u/XenoAcacia

I work in residential treatment and my coworker wants to bring in a 12-step model

I've posted here before about my experience attending a meeting with my clients as someone who myself is over 5 years sober. I work in a live-in treatment center for youth with a range of substance use issues, along with which come the ever-linked social, emotional, cognitive, functional, etc. issues frequently tied to trauma, poverty, and familial abuses. In sum: I did not feel good about taking those kids into that room.

Fast forward to today: myself and my coworkers are talking about issues we've observed as frontline workers within our non-profit organization's treatment model(s). My one coworker, the only other staff member in recovery, remarks that it's ridiculous that she is not able to take the kids through the 12 steps and that XA principles are absent from our programming. Keeping in mind, this coworker encourages the kids (with compelling dynamism) to attend NA meetings off-site and is the only staff member who accompanies them to these. She is "in the rooms" herself and, despite proporting to accept biopsychosocial models of addiction and the use of evidence-based mental health supports, consistently demonstrates cult-like thinking around XA's superiority while exhibiting baffling defensiveness (she is otherwise regulated and generally self-aware) when faced with any views remotely contrary to her own.

This coworker and I are friendly and she is aware of my academic and professional background in substance use science, as well as my personal journey through recovery without any formal interventions. What ensued was a long conversation wherein she insisted I do not know what I'm talking about regarding XA, that my case is "an exception, not a norm", and that the harms I personally experienced in XA during an early foray into recovery are invalid—a result of "individuals and not the program itself". I prefaced the conversation by noting that I do possess biases regarding XA, and I did my very best to remain diplomatic while expressing my concerns, yet I felt like I was being given a condescending sales pitch and talked at for half an hour about how XA may not be the only way but it's undoubtedly the best and most effective way and anyone who can't see that is in the practice of "condemning without investigating".

Now, my coworker is incredibly charismatic, boisterous, and compelling; she admitted herself that she's very difficult to argue with. I enjoy debating but am rather soft spoken and conscientious, and I felt pretty fucking anxious and uncomfortable during moments of this conversation. I can only imagine how someone less prone to critical inquiry (say, a traumatized teen with addiction issues) would fold under the pressure. My coworker recited the 12 steps for me in a manner uniquely suited to my own proclivities as if I'd never heard them before, and played to my penchant for empirical evidence by highlighting the anecdotal nature of my experiences (as if I had not presented them as my own anecdotal experiences) followed by grandiose statements about how XA "saves so many lives" (as if I had not stated five times that I'm glad it helps the people who it helps).

The conversation wrapped with me 1) promising to read the Big Book so I can form an apprised opinion, and 2) stating that I would offer up the same level of critique to any program that was being presented as the gold standard of SU treatment, and that I believe the implementation of any method into our adolescent treatment program deserves careful examination and sound ethical and procedural considerations. She then said, "Well the ones we're using don't work!" and I reminded her that this is the very sentiment I was expressing to stir up this conversation in the first place.

She just could not get past this need to spin my concerns as a purely personal vendetta against XA, and I fear that she's too closely invested to ethically deliver care to our young clients without bringing in an air of coercion—even if we did find/create a nuanced way to introduce the 12 steps into our program as an option. She is liked by the youth and they want her to like them; when she doesn't like you, you somehow feel like a loser idiot who can't look their own shadow in the eye. I hate to say it but I do feel that this "god complex" (so called by another coworker in reference to her) is a result of XA thought patterns and hierarchical recovery paradigms. She is the loudest person in the room and she's always got a catchy one-liner to solve a complex issue. I do admire her in many respects and I care for her on a personal level, but she makes me nervous the louder she gets in the workspace, and management functions (or doesn't function) such that I feel like they would also cave to her whims.

I mainly posted this to vent my frustrations, but I'm also looking for suggestions for how to respond to someone like this in a way that maintains my own sense of responsibility to my field, as well as one that honours my personal experiences in recovery. It would be far, far easier and less emotionally taxing to just agree with her, but I can't do it in good conscience.

Thank you if you read all this, and thank you all for sharing your own experiences so that I feel I'm not so out of line criticizing this model.

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u/XenoAcacia — 2 days ago