Bridging the Gap: The Compatibility of CBT-Based Approaches with Twelve-Step Programs in the Treatment of Substance Use Disorders

Background: Cognitive-behavioral therapy is an umbrella term which encompasses a wide range of distinct, yet related interventions, several of which have been shown to be efficacious in the treatment of substance use disorders. However, 12-Step programs (including Alcoholics Anonymous and Narcotics Anonymous) are traditionally the most widely known and commonly used approaches to managing alcohol and substance abuse. Objectives: Therefore, this paper attempts to offer a summary of the compatibility of CBT-based approaches and 12-Step philosophy, in order to assist clinicians who work with patients with a strong adherence to 12-Step ideology. Results: Specific passages from AA's Big Book, NA's Basic Text, and ancillary 12-Step literature will be highlighted where appropriate. Moreover, common roadblocks to synthesis (e.g. belief in a "higher power;" acceptance of one's "powerlessness") will also be addressed. Conclusions: Clinicians who are committed to evidence-based, CBT-related practices are ultimately advised to adopt flexibility when working with patients who identify with the cultural values of 12-Step programs.