John Salter grew up in an environment of alcohol abuse. His family owned bars, the kind that served pickled pigs' feet and had go-go dancers on the pool tables, where the regulars traded food stamps for half their worth in alcohol while the kids waited in the station wagon.
At home, Salter saw Alcoholics Anonymous (AA) literature lying around. He also saw family members who never recovered from their alcoholic lifestyles.
In college, Salter began the battle against his own dependency. Treatment and recovery professionals explained and re-explained the 12-step principles of AA.
"You are powerless over alcohol," they told him. "Turn your will and your life over to the care of God as you understand him."
But that type of talk alienated Salter.
"It just missed me the whole time, and I'd get angry at the counseling community for not giving me anything I could use," he says.
Now it's been 11 years since Salter's had a drink. His recovery started when he moved to Cincinnati and discovered programs such as Rational Recovery and SMART Recovery. The underlying philosophy of these abstinence-based groups differs from the 12-step approach.
Salter didn't have to accept tenets that he didn't believe. These programs focus on self-empowerment instead of powerlessness. That made the difference for Salter.
Skipping the 12 steps
Now a social worker at the Veterans Affairs Hospital, Salter founded Recovery Resource Center Inc. (RRCI), an organization that offers a variety of alternative substance abuse programs.
"I don't endorse a cookie cutter approach to treatment," he says. "We know AA is only going to work for a fair fraction of the population that needs help. That other section of folks, they need help, too."
New methods for treating addiction would seem good news for treatment professionals. But since RRCI opened in March, Salter says he has met resistance and ignorance on nearly every front.
"If you need to go into an inpatient treatment program in Cincinnati, you are going to be put into a 12-step program, regardless of what your beliefs are," he says. "The addiction care industry is not interested in asking who's right for what program. There is a strong core in the recovery community that believes AA should work for everybody if they gave it a true effort."
But research -- and even AA's own Big Book -- show that no single treatment program is for everyone, according to Salter.
The four non-traditional programs supported by RRCI have existed for about 15 years, but many of the most influential people in the field of addiction care don't want to hear about alternatives, Salter says. He cites a meeting he had with Luceille Fleming, director of the Ohio Department of Alcohol and Drug Addiction Services.
"Five minutes into it, the director walked out saying, 'If you don't support the 12 steps, you'd better be talking to somebody else,' " Salter says.
Fleming didn't return a reporter's phone calls seeking comment.
"What we object to is that AA has become such the standard of care that everything else seems to be blocked out," Salter says.
RRCI operates on a three-year start-up grant from the Health Foundation of Greater Cincinnati -- one of the few places that respects diversity, Salter says.
'I'm Nancy, and I'm a strong person'
The need for diverse programs stems from an array of issues. Some, such as SMART Recovery and Rational Recovery, disagree that alcohol abuse should be labeled a disease.
All four programs reject the idea that an individual is powerless against the temptation to drink and that a higher power must be involved in recovery.
Twelve-step programs view alcohol dependency as a spiritual malady, according to Richard Blumberg, who moderates LifeRing Secular Recovery (LSR). By contrast, LSR has a cognitive behavior orientation.
"It doesn't preclude a spiritual model, but we don't insist that it's that important," says Blumberg, vice president of RRCI's board of directors. "I go into an AA meeting and say, 'I don't believe in God' -- I'm a very distinct minority. I feel very comfortable in an LSR chat room."
A public misperception holds that non-traditional programs involve moderate drinking, Blumberg says. But the agency's policy is abstinence.
Another program offered by RRCI, Women for Sobriety, differs from AA in that it focuses on issues such as self-esteem and self-confidence.
"Quite a few women have trouble expressing those emotions in a mixed meeting," says Nancy Cross, who moderates a Women for Sobriety meeting and serves on the boards for both organizations.
While all the programs except Rational Recovery include group meetings similar to AA, Cross says the atmosphere of the meetings is different.
"At an AA meeting, I would say in the introduction, 'Hi, my name is Nancy and I'm an alcoholic,' " she says. "I don't need to say that. I already know that. We do introductions as, 'Hi, my name is Nancy and I'm a capable, confident, caring and compassionate woman.' "
Alternative treatment programs are important, according to Cross.
"I wish I would've had a choice when I went into rehab," she says. "Even though Women for Sobriety was around, it wasn't known."
Salter says it shouldn't be that way.
"I don't want anybody to have to work as hard as I did to find a program that works," he says. ©
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