Talk:Twelve-step program

Courage International and Homosexuals Anonymous

I would like to suggest removing the entries for "Courage International" and "Homosexuals Anonymous" from the Twelve-step program page. The reasons are as follow:

1. Twelve Step organizations are based on the premise that members need support in dealing with issues, habits and or other problems that are innately harmful to the individual. This would not include any organization that would be for example, a 12 Step program for "de-Judaizing" or "de-Catholicizing" an invidividual since Jewish or Catholic religions identities are not inherently harmful to the individual and believer.

2. These two organizations are based on the false premise that homosexuality is in any way a mental illness, disorder or in any way by itself contributes to harm. Homosexuality is a normal expression of sexuality. Organizations that purport to help individuals either change their sexual orientation or at least avoid healthy sexual experience actually support and maintain mental illness. This would be comparable to any 12 Step program that sought to support members is never feeling anger. Anger is a healthy emotion. Suppressing angerleads to mental illness.

3. While homosexuaity is freighted with a history of condemnation, using that history to support a need to avoide one's sexual orientation is based on the fallacy of tradition. The same fallacy used to justify human slavery for centuries.

4. The mental health organizations which are not based on any religious bias removed homosexuality as a disorder decades ago. These two organizations are religion based groups. They are premised on ideas that are contrary to science. They contribute to harming, not helping the individual they purport to help.

5. At the very least, if both organizations are continued in their listing, then they both need caveats stating that these are not in any way based on scientific evidence and that they are based on religious beliefs.

Dale-BandB (talk) 21:06, 11 June 2021 (UTC)

References

Effectiveness

@CH Yong: @SkylabField: @Sundayclose:

My intuition is that this article would be more appropriately cited in Drug addiction recovery groups or in Alcoholics_Anonymous#Effectiveness. The Wikipedia Twelve-step program article focuses on twelve-step in general, not just on substance abuse-related groups. I also believe there are WP:MEDRS issues with citing a 2017 review when the 2020 should supersede it. - Scarpy (talk) 20:01, 15 March 2022 (UTC)

I moved to Alcoholics_Anonymous#Effectiveness. Yurt. - Scarpy (talk) 03:24, 21 March 2022 (UTC)

My sense looking at the 2017 review is that it's not saying 12-step programs do not work for drug abuse, but that we don't have enough solid evidence to say they work beyond a reasonable doubt. It's similar to where we were with Cochrane in 2006: We couldn't say they don't work, but we couldn't say they work too. Wherever it goes, it should probably be contrasted with the 2020 Cochrane review showing solid evidence AA works for drinking. SkylabField (talk) 06:33, 24 March 2022 (UTC)

I'm not sure either study belongs here, but I also don't think we can mention the 2017 study showing no results either way without also mentioning the 2020 study showing that AA almost certainly helps alcoholics get abstinent better than other interventions. I don't know where to put both together, but they belong together, so this page will do for now. SkylabField (talk) 06:42, 24 March 2022 (UTC)

Mutual Aid

I removed a link in the firt paragraph describing these as mutual aid programs, with a link to mutual aid page- This seems very prominent and while some 12 step programs are certainly run like this, I don't think it's a defining feature of the programs- many state, charity and church funded residential centres are 12 step programs, for example, and these are definitivley not mutual aid programs- both in terms of funding, and structure. If we want to have a note that some programs fit within that oranisational structure, we should put it in a later paragraph, with more nuance. Adacable (talk) 13:45, 26 August 2022 (UTC)

I’m not going to revert this change, but WP:RS do describe 12-step programs as being mutual aid or words to that effect. For example, “AA is a widespread and free mutual‐help fellowship”. There’s a very significant difference between going to a 12-step meeting (free mutual help group) and going to a treatment center, which is not a 12-step meeting per se, even though the center may host their own 12-step meetings. SkylabField (talk) 09:35, 29 August 2022 (UTC)

Hmm, this is an interesting point- The | actual paper cited focuses on specific histories of "recovery mutual aid", with the NIH writeup shortening it to "mutual aid" for the title(and not discussing it further). "Recovery mutual aid" in the paper includes everything from temperence societies to native american cultural preservation movements, and as they say "the boundary between mutual aid and treatment has not always been a clear one"- this seems in opposition to the clear differnetiation between, say, mutual aid and charity, or external coercion that's drawn up on the organisational page.

I think maybe there's a political/organisational term "mutual aid", and a medical term "recovery mutual aid", which have similar meanings but which aren't actually synonyms? I've not got time to go through the citations in the paper at the moment, maybe one of them will yeild a specific definition or root of the medical term?

Either way- Thanks, the NIH article was an intertesting read, and discovering a second tradition of mutual aid is interesting in itself. (edited link to go to the right place) Adacable (talk) 23:07, 29 August 2022 (UTC)

Ok, having done a bit of reading, there's one source which extensivley discusses 12 step and mutual aid vs other terms, which is already cited in the article.

It distingurishes between mutual aid movements and mutual help movements, describing AA as the latter(in fact, it's the premise of the entire work), and is also(presumably) the citation for refering to AA as a mutual aid movement on the AA page(the other two citations in the lede don't mention mutual aid at all- though why it was recorded as mutual aid rather than mutual help I don't know).

The 2020 cochrane review, also describes it as a peer-to-peer help organisation, which could be another term which would fit well into that slot.

I'm going to edit it to "mutual help", without a link to the mutual aid (organisation theory) page, replacing my clunky uncited description, and use MAKELA 1996 as the citation for it. Also going to go over and do the same for the AA page, as it appears to fall into the same trap. Adacable (talk) 17:50, 30 August 2022 (UTC)

Also, you make a good point about recovery centres not in themselves being 12 step by the definition of the 12 steps, but simply hosting(sometimes questionably) 12 step meetings.

I think there's a lot of things which are not 12 step by the original definition of the 12 steps, but are understood as 12 step by reliable sources- The most obvious being court ordered 12 step- which isn't more than superficically 12 step(because 12 step is first about wanting to stop drinking- A court can't order you to admit that you're powerless over alcohol, let alone get any further!).

This is also a very good example of something that is considered to be 12 step by reliable sources, but is not voluntary, and thus not mutual aid as discussed in the mutual aid (organization therory) page.

If it's important to discuss structure and "mutual aid(Organization theroy)"/"recovery mutual aid" Maybe we should have a paragraph on the structure of the groups further down, discussing the structure of the programme(s) it seems maybe there should be a discussion on meeting/organisational structure in general, which is left somewhat implicit through the page(meetings, with a given structure, are a commonality to all of the programmes mentioned I think, but their common structures aren't mentioned on the page). Adacable (talk) 09:31, 30 August 2022 (UTC)

Preferring mutual self-help, while well intentioned, is ahistorical and can not stand once Wilson’s reliance on Kropotkin’s anarchist mutual aid ideology—the title of one of his books-is considered. Makela adheres to regarding AA as an “international mutual aid movement”, and in the introduction takes no issue with the term. — Preceding unsigned comment added by 66.60.170.151 (talk) 17:08, 5 September 2022 (UTC)

Do you have a citation for the Kropotkin/Wilson link? I think adding it to an expanded section on structure would be really useful. Adacable (talk) 11:23, 20 September 2022 (UTC)