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Why Does Traditional Alcohol Rehab Fail?

The reasons for failure of conventional drug and alcohol rehab and treatment are straightforward. The current paradigm is based on aging methodologies that are consistently shown not to work and an increasingly discredited "disease concept" of alcoholism that has no scientific or medical foundation that can stand up to scrutiny and scientific data. Yet most US treatment continues to be based on fundamentalist religious dogma that requires powerless surrender to a higher power and that strips participants of empowering self efficacy, holistic values and broad community involvement.

  1. Conventional Treatment is Seldom Entered by Choice

    • The majority of people enter treatment because of external pressure---ranging from constant nagging to intense confrontational interventions, ultimatums and illegal coercion---exerted by concerned friends and loved ones that do not know what to do (and will certainly not find out about alternative approaches from most alcohol counselors), an indifferent court and legal system, professional licensing bodies, or their employers or EAPs. In the worst of cases they are swept up and taken to residential treatment centers without much to say about it and without honest assessments to place them on any sort of diagnostic continuum of alcoholism that would point to individualized treatment. They are simply categorized as alcoholic, with a black or white diagnosis, and treated with a one-size-fits-all approach. Should they have concurrent or dual diagnosed mental illnesses they are really out of luck as there will be little capability to deal with them from a psychiatric standpoint and they may even be denied medications.

    Brainwashing Not Treatment

    • Beginning immediately people in treatment will be convinced their minds are mush and that they should abandon any sort of free or independent thought (many programs will restrict reading materials to only that approved by the program). They will be convinced that the only possible path to recovery is through a forced spiritual awakening, powerless surrender to a higher power, and convergence to fundamentalist religious dogma that will be assisted by alcohol counseling, confrontational peer pressure, alcohol education films, 12-step facilitation and other such techniques---all of which score deep in the negative range in the meta-analysis of treatment effectiveness conducted by Hester and Miller in 2003.

    Why It Does Not Work

    • Simply stated, people do not respond to cookie-cutter treatment protocols and to having their feelings of personal control attacked with threats of self-fulfilling prophecies; mountains made of molehills where they are not properly evaluated or assessed in the first place; the worst of alcoholics least able to manage their lives held up as role models; and lifestyles forced on them that involve contact primarily with other recovering alcoholics as the core of their existence rather than with diverse, nurturing and fulfilling communities of people.

    The Disease Concept is Dishonest and Dangerous

    • Being told they have a lifelong, incurable disease is untruthful and stigmatic to people and is inappropriate for the young. It interrupts the natural "maturing out" process that many will find moderates or eliminates their drinking without treatment. Disease model treatment falsely empowers alcohol in ways that are not real and ignores the rest of the person's problems by blaming them all on alcohol, thereby preventing individuals from developing strong values and a sense of responsibility to themselves and the greater community.

    Successful Methods Are Excluded

    • Perhaps most significant to failure is that conventional treatment excludes other empowering methods that are proven successful.

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