Therapies & Interventions for Addiction: Self-Management Programmes | AQA GCSE Psychology Revision Notes 2019

12-step recovery programmes

12-step recovery programmes involve an individual taking charge of their journey to beating their addiction
The original 12-step programme was devised by Alcoholics Anonymous (AA) as a way for addicts to

share their experiences of addiction
gain strength and support from each other
find hope in what may seem a hopeless situation
help each other recover from alcoholism (these days other addictions are part of the AA ‘family;)

The only requirement for membership in AA is a desire to stop drinking alcohol
The 12 steps are as follows:

Members of AA consider themselves to be lifelong addicts, seeing addiction as a condition that is never really ‘cured’, more that it is held in check by continuing attendance at AA meetings
Everything discussed at an AA meeting is confidential and no surnames are used, to protect AA members’ identities
An AA member who has been in recovery for a year or more can become a sponsor, helping newer members cope with the road to sobriety

Self-help groups consist of a group of people who come together to aid each other’s experience and recovery from a range of issues including addiction
Self-help groups are not led by an ‘expert’ or a professional (as in a therapy session involving a trained therapist); they are run by peers who share a common goal and may have much in common with each other
Examples of self-help groups include:
- Alcoholics Anonymous
- Narcotics Anonymous (drug addiction)
- Gamblers Anonymous
- Overeaters Anonymous
Self-help groups can be selected to suit the individual and their needs e.g. single-sex groups, LGBTQ+ groups, atheist groups
SMART (Self-Management and Recovery Training) do not involve the idea of a higher power; they focus on a more objective approach to recovery
SMART focuses on:
- building and maintaining motivation to quit the addictive behaviour
- how to cope with cravings and urges to return to the addictive behaviour
- managing cognitions around the addictive behaviour e.g. feelings, obsessive thoughts
- how to live a balanced life

Self-management programmes take a holistic approach to treating addiction, with their emphasis on the whole person and how addiction impacts their life and those around them
Self-help programmes remove the burden of guilt from the addict which means that an individual can approach an AA meeting without fearing that they will be judged by others attending

The data on the success rates of 12-step programmes is unclear: there is no statistical evidence that it is more effective than other treatments
Some people may dislike the emphasis on a ‘higher power’ in the AA programme; others may find its approach too dictatorial which means that it does not account for individual differences

Examiners report that students often fall short when writing about therapies and intervention for addiction as follows:

They tend to describe self-management programmes without explaining how they are holistic
They compare the two therapies but not in terms of their reductionist and holistic perspectives
They misunderstand the terms ‘reductionist’ and ’holistic’ (e.g. they think that reductionist means reducing an addictive behaviour)

Here is an example of a question you might be asked on this topic - for AO1 and AO3.

AO1: You need to demonstrate knowledge and understanding of key concepts, ideas, theories and research.

AO3: You need to analyse and evaluate key concepts, ideas, theories and research.

Question: Aversion therapy and self-management programmes are both used as interventions for addiction.

Explain how aversion therapy is used as an intervention for addiction.

Use your knowledge of both the reductionist and the holistic perspectives to compare aversion therapy with self-management programmes. [9]

Model answer:

AO1:

Aversion therapy aims to stop addicts from using the substance by causing them to experience something unpleasant when they carry out the unwanted behaviour e.g. vomiting whenever they drink alcohol.
This use of aversive stimulus results in a link being made between the unwanted behaviour and the unpleasant experience as it is based on the mechanisms of classical conditioning.
Electrical aversion therapy may also be used, particularly with gambling addicts.

AO3:

The reductionist perspective is the idea that a phenomenon such as addiction can only be understood by simplifying it to its most basic constituents.
The holistic perspective is the idea that all the aspects of a phenomenon such as addiction are connected and are only fully able to be understood by looking at the ‘bigger picture’ or referring to the whole.
By itself, aversion therapy is reductionist because it only focuses on changing the link between unwanted behaviour and pleasure.
However if aversion therapy is combined with other treatments or therapies (such as CBT), it becomes more holistic.
Self-management programmes can be viewed as holistic because they help people to work on the ‘bigger picture’ which is achieved by not only dealing with someone’s urge to use a substance but also by addressing other factors that are often linked to addiction, such as environmental or social factors.
Self-management programmes also help people to address events or experiences from their past such as trauma or loss.
Self-management programmes tend to be more holistic than aversion therapy.