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This article is supplied by Alison, a long‐time member of Dual Recovery Anonymous (DRA), about the aims and principles of their 12‐step programme. DRA's 12‐step programme helps members to recover from both a drug or alcohol dependency and emotional or psychiatric illness (dual diagnosis) by focusing on relapse prevention and actively improving the quality of their lives.

The purpose of this paper is to investigate how clients – five years after completing treatment interventions endorsing abstinence – view abstinence and the role of Alcoholics Anonymous (AA) in their recovery process.

Interviews with 40 clients were conducted shortly after them finishing treatment and five years later. All the interviewees had attended treatment programmes based on the 12-step philosophy, and they all described abstinence as crucial to their recovery process in an initial interview.

At follow-up, the majority remained abstinent. For many, attending AA meetings was still important – some described attending as a routine, whereas others stressed that the meetings were crucial for remaining abstinent. For those who reported controlled drinking (CD), this was described either as a natural step in their recovery process or as associated with worries and self-doubts.

The results suggest the importance of offering interventions with various treatment goals and that clients choosing CD as part of their sustained recovery would benefit from support in this process, both from peers and professionals.

There are heterogeneous views on the possibilities of CD after recovery from substance use disorder both in research and in treatment systems. This study on client views on abstinence versus CD after treatment advocating total abstinence can contribute with perspectives on this ongoing discussion.

There is limited research documenting recovery experiences of residential service users. The purpose of this paper is to explore the perceptions service users on methadone have about recovery. In depth, semi structured 1-1 interviews with seven poly drug using homeless males between the ages of 37 and 46 and analysed using NVivo software. Results are presented thematically. Participants conform to “recovery” norms allowing stigma and shame of illicit drug use to be attributed to former addict identities. Participants on methadone maintenance report inner conflict arising from changing societal and cultural norms that equate recovery with abstinence. Tensions were revealed in true motivations for active rather than passive participation in adopting group work norms.

A qualitative design utilises small numbers of participants to gather rich data. In depth, semi structured 1-1 interviews conducted with seven poly drug using homeless males who have completed between ten and 15 weeks of a minimum 26-week residential treatment programme. Participants were aged 37-46. Results were analysed thematically using NVivo software.

Participants conform to “recovery” norms allowing stigma and shame of illicit drug use to be attributed to a former stigmatised addict identity. Participants on methadone maintenance report inner conflict arising from changing societal and cultural norms regards recovery and abstinence. A significant process of recovery involved adopting the norms of 12-step groups and TC therapy to gain enough trust to leave the therapeutic community (TC) unsupervised. This created tension regards motivation, were these individuals in recovery, or merely “faking it”?

A female perspective may have provided a more balanced discussion and yielded greater depth in results. Only one service was studied and the findings may be specific to that cohort. The duration of stay at the service of ten to 15 weeks is a relatively short time and excluded participants resident for six months or more. Longer term residents may have been more reflective and informative.

Encourage active options and increased debate on the variety of treatment options available to long term homeless opiate users who have failed to comply with previous treatments. While this is a small modest study, the rich data yields practical advice for policy makers and service providers.

This research study adds to an informed perspective by encouraging debate on methadone as a challenge to definitions of recovery that infer abstinence as a key definition of success.

There is a paucity of research documenting a Scottish TC service user perspective using qualitative methods on experiences of addiction, treatment and recovery.

This article considers the role of mutual support on acute admissions wards. Building on the authors own experience of a 12‐step specialist inpatient programme Marion identifies some of the limitations of the approach and considers how some of the positive aspects might be modified and transferred to acute inpatient wards to help people with a dual diagnosis in this setting.

The purpose of this paper is to investigate research in the field of addictions utilising CBT and 12 step fellowship methods and to create an evidence base for an integrated treatment method utilising both approaches.

Research on CBT and 12 step fellowships and their current applications in addiction treatment are presented. Models of severe mental illness are referenced and the use of directive and guided referrals are used as a basis to build the paper's hypothesis. A mode of action how the treatments may work together is presented.

Findings indicate that guided treatment approaches for dual diagnosis are more likely to lead to long term therapeutic gains. Discussion involves the practical implications of this treatment and its ability to create a synergistic approach.

Implications include the potential for streamlined treatment approaches which have the potential to increase treatment adherence and outcomes. Implications, such as the joint use of social reinforcement techniques between 12 step fellowship approaches and CBT, are also discussed.

There is no previous research on the application of CBT and 12 step treatment modalities working together in a structured manner. Previous work has focussed primarily on severe mental illness. The current paper aims to provide an approach to treatment which utilises several modes of treatment to create more robust treatments for people suffering from dual diagnoses.

Using strikingly different managerial techniques from conventional organizations, 12 Step Fellowships, most prominently Alcoholics Anonymous, provide useful clues to producing more effective, functional and humane organizations in contrast with our many dysfunctional firms which abuse their employees, behave unethically towards their customers, damage their social and ecological habitat and find it difficult to complete in a turbulent global environment. The founding Fellowship, Alcoholics Anonymous (AA), extends to 131 countries with 1,550,000 members while the second largest, Al‐Anon/Alateen, has 414,000 members in 84 countries. Without advertising, government support or experts, AA is widely considered the most effective method for treating alcoholism. This success story was produced by members who, prior to AA, were themselves severely dysfunctional and often unemployable. Examines facets of the Fellowships (organizational structure, culture, communication and problem solving techniques) to demonstrate a powerful, little studied model for organizational learning and transformation.

The purpose of this paper is to assess the impact of the recommendation to replace identity-first language with person-first language on people who self-identify as recovering addicts as part of a recovery programme. Narcotics Anonymous (NA) will be used to illustrate the contextualised nature of the recovering addict identity.

To demonstrate the value of the recovering addict identity and social relations in NA, this paper draws on Axel Honneth’s theory of mutual recognition and self-formation.

Person-first language overlooks the significance of identity-first language to people in 12-step recovery. This oversight is linked to the logic of stigma reduction which excludes all identity-first language by association rather than assessing the impact of such terms on a case-by-case basis. Honneth’s theory is used to show how the recovering addict identity facilitates self-confidence and self-esteem through relations of mutual recognition in NA.

The argument excludes people who identify as recovering addicts, but do not attend 12-step groups. Further research would be needed to understand how the recommendation to use person-first language instead of identity-first language impacts upon other recovery communities and pathways.

The recommendation to replace identity-first language with person-first language might result in 12-step fellowships becoming marginalised within the broader academic and policy and practice arena. Language preferences can become a contentious issue when 12-step groups and their members enter the wider recovery arena where their preferred terminology is viewed as stigmatising and dehumanising.

To the best of the author’s knowledge, this is the first article to propose an alternative theoretical framework to stigma reduction for judging morally appropriate language in the alcohol and drugs field.

This article describes the significance of mutual aid and self‐help groups for employee assistance programmes (EAPs). In an era of dwindling resources, groups can be valuable adjunctive resources. Examples given are a recovery network of AA members at the workplace willing to act in a 12‐step fashion with EAP clients, a co‐dependency assessment and support group, a supervisor′s mutual aid support group and a peer support group diversity network. The benefit to EAP professionals of developing these groups is an expanded range of referral resources, increased visibility for the EAP and an opportunity to engage in community building within the workplace.

Attendance at alcoholics anonymous (AA) or narcotics anonymous (NA) meetings and affiliation with the fellowship has potential benefits for people with alcohol or drug use disorders. This effect is present whether or not the individual attends professional treatment services, but the two process can have a synergistic effect. Limited information exists about the extent to which people attending UK specialist treatment services also attend AA/NA and their views about such attendance. The paper aims to discuss these issues.

A cross-sectional survey of 200 consecutive attendees at the specialist treatment service in an English region was conducted between January and April 2018. A measure of past attendance and affiliation with AA/NA (AAAS) and a scale designed to quantify future readiness to attend (Survey of Readiness for Alcoholics Anonymous Participation) were administered and anonymously linked to data supplied to the National Drug Treatment Monitoring Service (NDTMS).

A minority of the sample had ever attended an AA meeting (31 per cent, n=59) or an NA meeting (41 per cent, n=79), and only 14 per cent (n=27) and 24 per cent (n=45) had attended an AA or NA meeting, respectively, in the past year. Only two variables significantly predicted level of readiness to attend AA or NA in a regression model: attended more AA/NA meetings in the past (ß=0.149, p=0.036) and previous level of participation (AAAS score) (ß=0.409, p < 0.001).

A significant proportion of attendees of a specialist drug and alcohol treatment service had never attended AA/NA, despite many positive views about their potential benefits. Given the established benefits of attending AA/NA meetings and participating in the AA or NA fellowship, these results suggest that professional treatment services should do more to explain the process and challenge preconceived ideas about how they operate.

The authors are not aware of any published research that captures the rates of attendance of and participation in both AA and NA groups in a UK-based community treatment sample. These results may therefore provide a baseline for evaluating the impact of interventions to increase attendance/participation, and also provide some insight into the potential barriers to attendance in this population.

I am proud to be known as an expert by experience in recovery from mental distress, but I am also a co‐founder and director of a multi‐award winning, peer‐led charity called Changes 12 Steps to Mental Health. In the 1980s, after experiencing my third breakdown, I was an extremely angry person because of the lack of cross‐sector service provision to assist me in becoming whole again. Thankfully I used my rage to develop, along with my co‐founder Dave Wheat, our Changes 12 Steps to Mental Health services to meet the needs of those in mental distress. Changes 12 Steps to Mental Health provides person‐focused, recovery‐rooted services that aim to promote recovery, enabling people to become contributing members of society again. This is the history of Changes 12 Steps to Mental Health, our achievements and the challenges that we have faced in developing the services that we provide today.