👥 Meetings
Members meet regularly, often in a local hall or online. Anyone who wants to stop can come. People can go as often as they need.
Treating Addiction » Self-management Programmes
What you'll learn this session
Study time: 30 minutes
AQA spec: 3.2.4.8
- What self-management programmes are, including self-help groups and 12 step programmes
- How they work: meetings, sharing, a sponsor, the steps, books and apps
- How they improve mental health, and their problems
- How they compare with aversion therapy: reductionist and holistic views
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Unlock This CourseHelping yourself, with others
Aversion therapy is done to a person by a professional. Self-management programmes work in a different way. The person with the addiction takes an active part in their own recovery, usually alongside other people who have the same problem.
Key terms:
- Self-management programme: a treatment where the person takes charge of their own recovery, with support from a programme or group.
- Self-help group: a group of people with the same problem who meet to support each other.
- 12 step recovery programme: a self-help programme where members work through twelve set steps towards staying free of the substance. Alcoholics Anonymous (AA) is the best-known example.
- Sponsor: an experienced member who has stayed free of the substance and gives one-to-one support to a newer member.
- Anonymity: keeping your identity private. AA members often use first names only.
How a 12 step programme works
💬 Sharing experiences
Members talk about their addiction, their struggles and what has helped. Hearing others who have been through the same thing shows the person they are not alone.
🤝 A sponsor
A newer member is paired with a sponsor they can call when a craving hits. The sponsor guides them through the programme.
📝 The steps
The twelve steps are worked through one at a time. In AA, the first step is admitting you cannot control your drinking. Later steps include looking honestly at your behaviour and making amends to people you have harmed.
📖 Books
Programme books explain the steps and share recovery stories, so members can read them between meetings.
📱 Apps
Apps can count days without the substance, remind members of their goals and help them find online meetings.
Worked example
Nina, 17, has been drinking heavily and wants to stop. She goes to a self-help group for young people. At the first meeting she listens to others share their stories and feels less alone. She gets a sponsor, Ahmed, who has been alcohol-free for two years. When she has a strong craving on a Saturday night, she calls him and he talks her through it. She also counts her alcohol-free days on an app. Nina is managing her own recovery, but with plenty of support.
How they improve mental health
- Support: being with people who understand reduces loneliness and shame, and helps the person feel accepted. Friends who are also in recovery are a positive influence, the opposite of the peer pressure you met earlier.
- Responsibility: the person is in charge of their own recovery. This builds self-confidence and a sense of control.
- Long-term change: the programme is ongoing, not a short course. Members can keep going to meetings for years, which helps them stay free of the substance.
Problems with self-management programmes
💪 Relies on motivation
Nobody forces the person to attend or to work through the steps. If their motivation drops, they may stop.
🚪 Drop-out
Some people leave early, for example if they feel uncomfortable sharing in a group. They then lose the support.
📈 Hard to measure success
Members are anonymous and nobody has to report back, so it is hard to count how many people really stay free of the substance.
🔒 Anonymity
Anonymity keeps people safe and private, but it also makes research difficult. Some people may also find it hard to open up to strangers.
Reductionist or holistic?
Remember, a reductionist approach reduces a problem to one simple part, while a holistic approach looks at the whole person. Here is how the two treatments compare:
🧪 Aversion therapy: reductionist
It reduces addiction to a learned link between the substance and a good feeling, and changes only that link. It ignores the person's friends, feelings and life.
🌟 Self-management: more holistic
It looks at the whole person: their feelings, their friends and support, their daily life and their choices. It aims to change the way they live, not just one behaviour.
Evaluation: the holistic approach is more likely to deal with causes such as stress or peer pressure, so it may lead to longer-lasting change. But it is harder to test and depends on the person staying involved. Aversion therapy is simpler and focused, but it can leave the causes untouched.
Common mistakes
- Saying a sponsor is a doctor or therapist. A sponsor is another member who has stayed free of the substance.
- Saying the person is forced to attend. Self-management relies on the person choosing to take part.
- Calling self-management reductionist without explaining. It is usually described as more holistic because it deals with the whole person, but give a reason.
- Forgetting to name the problem you are evaluating. "It might not work" is too vague. Say, for example, that it relies on motivation.
Exam-style question
(a) Describe one way a 12 step recovery programme, such as Alcoholics Anonymous, helps someone with an addiction. [2 marks]
(b) Explain one problem with self-management programmes. [2 marks]
(c) Evaluate self-management programmes compared with aversion therapy, using reductionist and holistic perspectives. [4 marks]
Model answer
(a) Members are paired with a sponsor (1) who they can call when they have a craving, giving them one-to-one support (1). [Also accept: sharing experiences at meetings so they feel less alone.]
(b) They rely on motivation (1) because no one forces the person to attend, so they may drop out and lose the support (1).
(c) Aversion therapy is reductionist (1) because it reduces addiction to a learned link between the substance and feeling good, and ignores other causes such as stress or friends (1). Self-management programmes are more holistic (1) because they support the whole person, for example through group support and long-term change, so may lead to longer-lasting recovery, but they are harder to measure and depend on motivation (1).
Exam tip
In a 4-mark compare question, write about both treatments and use the words reductionist and holistic, each with a reason from addiction.