The Difference Between Addiction Treatment and 12-Step Fellowships

The Difference Between Addiction Treatment and 12-Step Fellowships


Written By: Fiona Stockard

Addiction Treatment and 12-Step Recovery Aren’t the Same Thing

This point can’t be made clear enough! Substance abuse treatment is not the same as attending a 12-step recovery fellowship.

In today’s world, it seems like a lot of people confuse the two. This could be for any number of reasons, not the least of which is the media’s portrayal of rehab and twelve-step groups. The two are often shown interchangeably.

While it’s certainly a fact that treatment and twelve-step recovery go hand-in-hand, they’re not the same thing. While all twelve-step groups offer a way to arrest and treat addiction, all treatment centers don’t subscribe to twelve-step beliefs.

difference between treatment and 12-step recovery

Both rehab and twelve-step recovery are vital parts of long-term sobriety from addiction and unhealthy behavior, but they have some major differences.

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Treatment is a Business & Twelve Step Groups Aren’t

This is probably the largest and most obvious difference. Treatment costs money and twelve-step fellowships don’t. Treatment centers, even non-profit organizations, collect revenue. Twelve-step fellowships, on the other hand, exist only to help the still sick and suffering alcoholic.

But Fiona, you may be saying, treatment centers do help the sick and suffering alcoholic! You’re absolutely right, they do. I don’t want to badmouth rehab at all. It helps A LOT of people, myself included.

Treatment centers provide safety and security for those looking to achieve sobriety. They often provide information about addiction and advocate on behalf of recovering individuals. They also provide jobs for many, both in recovery and nonalcoholics. They do A LOT of good.

Still, people working in treatment get paid. In twelve-step fellowships, no one is getting paid. Yes, a basket is passed around at meetings. Yes, the world service committees do retain money. All of this is completely optional, though. You don’t want to put a dollar in? Don’t worry about it.

There are Many Forms of Treatment & One Form of 12-Step Program

Let’s list the different forms of substance abuse treatment. There’s one-on-one therapy, group therapy, medical detoxes, harm reduction (including opioid replacement therapies), outpatient, intensive outpatient, partial hospitalization, inpatient, long-term inpatient, and therapeutic communities (very long-term inpatient programs).

That’s a lot! Even within each of those types of addiction treatment, there are different modalities, beliefs, medication regiments, etc.

Through its many forms, substance abuse treatment offers a more comprehensive scope of recovery than traditional twelve-step fellowships do.

Now, that isn’t to say 12-step recovery isn’t comprehensive. Through attending meetings, working the steps, and taking others through the steps, people are relieved of the obsession to drug and drink. That’s pretty comprehensive.

Still, treatment centers simply offer more avenues for recovery than twelve-step fellowships do.

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Treatment is Secular & 12-Step Recovery Isn’t

This is another rather obvious difference. Addiction treatment doesn’t require that you believe in any sort of spiritual principals. Twelve-step recovery doesn’t require that either. However, they do strongly suggest it.

If you’re suffering from addiction and want to attend a 100% secular rehab, you can. In fact, many facilities use that as a selling point. They boast their noninvolvement with all forms of religious and spiritual groups.

On the other hand, twelve-step fellowships exist as deeply spiritual vehicles for recovery. It’s important to note here that they’re spiritual, not religious. While there’s certainly some overlap, those two terms have drastically different meanings.

Ultimately, it’s up to the individual to decide whether they want to incorporate spiritual or religious teachings into their personal recovery.

Treatment Offers Therapy & 12-Step Meetings Don’t

I’ve often heard that rehabs have “watered down” twelve-step recovery. While that’s nothing more than hearsay, it does highlight a large difference between the two.

Addiction treatment is, at its center, a therapeutic way of addressing substance abuse. Indeed, addiction treatment and therapy are almost always one-and-the-same. Individuals in treatment are encouraged and required to talk about their feelings, emotions, and inner-lives.

Twelve-step fellowships operate a bit differently. While the twelve-steps can be, and often are, a sort of therapy, they’re fundamentally different from counseling. They exist as a mode of changing thoughts via actions, rather than changing actions via thoughts.

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