Sunday, July 28, 2013

Step Zero

“The only requirement for A.A. membership is a desire to stop drinking" - That's very inviting for those who qualify but what about the millions of people out there who have an alcohol or drug issue of some kind but have little or no current desire to stop? One may reason that it is just too bad for those unfortunate individuals who don't want to stop using and there is nothing anyone can do for them. That may very well be true in some instances, theoretically speaking, as it is extremely difficult to help someone to change who does not want to change.

Realistically speaking, however, if you ask any substance abuse treatment provider which types of situations dominate their treatment programs, they will likely tell you that treatment usually consists of a huge mandated and coerced population. The truth is that a huge proportion of people in substance use treatment often have to stop to avoid consequences (for example, someone on parole who enters a program to avoid returning to prison, or a man who is going to lose his job if he doesn't complete a program because he gave a random dirty urine on the job) Let's not forget the countless adolescents and young people in treatment, most of whom will openly state that the only reason that they are in treatment is to get someone like their parents or probation officer off of their back and the minute that the smoke clears (no pun intended) they intend to go right back to getting high.

When we consider these and other similar examples and look at all of the people who end up in treatment programs who have little or no motivation or desire to stop using other than to avoid consequences, then obvious next question is: Why are so many treatment programs still strictly using 12 step methodology when many people don't even meet the basic minimum requirement for the 12 steps (A desire to stop?)

The reality is that such a huge percentage of people who have substance use issues who are in treatment are actually on Step Zero. This would describe an individual who is clearly not ready for the 12 steps, therefore it does not make sense to try to force an approach on someone who does not meet the basic qualification. Rather an alternative approach and perspective is so desperately needed that starts from the point of building motivation and insight where those qualities may be lacking. Starting at Step Zero is about the critical process of carefully igniting the spark that can light the fire within, needed for positive change


  1. Hi Kenneth I believe we are singing from the same hymn-sheet here. Unless you are an atheist, in which case it's probably Pink Floyd or Radiohead or something. But the general point remains. Good to find you on here buddy, and I hope your blog does well. People need to hear what you have to say.