker, blogger, and frequent media guest expert. He started Lighthouse Network, which helps people navigate life’s storms and find healing. Lighthouse Network has great relationships with many Christian and secular treatment options around the country and, as your advocate and guide, can quicken and ease the process of getting to your best treatment option.

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