Alcoholics Anonymous (AA) and its 12-step cousins are the oldest, best known, and most widely available recovery support groups. In recent decades, however, a number of alternatives have appeared that may be better suited for some people in recovery (Humphreys K, J Subst Abuse Treat 2004;26(3):151–158; Kelly JF & White WL, J Groups Addict Recover 2012;7(2–4):82–101). Providers should recognize that virtually nothing is known about their effectiveness relative to traditional 12-step recovery, each other, or no treatment at all. Only one intervention, Moderation Management, is listed in the Substance Abuse and Mental Health Services Administration’s National Registry of Evidence-Based Programs and Practices (http://1.usa.gov/1ntgcrZ).

SMART (Self-Management and Recovery Training) Recovery

SMART was founded in 1994, is based on a four-point program that includes building and maintaining motivation; coping with urges; managing thoughts, feelings, and behaviors; and living a balanced life. Free face-to-face meetings occur around the world. Daily online meetings, an online message board, and a 24/7 chat room are also available.

The program states that “our efforts are based on scientific knowledge and evolve as scientific knowledge evolves,” and is friendly to psychotherapy and psychotropic medications. The question of God or a higher power, or whether addiction is a disease, is left up to participants to decide. [www.smartrecovery.com]

Secular Organizations for Sobriety (SOS)

SOS was founded by James Christopher, a recovering alcoholic, in 1985, as an alternative to programs that were religious in nature. SOS follows the same meeting model as AA, with independent, non-professional groups worldwide.

Members include those with addiction to alcohol and other drugs, as well as process addictions like compulsive eating. The program has six suggested guidelines for achieving sobriety. [www.sossobriety.org]

Moderation Management

This program is designed specifically for problem drinkers to reduce alcohol-related harm. It offers education, behavioral change techniques, and peer support for people who want to decrease their drinking—whether they simply want to cut down or become totally abstinent.

Moderation Management follows a nine-step model. The first step is to attend meetings or online groups to learn about the overall program. Participants then abstain from alcohol for 30 days and complete additional steps such as examining how drinking affected their lives.

A small, randomized controlled trial found that Moderation Management reduces alcohol consumption and alcohol-related problems (Hester RK et al, J Consult Clin Psychol 2011;79(2):215–224). [www.moderation.org]

LifeRing

A network of self-help and support groups that offer sober, secular self-help for those with addiction, LifeRing operates on the “3S” philosophy of sobriety, secularity, and self-help. Founded in 2001, LifeRing is similar to AA in that it involves abstinence-based, confidential support groups.

It claims to differ from AA by working through positive social reinforcement. For example, at most meetings people talk about the highlights and challenges of their past week and important upcoming decisions.

Conversations or “cross-talk” is encouraged. Personal histories about drinking and drug use are discouraged. [www.lifering.org]

Women for Sobriety

Started in 1976, Women for Sobriety bills itself as the first and only self-help program that specifically addresses the problems encountered by women recovering from addiction. These include the need for feelings of self-value and self-worth and the importance of shaking free from guilt, shame, and humiliation.

Women for Sobriety offers small self-help groups across the US and abroad that focus on developing coping skills, emotional growth, spiritual growth, self-esteem, and a healthy lifestyle. It is based on a 13-statement program called “New Life” that involves positive thinking, metaphysics, meditation, group dynamics, and nutritional support, to encourage emotional and spiritual growth. [www.womenforsobriety.org]

Celebrate Recovery

Celebrate Recovery describes itself as a “Christ-centered recovery program,” and was started by Saddleback Church in Lake Forest, California, about 20 years ago. It is now available in more than 20,000 churches worldwide.

Celebrate Recovery uses religious commitment and the Christian scriptures to help people address “a wide variety of hurts, hang ups, and harmful behaviors.” [www.celebraterecovery.com]