I am a qualified psychodynamic counsellor and thought that perhaps this following article might be useful in the course of this discussion. I also spent over 5 years in AA. My experiences have been both positive and negative. I do believe that the following article reflects my views. AA certainly has the potential to damage people. The whole article cannot be posted here in full, but can be found on- http://www.unhooked.com/sep/aacouns.htm - where it examines each of the 12 steps and its conflicts with a range of theoretical principles inherent in various counselling and psychoanalytic orientations. Alcoholics Anonymous and the Counseling Profession: Philosophies in conflict By Christine Le, Erik P. Ingvarson, and Richard C. Page From: Journal of Counseling & Development, 07-01-1995, p. 603. This article describes the contribution of Alcoholics Anonymous (AA) to drug and alcohol treatment. The potential for AA 's steps to encourage growth is discussed, and their consistency with counseling philosophy examined. To stimulate constructive discussion, 12 new steps based on counseling theory are proposed and contrasted with AA 's steps. The need for counselors to be aware of these differences is emphasized and the move toward more solid boundaries between AA and the counseling profession is advocated. AA has also been instrumental in bringing about the acceptance of the disease model of alcoholism (Kurtz, 1988). It supports the idea that some people may be "allergic" to alcohol and unable to use it in any form (AAWS, 1976a), and presents alcoholism as a progressive illness that can be arrested but not cured (AAWS, 1984). Although AA's explanation of alcoholism as a disease is supported by the American Medical Association, its validity continues to be debated in the literature (Erickson, 1992; Miller, 1991; Peele, 1990, 1992). Some of the controversy concerning the disease model has arisen due to a lack of scientific evidence, and from differing definitions of disease (Fingarette, 1988). It is beyond the scope of this article to discuss this debate in detail; however, it should be noted that for many individuals AA's view has reduced feelings of guilt and shame, clarified the cause of their desire to drink, and removed much of the stigma associated with treatment. As research has failed to assess the effectiveness of AA, counseling theory may be a more appropriate standard of measurement. Through a comparison of AA and counseling philosophy, counselors can have the opportunity to decide for themselves if the AA program is consistent with their counseling values and potentially helpful for their clients. This decision is similar to the numerous choices that counselors must make concerning the use of different treatment methods, models, techniques, and schools of thought. Becoming well acquainted with the AA program will help to make this choice easier and will allow counselors to be clearer on the extent to which they wish to integrate AA into their work. AA's 12 steps are especially relevant as they represent the AA program and are the member's main guide to sobriety. Because the counseling profession advocates the use of these steps with a wide variety of clients (Chappel, 1992; Polcin, 1992; Ratner, 1988), it is desirable that counselors be knowledgeable about the steps and aware of any differences between them and their own counseling philosophy. AA's 12 steps are therefore examined and their consistency with counseling philosophy discussed. Because of the diversity of philosophies that exist within the counseling field, the AA steps will be looked at in relation to the theories of selected writers including Rogers (1961, 1980); Maslow (1968); Jung (1933); Homey (1950); Frankl (1959); Perls, Hefferline, and Goodman (1951); Ellis (1989); and Bandura (1982). This selection represents a variety of counseling theories and includes the person-centered, humanistic, analytical, neo-Freudian, existential, Gestalt, rational-emotive, and cognitive approaches to counseling. As there is no single inclusive theory of counseling, our choice will necessarily be both subjective and limited. Nevertheless, as the theories chosen place emphasis on change, growth, and the development of the individual, they are representative of the values held by many professionals in the field, and are consistent with what is taught in most graduate programs in counseling. To help stimulate constructive thought and discussion, 12 new steps will be proposed. AA's steps have been rewritten by several professionals, including B. F. Skinner (1987), who wished to provide an alternative program for the nonreligious. The goal of this article is not to provide an alternative program, but to offer the reader the chance to compare AA's steps with steps containing principles drawn from counseling theory. Inconsistencies between AA philosophies and counseling values will be clarified and the possible consequences for the client examined. THE 12 STEPS Step 1 AA Step 1: We admitted that we were powerless over alcohol, that our lives had become unmanageable. Proposed Step 1: I realize that I am not in control of my use of alcohol. AA views the admission of powerlessness as the first step toward sobriety. Here, individuals learn that they are passive victims, resting at the mercy of the greater power of alcohol. Admitting powerlessness has the potential of guiding the individual in one of two directions. The first leads toward the AA program and Step 2. The second, and more dangerous, encourages the individual to view himself or herself as a helpless alcoholic who accepts the futility of trying to stop drinking. In a profession where empowerment is a widely accepted goal, it seems strange that powerlessness should be the primary focus of the most referred-to substance abuse treatment program. Stensrud and Stensrud (1981) wrote that the helping process can even be dangerous if feelings of powerlessness are increased. It is therefore advisable that, although the first step recognizes that the individual is not in control of his or her use of alcohol, it also has as an underlying rationale the belief that people are capable of self-direction and self-responsibility regardless of their level of alcohol dependence. Egan (1990) pointed out that "if clients are not urged to explore and assume self-responsibility, they may not do the things needed to manage their lives better, or they may do things that aggravate the problem they have" (p. 73). This belief in self-direction and self, responsibility is echoed in the writings of Rogers (1961), Maslow (1968), and Peris et al. (1951). The AA steps all begin with the plural "we," which may cause individuals to simply identify with the group as a whole without internalizing the steps for themselves, thus further reducing the need for self- responsibility. Having the steps in the first person (using "I" as opposed to "we") helps to emphasize the need for individual decision making and responsibility within the group atmosphere. According to Jung, the need to separate oneself from the collective and find one' s own way is essential for self-realization (Kaufmann, 1989). Because the AA steps are written in the past tense, they tend to imply that once a step has been achieved work in that area has been completed. The use of the present tense in the proposed steps may encourage continuous work on the steps and self in the here and now. Step 2 AA Step 2: We came to believe that a Power greater than ourselves could restore us to sanity. Proposed Step 2: I acknowledge that a spiritual awakening can help me to find a new direction. Having accepted powerlessness, AA's Step 2 reinforces the idea that change is only possible if a power outside of oneself can come to the rescue. The theme of greater forces saving powerless individuals reminds one more of ancient myths than modern day realities, and for many the promised happy ending never arrives. The goal of being restored to sanity also raises concerns. Even though some individuals in the AA community might have unique interpretations for certain words, for many clients and counselors it is unacceptable to label all problem drinkers as insane. Bufe (1991) pointed out that this step promotes the idea of individual helplessness and encourages dependency, which is directly contrary to the usual therapeutic goals of self-direction and independence. Although individuals in crisis may need direction from outside forces to help restore equilibrium, too much reliance on external powers may prevent the development of internal resources (Gorton & Partridge, 1982). Theorists like Rogers (1961, 1980), along with many professional counselors, place faith in the individual's ability to grow. For some counselors, the emphasis on outside forces and greater powers may be attributed to the recognition that a sense of spirituality is one of the factors that correlates with positive treatment outcomes (Ludwig, 1985; Rogers, 1980). Carl Jung expressed his belief in spirituality as an aid to recovery from alcoholism when writing to Bill Wilson (Adler & Jaffe, 1963). Wilson placed less emphasis, however, on recognizing the spirituality that lies within the individual and on helping people to awaken their own spiritual strength. Although some clients are comfortable with the idea of a "power greater than ourselves" coming to rescue them, others might feel this aspect of spirituality is foreign and alienating. Thus, rather than prescribing the type of spiritual assistance needed for the client, the focus could be changed to developing an individual spiritual awakening. This awakening could lead the client in a new, personal direction developed from within.