I have recently gotten my alcohol counseling certificate. It was a dificult task, because the places where I worked all endorsed the 12-step model, which I wasn't comfortable with. Where can I go to practice the way I choose, which is more based on a cognitive-behavioral-experiential model, like the one you outline?

Anne:

That's a good question. I really can't tell you any part of the country where you can expect to find widespread use of an alternative model to the 12 steps. In fact, in private treatment centers around the country — and most public treatment programs — the 12 steps remain the principal way of practicing.

The main exceptions to this rule are in public health agencies dealing with drug users in major cities, including New York and San Francisco, where harm reduction has become accepted. Harm reduction embraces the idea of "meeting clients where they are at," and of allowing them to make progress at their own speed, without rejecting those who are not able to abstain.

In nearly alcohol and private treatment programs, you may find greater lattitude today as far as allowing you to introduce some methods that differ from those of the traditional treatment. But this woud not be official policy, and you would probably be largely on your own. You need to have a strong constitution and belief in what you do for this.

Good luck,

Stanton

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