CBT vs 12-step Programmes: Is CBT as Effective as 12-Step Programmes for Addiction Treatment?

Embarking on the road to addiction recovery can be a daunting task. Two prominent approaches, CBT (Cognitive Behavioral Therapy) and 12-Step programmes have shown promise in supporting individuals on their journey. 

In this blog, we will explore if CBT is as effective as 12-Step programmes for addiction treatment, what is the difference between CBT and 12-step programmes and whether  CBT or the 12 Steps is best for you. 

Here at RESET, we take a radically different approach to all treatments available out there. We believe that everyone deserves to live their full potential beyond addiction recovery. For that to happen, we advise a blend of our very own biopsychological approach in combination with the 12 Steps available for free via the NHS at SIAS and Wolverhampton – Recovery Near You – though please be aware that there might be a waiting list.

Regardless of whether you choose CBT, the 12-Steps or the RESET approach, we aim to help you make an informed decision on the best path for your unique recovery needs.

CBT vs 12-step Programmes

CBT vs 12 Steps: what is the difference?

CBT is a form of talk therapy that improves mental well-being by identifying and changing unhelpful thought patterns and behaviours. It has been shown to be effective for various mental health conditions, offering practical coping strategies. In addiction recovery, CBT helps individuals recognise connections between thoughts, feelings, behaviours, and their impact on recovery.

12-step programmes on the other hand are international mutual aid programmes for recovery from substance and behavioural addictions. Created by the founders of Alcoholics Anonymous (AA), the 12-steps aim to overcome addiction. The process involves admitting a lack of control over addiction, examining and amending past errors, adopting a new code of behaviour and assisting others in their recovery.


How does CBT work?

CBT helps individuals in addiction by identifying triggers and developing better coping mechanisms for them. It helps to recognise negative thought patterns leading to self-sabotaging behaviours and encourages new perspectives to develop helpful coping mechanisms. CBT also equips individuals with coping skills to regulate feelings without resorting to substance or behavioural use, like relaxation techniques.

CBT for support with addiction as well as trauma, anxiety and depression

Often, addiction is accompanied by underlying mental health issues, such as unprocessed traumatic experiences, anxiety or depression. 

As CBT works to address these co-occurring conditions, this can be a useful tool to manage both addiction and mental health concerns simultaneously. 

What do NICE guidelines say about CBT?

National Institute for Health and Care Excellence (NICE) is an independent body in the UK operating as part of the NHS and Department of Health and Social Care (DHSC), providing evidence-based guidance to ensure safe, high-quality practice. 

Though not all therapists follow NICE guidelines, NICE recommends CBT alongside medication for alcohol dependence, to help individuals stop substance/ behavioural use and maintain abstinence. 

Does CBT work?

CBT may not be the most appropriate treatment for complex mental health needs and doesn’t address underlying causes of current conditions. For more complex mental health needs, you might want to choose DBT or other forms of therapy. 

CBT can also be less accessible due to availability and affordability, which may be of concern for those who require immediate support for their addiction. However, CBT has been shown to be highly effective for addiction recovery treatment.

12 Steps Programme

How do 12-Step Programmes work?

12-Step programmes are mutual aid groups offering a safe, supportive environment for individuals with shared experiences, fostering an understanding and non-judgmental space. They promote accountability, acceptance, and coping mechanisms for managing emotions without resorting to addictive behaviours.

Does 12-Steps use Psychology?

12-Step programmes incorporate various psychological tools, like “radical acceptance” from Dialectical behaviour therapy (DBT) (e.g., the serenity prayer), self-awareness through reflection on patterns in behaviour, community support, goal-setting, gratitude, and relapse prevention strategies. 

Though not explicitly recommended by NICE, many concepts used in 12-Step programmes do align with widely used psychotherapeutic techniques.

How much 12-Steps cost?

12-Step programmes like AA are free of cost and available worldwide, ensuring meetings are accessible even during the night. This makes it a highly accessible and long-term treatment option for ongoing recovery.

Does 12-Steps work?

Research indicates that individuals involved in 12-Step programmes have achieved longer periods of abstinence compared to those attempting to quit on their own. 

Some studies suggest that 12-Step programmes can be as effective as, or even more effective than CBT for certain individuals. 

CBT or 12 Steps Programme: Which is best for me?

For those interested in following NICE guidelines for addiction recovery support, especially when addressing mental health concerns alongside addiction, CBT can be a preferred treatment option. When integrated with other treatment options, CBT can support sustainable recovery journeys well.

For those looking for affordable, community-based, long-term support in their recovery, 12-step programmes may be preferable. 

If you are unsure, try attending a meeting and see for yourself, there is nothing to lose and everything to gain. The AA World Services website and online meetings might be a good start if you are considering this.

CBT vs 12-step Programmes

How to choose between CBT or the 12 Steps Programme

We’ve explored two major approaches to addiction recovery: CBT and 12-Step programmes. 

Both offer valuable support and have proven effectiveness. The choice depends on your individual needs and preferences.

Remember to seek professional advice or attend meetings to gain firsthand experience. 

As mentioned, here at RESET, we take a radically different approach to all treatments available out there. We believe that everyone deserves to live their full potential beyond addiction recovery. For that to happen, we advise a mixture of our very own biopsychological approach in combination with the 12 Steps. 

Embrace this step forward you have made by reading this blog and informing yourself, your journey to recovery begins now. 

If you would like to learn more about therapy and the difference between CBT and DBT, have a look at this blog. We also listed the best free rehab and addiction recovery support in Birmingham for you.

MSc Tilly Blunkett is an Assistant Psychologist at the RESET Health Group, a Psychology PhD student and recovery programme lead at the NHS Wolverhampton.

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