What can I say to my employers who push 12-step methods?

Dear Stanton,

I am a CASAC, that is a Drug and Alcohol Counselor, in the state of NY. I went into this field because I wanted to assist people with many aspects of their lives affected by overusing drugs and alcohol. I don’t believe in a disease of addiction and your site is welcome and refreshing.

My problem is this…my employers are great people, and they care about their patients, but they push 12 steps and meetings relentlessly. I have been honest, and said unless a patient really wants to attend AA I don’t push them. I have quite a caseload of people who don’t want to go to meetings…and I agree with them…I wouldn’t go either.

What can I say to my employers, and to any future employers in this field (or is that business)? I have already explained that I prefer to have my clients develop working on creating other positives in their lives, and making their own choices, rather than being shoved into programs and meetings they don’t like and that I find cult-like.

Thank you,

Joan

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Dear Joan:

You will have to devise your own strategy for this. Actually, it sounds as though you have gotten pretty far, to be even able to have this conversation with your employers. I suspect you have already figured out much of the following:

1. Don’t challenge the validity of their approach.
2. Speak in terms of reaching people who are not currently being reached. (Ask questions like, “In your experience, what percentage of our clients/alcoholics in general respond to AA?” – ask as a genuine question, not a challenge.)
3. Promise that, if alternatives don’t work for a client, you will suggest AA – you can say that, if they prove to themselves that other approaches don’t work, then they’ll see the wisdom of trying the AA way.
4. Gently point out to receptive colleagues/management successes from your approach, and attribute this success to management’s willingness to allow you this freedom.
5. Develop ongoing conversations with your more moderate colleagues – you want them to say something in the future like, “We allow different approaches in our center, because we understand that while AA may be the best approach, not everyone responds to it.” In other words, allow them to develop pride in their openness and the positive clinical consequences of it.

Best,
Stanton