Conclusion

This writer feels that many therapists miss a very important aspect of recovery. Too often the only goal is abstinence and the client is not encouraged to commit to a long-term program of recovery. This may deny the client an opportunity to gain a more fulfilling and purposeful life in addition to remaining drug and alcohol free. If a therapist is not well trained in substance abuse or has no experience with addicts and alcoholics who have achieved sustained sobriety through the 12-steps, the therapist may not understand how much clients can gain from these programs. In 12-step circles, achieving abstinence without a life changing program or event is referred to as a “dry-drunk' meaning the person may still live the same unhappy existence though not using alcohol or drugs.

Cognitive-behavioral therapy gives treatment providers and therapists another tool to effectively help a large number of clients. CBT is proven effective in a broad range of settings with a wide range of clients. It is outcome driven and time limited, meeting the requirements of today's managed care. CBT often works with clients who are unable or unwilling to commit to other types of therapy and recovery programs. In this writer's opinion and experience, however, it usually does not replace the support, spiritual growth, and social aspects of 12-step programs. To clients for whom 12-step programs work, they can become the foundation for a whole new fulfilling life – not just a means of survival. 

References

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Beck, A.T., Rush, A.J., Shaw, B.F., & Emery, G. (1979). Cognitive therapy of depression . New York , N.Y. , Guilford Press.

Beck, A.T. & Rector, N.A., (2000). Cognitive therapy of schizophrenia: a new therapy for the new millennium. American Journal of Psychotherapy, 54, (3), 291-301.

Beck, J.S., (1998). Complex cognitive therapy treatment for personality disorder patients. Bulletin of the Menninger Clinic, 62, (2), 170-195.

Black, J. L., & Bruce, B.K., (1989). Behavior therapy: a clinical update. Hospital and Community Psychiatry, 40, (11), 1152-1158.

Burns, D. (1999). The feeling good handbook. New York, N.Y. Plume/Penguin Books, Ltd.