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"How Belief Systems Can Undermine Substance Use Treatment Outcomes"

"How Belief Systems Can Undermine Substance Use 
Treatment Outcomes"

Perhaps the abysmal outcomes of dogmatic abstinence-only 12-step treatment programs demonstrates the need for new ideas. At least the DSM reflects the changing landscape of criteria and diagnosis of behavioral healthcare. The Big Book, AA Promises and Traditions have not been significantly altered since 1939.I don't fault AA because it is not treatment. 

AA is a non-professionally run support group of peers--not unlike going to church or temple. For some it has significant purpose and helps them move forward; for others it is a stagnant experience that deters emotional growth, independence and healing.  

If addiction professionals offered diverse treatment choices other than the abstinence-only model, imagine how many more at-risk substance users would feel empowered to seek treatment. Accountability lies with the belief system of the addiction treatment industry. Rather than change despite poor outcomes, AA-Centered treatment has been the only game around. But new healthcare reform law demands
Person-Centered therapy and more. 

Hopefully the industry will prioritize and promote new ideas and more research to attract greater numbers of substance users in need.

The Dogma of Spirituality and Religion Summed Up By AA Founder, Bill Wilson, and then by Chris Rock (Rufus) and Linda Fiorentino (Bethany) in a scene from the brilliant satire, "Dogma."


From the AA Big Book (also referred to as the AA Bible), Holy Roller Bill Wilson writes:

"Rarely have we seen a person fail who has followed our path. Those who do not recover are people who cannot or will not completely give themselves to this simple program, usually men and women who are constitutionally incapable for being honest with themselves. There are such unfortunates."                             

(Big Book. 4th Edition, p. 58.)

"It is an historical fact that practically all groupings of men and women tend to become more dogmatic; their beliefs and practices harden and sometimes freeze. This is a natural and almost inevitable process…."

(The Language of the Heart, Bill W.'s Grapevine Writings, p. 333)

"But dogma also has its liabilities. Simply because we have convictions that work well for us, it becomes very easy to assume that we have all the truth….This isn’t good dogma; it’s very bad dogma." 

(Wilson, 1965/1988, p. 333)

"It could be especially destructive for us of AA to indulge in this sort of thing."

(Wilson, 1965/1988, p. 333)


From the film, "Dogma" written by Ben Affleck and Matt Damon:

Rufus: [God] still digs humanity, but it bothers Him to see the shit that gets carried out in His name - wars, bigotry, televangelism.  But especially the factioning of all the religions.  

He said humanity took a good idea and, like always, built a belief structure on it.

Bethany:  Having beliefs isn't good?

Rufus:  I think it's better to have ideas.  You can change an idea.  Changing a belief is trickier.

The Dangers of dogma as a belief system are comparable to the billion dollar Treatment Programs founded upon belief system in 12-Step Programs.

From the film,