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Essay, Pages: 3, Psychology

DBs Unit 4

DBs Unit 4

DB 4.1: Self-Help Groups and Moderated Drinking – A Balanced Perspective

Two recovery programs, Moderation Management (MM) and Rational Recovery (RR), are alcohol programs that do not support the completely dry notion of recovery. However, there are notable cons to this approach. First, since MM and RR are not based on the concept of abstinence, those who are vulnerable to relapse may well struggle to regulate their drinking, and their addictive behaviors go into cycles of reduction and relapse (Guenzel & McChargue, 2023). Second, traditional perspectives on addiction, such as the disease model, suggest that addiction is a chronic condition requiring abstinence for long-term recovery. Non-abstinence groups may downplay addiction’s severity, potentially misleading individuals about their recovery needs (Lamb & Kougiali, 2024). Third, patients with severe addiction need a clear ban on the use of substances that may lead to relapse. Such services as MM are loosely defined to provide the required structure of care for individuals with higher dependency, which may result in poor results of the program.

Fourth, moderation programs rely heavily on self-monitoring, which can be challenging for individuals with addiction. This focus on moderation may unintentionally place undue pressure on participants to exercise self-control, potentially exacerbating feelings of failure when lapses occur (Kelly et al., 2024). Lastly, traditional abstinence programs, such as AA, foster community support through shared experiences in total sobriety. In contrast, MM and RR may lack this collective focus, potentially reducing the emotional support critical to long-term recovery (Eddie et al., 2022).

These cons demonstrate that moderated drinking models are not easy and should not be tried by anyone, but particularly severe addicts.

References

Eddie, D., Bergman, B. G., Hoffman, L. A., & Kelly, J. F. (2022). Abstinence versus moderation recovery pathways following resolution of a substance use problem: Prevalence, predictors, and relationship to psychosocial well‐being in a U.S. national sample. Alcoholism: Clinical and Experimental Research, 46(2). https://doi.org/10.1111/acer.14765

Guenzel, N., & McChargue, D. (2023, December 8). Addiction Relapse Prevention. Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK551500/

Kelly, J. F., Levy, S., & Matlack, M. (2024). A systematic qualitative study investigating why individuals attend, and what they like, dislike and find most helpful about, smart recovery, alcoholics anonymous, both, or neither. Journal of Substance Use and Addiction Treatment, 161(65), 209337–209337. https://doi.org/10.1016/j.josat.2024.209337

Lamb, R., & Kougiali, Z. G. (2024). Women and shame: Narratives of recovery from alcohol dependence. Psychology & Health, 23(47), 1–38. https://doi.org/10.1080/08870446.2024.2352191

DB 4.2: Secular and Traditional Recovery Models – A Comparative Analysis

The Secular Organization for Sobriety (SOS) and the Women for Sobriety (WFS) are two other organizations that provide more secular alternatives or empowerment-oriented approaches to the traditional 12-step programs of AA. These secular groups are very different in both philosophy and approach from one another; thus, they provide different recovery landscapes for those who may not find themselves identified with the spiritual or religious underpinnings of AA (Yeung, 2021). On the other hand, SOS was started as a secular organization; it removes all religious and spiritual contexts and inspires recovery through personal empowerment and the use of secular approaches. (Davis, 2024) This is an extreme comparison to how AA approaches “surrender” to a higher power, which is believed to be associated with recovery from addiction. Modifications in the program of WFS appeal particularly to women’s needs, perhaps because of gender-specific problems that ladies may experience in recovery from addiction. WFS puts great emphasis on self-esteem and affirmation, encouraging participants to develop self-worth and resilience.

In addition to this philosophical level, these secular groups also tend to contrast with clinical treatment in some relatively fundamental ways. Whereas clinical treatments might include professional resources and might even venture into diagnosing and treating psychological afflictions at their roots, SOS and WFS are essentially peer-driven. Indeed, such a peer-based approach might be attractive for individuals seeking a somewhat more relatable, communal process; however, it might be bereft of the expert care that a clinical setting would afford (Schuman-Olivier et al., 2020).

Moreover, promoters of AA will always object to such secular options as SOS and WFS due to their diversified look at the disease concept of addiction. Whereas AA describes addiction through the “powerlessness” over alcohol, SOS and WFS concentrate their attention on their autonomy and deny any inherent “powerlessness.” In the end, secular recovery groups like SOS and WFS are enlightening options apart from more traditional 12-step models; they give a chance to provide services for people who do not feel comfortable with spiritual or religious contexts within addiction recovery (Young & Wagner, 2020).

References

Davis, M. T. (2024). Religious and non-religious components in substance abuse treatment: A comparative analysis of faith-based and secular interventions. Journal of Social Work, 14(3), 243–259. https://doi.org/10.1177/1468017313476589

Schuman-Olivier, Z., Trombka, M., Lovas, D. A., Brewer, J. A., Vago, D. R., Gawande, R., Dunne, J. P., Lazar, S. W., Loucks, E. B., & Fulwiler, C. (2020). Mindfulness and behavior change. Harvard Review of Psychiatry, 28(6), 371–394. https://doi.org/10.1097/HRP.0000000000000277

Yeung, J. W. K. (2021). Faith-based intervention, change of religiosity, and abstinence of substance addicts. Brazilian Journal of Psychiatry, 44(1). https://doi.org/10.1590/1516-4446-2020-1576

Young, M., & Wagner, A. (2020). Medical ethics. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK535361/

DB 4.3: Moderation Management Versus Abstinence-Only Models in Recovery

Moderation Management (MM) offers a distinct alternative to abstinence-only models like AA by focusing on controlled drinking as a goal for individuals with lower levels of alcohol dependency. This group has drawn to it individuals for whom lifetime abstinence feels unrealistic and who wish to follow a pathway to recovery with more leeway. Unique advantages and challenges in both MM and abstinence-only models underpin the heterogeneity in addiction treatment.

A principal difference between MM and abstinence-only approaches is in their essential objective. MM allows members to set a goal of moderated drinking; this approach is designed for individuals with low to moderate levels of alcohol dependence. In sharp contrast, AA states that abstinence is the safest and surest goal, particularly for those who have been diagnosed as alcohol dependent (Eddie et al., 2022). The MM approach also reflects a belief in behavior modification, holding that individuals are capable of controlling their drinking through the use of self-management techniques. In contrast, AA, along with its affiliated 12-step programs, subscribe to a spiritual philosophy of surrender and the acknowledgment of “powerlessness” over alcohol as fundamental to permanent change and recovery from addiction to alcohol (Nieto et al., 2021).

Despite these differences, MM and abstinence-only models do share certain areas of consensus. Both models recognize that those at the far end of the continuum toward alcohol dependence are likely to find that abstinence is the preferable alternative since controlled drinking is not a viable result. In addition, both programs reference the benefit of support systems, even as they differ in the structure and theoretical underpinning for such support (Paquette et al., 2022).

Research suggests that programs such as MM are of growing interest to younger, less addicted drinkers. The majority of this age group also favors accommodation models that can accommodate moderate drinking rather than zero consumption, demonstrating greater public tolerance for non-abstinence treatment models, too (National Cancer Institute, 2021). Overall, MM represents an important option for non-addicted drinkers; for the most severely addicted drinkers, however, abstinence is generally the better option, highlighting the need for more varied and flexible routes of treatment.

References

Eddie, D., Bergman, B. G., Hoffman, L. A., & Kelly, J. F. (2022). Abstinence versus moderation recovery pathways following resolution of a substance use problem: Prevalence, predictors, and relationship to psychosocial well‐being in a U.S. national sample. Alcoholism: Clinical and Experimental Research, 46(2). https://doi.org/10.1111/acer.14765

National Cancer Institute. (2021, July 14). Alcohol and cancer risk. National Cancer Institute; Cancer.gov. https://www.cancer.gov/about-cancer/causes-prevention/risk/alcohol/alcohol-fact-sheet

Nieto, S. J., Grodin, E. N., Aguirre, C. G., Izquierdo, A., & Ray, L. A. (2021). Translational opportunities in animal and human models to study alcohol use disorder. Translational Psychiatry, 11(1). https://doi.org/10.1038/s41398-021-01615-0

Paquette, C. E., Daughters, S. B., & Witkiewitz, K. (2022). Expanding the continuum of substance use disorder treatment: Nonabstinence approaches. Clinical Psychology Review, 91(91), 102110. https://doi.org/10.1016/j.cpr.2021.102110

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Question 

DB 4.1

  • In thinking about the concepts of Rational Recovery and Moderation Management and other self-help groups that condone moderated drinking, what are your general impressions of a self-help groups which do not promote total abstinence and what you have learned about the disease of addiction? Please discuss at least 5 “pros or cons” of these self-help groups in detail.

NOTE: You must make at least 1 substantial posting and 2 substantial replies to this thread. You must participate in the Unit discussion board (making postings/replies) at least 3 days per unit to qualify for full credit and also have at least 1 posting by Wednesday at midnight. You also must use APA style in your posting and replies so please use in-text references and provide a reference to give proper credit to the authors.

DB 4.2

  • In treating addictions such as cocaine, group therapy is one of the key parts of the treatment process. Traditional supporters of Alcoholics Anonymous and Narcotics Anonymous do not support the ideas of the Secular Organization for Sobriety or Women for Sobriety. How do these groups differ from clinical treatment groups specifically? Why might the ideas of Women for Sobriety or Secular Organization for Sobriety also be viewed as different from traditional 12 step models? Please be sure to explain your reasoning and use examples.

NOTE: You must make at least 1 substantial posting and 2 substantial replies to this thread. You must participate in the Unit discussion board (making postings/replies) at least 3 days per unit to qualify for full credit and also have at least 1 posting by Wednesday at midnight. You also must use APA style in your posting and replies so please use in-text references and provide a reference to give proper credit to the authors.

DBs Unit 4

DBs Unit 4

DB 4.3

NOTE: You must make at least 1 substantial posting and 2 substantial replies to this thread. You must participate in the Unit discussion board (making postings/replies) at least 3 days per unit to qualify for full credit and also have at least 1 posting by Wednesday at midnight. You also must use APA style in your posting and replies so please use in-text references and provide a reference to give proper credit to the authors.

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