All posts by Dr. Natha

Differences between 12-Step and 12-Step Alternative Programs

A 12-step alternative program utilizes methods to treatment that differ significantly from the 12-step approach in a few fundamental areas. The philosophy of the 12-step approach is that an individual is powerless over their addiction and encourages surrendering. The 12-step also encourages one to identify as an addict or alcoholic. The 12-step alternative takes an empowerment approach where the individual is self-directing their recovery in initiating healthy choices and learning tools. By empowerment, it means people can learn to manage their substance use and addiction over time through psychological therapies and medical interventions.  Alternative programs discourage labeling oneself, but rather recognizes that the individual suffers or struggles with addiction as a mental health issue.

A 12-step alternative approach includes recovery methods that incorporate relapses as a learning experience within the recovery process. This approach accepts that relapse is part of the recovery process for the majority of individuals struggling with addiction. In other words, the program does not require complete abstinence immediately but rather helps the individual come to this decision on their own through approaches such as motivational enhancement therapy, relapse prevention techniques, cognitive behavioral therapies, moderation techniques, rational emotive behavior therapy, and other approaches. Overtime, sobriety is extended as the individual begins to learn tools and gains confidence in their ability to manage their addiction. Smart Recovery meetings are generally used as an aftercare tool, which continue to remind individuals to utilize tools that have been researched.  Many alternative programs create a individualized plan or approach and recognize that there is not a standard protocol that works for all.  The AA model utilizes the Big Book, which goes over a sequence of the well known 12 steps each person in recovery must follow. AA meetings are used as an aftercare resource since these are readily available in the community in many rural and urban areas.

The 12-step alternative programs generally incorporate individual and group therapy that is provided by mental health practitioners. Groups include tools based off of psychological therapies and principles that have been researched. There are additional services that may be included such as continued medical assistance and monitoring. The 12-step programs utilize AA meetings as a primary tool in aiding individuals in becoming sober. It utilizes chips to mark sobriety and has individuals who have attained long-term sobriety pair up and assist newer members.

Spirituality and religion are not the foundation of 12-step alternative programs, though it may be incorporated through their individual therapy if this is an area that is important to the individual. AA model was initially founded with a religious affiliation and over time the language has been amended to use words such as spirituality or God in order to generalize to different religious backgrounds and faiths.

In the end, it is a matter of choice and preference. Individuals who have been unsuccessful with 12-step programs or found that they do not connect with 12-step philosophy may benefit from considering alternative approaches. Those who have co-occurring mental health issues such as anxiety, trauma, or depression could also benefit from an alternative approach since this usually incorporates some form of individual counseling by licensed mental health professionals to address underlying issues, which may affect a person’s ability to recover or could be exacerbating the addiction issues.

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Ways To Deliver Psychological Services

Ways To Deliver Psychological Services

  • Face-to-Face: This is most traditional method that psychological services are delivered.  The client and therapist meet in person in an office setting.  The therapeutic relationship between the therapist and client is created in person.  Many individuals prefer this type of a connection with their therapist.
  • Videoconference/Online Therapy: With increasing use of technology in most areas of life today, the mental health field has also moved toward expanding services through the use of technology.  Using technology to deliver mental health services has been referred to as telehealth or telepsychology. This allows for all individuals in the community to have access to mental health services if there are barriers to attaining treatment due to their location, time-limitations, or other barriers that prevent individuals from physically coming in to meet with a therapist.  Online therapy has become increasingly more common due to the ease and practical nature of receiving services.
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Cognitive Behavioral Therapy


The main theoretical orientation utilized within our practice is cognitive behavioral therapy (CBT). This form of therapy has received wide acceptance by the mental health community due to the scientifically validated nature of the treatment process for anxiety, depression, addiction, and many other concerns. The premise of CBT is that our thoughts, behaviors, and emotions are all connected and have a relationship with one another. Understanding the relationship between these three elements can help alleviate symptoms of different mental health concerns.

CBT focuses on helping the client become effective in learning ways to manage their own symptoms through teaching concrete skills as well as uncovering existing “schemas” that have developed through different early experiences that may be contributing to current difficulties you are facing. The therapist typically takes an active approach and works alongside the client to help achieve specific goals in treatment. Helping you recognize and get to the root causes and connections of any destructive patterns that exist can help reduce any distorted perceptions that may be exacerbating the level of depression, anxiety, anger, hopelessness, or other feelings you may be experiencing. Depending on your individual concerns, we provide more intensive work that goes into different parts of your life and/or more skill oriented therapy if management is your primary goal. The practice integrates other approaches as necessary depending on your individual concerns.

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What Can I Expect From Therapy?

There are many misconceptions regarding what therapy truly consists of, who is likely to attend therapy, and what happens in the course of therapy. Therapy is a process, in which we create a meaningful and deep therapeutic connection to help you better understand your thoughts, feelings and behaviors.  Basic goals of therapy are to increase awareness about yourself and your past to better help you in the present and future.  Therapy can have very specific concrete goals that are short-term in nature or more long-term goals that will require more in-depth work.  Many times people believe that going to therapy means you must have severe mental health concerns. Therapy can be utilized for treatment and management of specific mental health issues (such as depression, addiction, trauma, or anxiety). Although this is one area in which therapy is beneficial, it is common to enter therapy for multiple other reasons.   Individuals can seek therapy for more common life difficulties that most all humans experience at one time or another such as stress, family conflict, marital conflict, or death or loss of a loved one.  Other times therapy is used as a protective measure to enhance existing relationships, or simply to gain a better understanding of yourself.  Utilizing therapy means you are turning to a healthy coping resource as opposed to denial of these difficulties, which can often worsen the problem. Everyone can use a helping hand from time to time. Some periods of life call for more support than others. It takes strength to acknowledge the need for therapy.

You are likely to experience a wide range of emotions throughout your sessions, at times positive and other times negative. It can be anxiety provoking to take the first step and start therapy. It’s normal to have this experience.  However, most of the time once contact is made most individuals begin to feel very comfortable.  Therapy gains and benefits are largely due to factors such as client’s willingness to work in therapy and the quality of alliance formed between the client and therapist. Therefore, it is essential both the therapist and client feel as though they are a good fit for each other in order to benefit from the therapeutic process.

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