Any social worker employed in the field of substance abuse is
familiar with the Twelve Steps of Alcoholics Anonymous. There
is a logical sequence to the Steps from Step One through Step
Twelve. The Steps culminate with Step Twelve: "Having
had a spiritual awakening as the result of these steps, we
tried to carry this message to alcoholics, and to practice
these principles in all our affairs."
In other words,
recovering alcoholics lend a helping hand to the alcoholics
who are still drinking. The goal is to lead the sick and
suffering alcoholic to a sober and meaningful life. It is
often referred to as doing a Twelfth Step, or,
Twelve Stepping someone. The A.A. fellowship was
founded on this concept. The recovering alcoholic selfishly
stays sober by unselfishly reaching out to those still trapped
in the insanity of alcohol dependence. So far, so good.
Now, should a
career in addiction counselling be considered a valid way to
work through Step Twelve? And, is addiction counselling an
arena in which recovering patients can legitimately work
through any Step? If these questions are not answered
correctly, then it is possible that the recovery of both the
counsellor and his patients could be negatively affected.
Let's turn to
one of the original resources, Twelve Steps and Twelve
Traditions, a standard publication of the Alcoholics
Anonymous World Services since 1952. Let's read the first
paragraph on page 106.
of living is the theme of A.A.'s Twelfth Step, and action is
its key word. Here we turn outward toward our fellow
alcoholics who are still in distress. Here we experience the
kind of giving that asks no rewards. Here we begin to
practice all Twelve Steps of the program in our daily lives so
that we and those about us may find emotional sobriety. When
the Twelfth Step is seen in its full implication, it is really
talking about the kind of love that has no price tag on
[End of quote.]
Twice in the
same paragraph it is mentioned that Twelve Step work should
not involve payment: "the kind of giving that asks no
rewards," and "the kind of love that has no price
tag." This would seem to rule out getting a paycheck as
a counsellor. That is, if the counselling job is being used
as a background for Twelfth Stepping. This means that Twelfth
Step work and a career in counselling are not identical.
Let's move on
to the second question. Even though the answer to the first
question voids the necessity of asking the second question,
the answer is nevertheless professionally significant. Are
the helping professions an arena in which Twelfth Step work
can be done? For example, there are numerous inpatient
rehabilitation facilities in which patients are expected to
work through all twelve Steps.
Can the Twelve
Steps be mandated or enforced? Does this not become almost
fanatic, or sort of like a state religion? If the Twelve
Steps are removed from the context of the A.A./N.A.
fellowships, does it not counteract the relationship of love
between the recovering alcoholic and the sick alcoholic? Can
the Steps be effective when transposed to a treatment facility?
Counsellors and A.A. sponsors are not identical. Treatment
facilities and A.A. meetings provide different structures and
produce a different kind of relationship.
seem to blur the boundaries between their own recovery needs
and their professional responsibilities. They seem to promote
client Twelve Step work as a totalitarian substitution for a
genuine treatment plan. They use a quasi-Twelfth Step as a
personal crutch to hold them up when among other professionals
or para-professionals who indeed have a strong career footing
in which the Twelve Steps is only a part of the larger whole.
This is not to
say that the Twelve Steps should be omitted from the treatment
plan. Teaching and discussing the terminology involved is an
essential part of good counselling. Patients need to have an
understanding of terms such as, powerless, Power greater
than ourselves, sanity, defects of character, and so on.
A good counsellor can compliment and supplement the work that
a patient is doing in the A.A./N.A. fellowships.
professionals are capable of understanding the Twelve Steps.
They are capable of applying the Twelve Steps to their
personal lives for personal reasons, since the Steps seem
adaptable to a number of emotional problems. Twelfth Stepping
is not solely a matter of ability, it is a matter of context
The trust a
patient places in the counsellor lends itself to discussion
of Step work, perhaps more in a manner of explanation,
clarification, and review. A beginner who has just worked Step
One with his sponsor, for example, may also gain therapeutic
benefit by reviewing this process in the counselling session.
But the actual Step work should take place within the A.A./N.A.
fellowships and between the sponsor and the sponsee.
Sobriety is not
the only consequence of working the Twelve Steps. An equally
important result is the continuation of the A.A./N.A.
fellowship itself. Counselling alone can be ineffective in
getting alcoholics sobered up. The A.A./N.A. fellowship must
continue from generation to generation, and counsellors need
to support the A.A./N.A. principles while maintaining
appropriate professional boundaries. (Written 05/19/03 -
Revised 12/01/03: bibliography available.)
Until we meet