When recovering addicts go to 12-step meetings there is an expectation that anything they say during a meeting will be kept confidential by other group members. About this need for and long-standing expectation of anonymity, Alcoholics Anonymous says, “Over the years, anonymity has proved one of the greatest gifts that A.A. offers the suffering alcoholic. Without it, many would never attend their first meeting. Although the stigma [of alcoholism] has lessened to some degree, most newcomers still find admission of their alcoholism so painful that it is possible only in a protected environment.”
AA’s statement hits the nail on the head. AA and other 12-step programs work for the same reason psychotherapy works: People know they can share about their problems, even their most shameful issues, without fear of that information being used against them. Without this protection, neither psychotherapy nor 12-step recovery would be nearly as effective, and many people would avoid help completely, never even giving themselves a chance at sobriety, healing, and a better life.
For therapists (and medical doctors and lawyers), confidentiality is an essential, legally protected element of the service provided. Without this protection, clients would routinely withhold important information and the professional would be “flying blind,” so to speak. Recognizing this, industry standards and the legal system impose not only a right to confidentiality but a duty, with a betrayal of this trust potentially leading to the suspension or loss of the professional’s license, plus civil liability.
Sadly, courtroom privilege/confidentiality has not yet been (officially) extended to 12-step programs, even though the vast majority of addiction treatment programs and addiction treatment specialists require (or at least strongly recommend) that their patients attend, in addition to therapy, 12-step programs. We do this because research very clearly shows that when dealing with addiction, the best results are achieved when therapy is coupled with 12-step recovery. As such, 12-step meetings tend to be viewed by both therapists and their addicted clients as an extension of the therapy room, not to mention an essential part of the healing and recovery process.
From my perspective as a therapist, there are four primary arguments for officially extending courtroom privilege/confidentiality to 12-step recovery groups. (I recently wrote a legal brief, based on these arguments, for an attorney who successfully used the information to prevent his client’s 12-step group from being forced to testify against him.)
- As stated above, 12-step groups are, for many recovering addicts, a direct extension of formalized therapy, recommended as an adjunct treatment by a rehab center or an outpatient clinician. This recommendation is made because research shows that when 12-step programs are used in conjunction with addiction-focused therapy, the addict’s long-term prognosis is much better; the odds of lasting sobriety increase significantly. Thus, 12-step programs are a required element in many (and maybe most) addiction treatment programs. When viewed in this light, a failure to extend courtroom privilege/confidentiality to 12-step meetings makes zero sense.
- It’s not just therapists who recommend 12-step recovery. Twelve-step groups can also be a direct extension of the confessional, the doctor’s office, and the lawyer’s office. In fact, there are probably as many people in AA and other 12-step groups because their priest, doctor, or lawyer suggested it as there are because a therapist suggested it. Failing to extend courtroom privilege/confidentiality to religious, medical, and legal referrals makes as little sense as failing to extend psychotherapeutic confidentiality.
- Every 12-step group has the word “anonymous” in its name, meaning these meetings are, by nature, anonymous and confidential. Attending and participating in a 12-step meeting creates an implicit pact/contract protecting anonymity and guaranteeing confidentiality. (As stated earlier, this is an important part of why these groups work as well as they do.) If you want a more explicit version of this pact, I can tell you that nearly all 12-step groups end their meetings with the following (or a very similar) statement: “Anonymity is the spiritual foundation of our program. If we are to recover, we must feel free to say what is in our minds and hearts. Therefore, who you see here, what you hear here, when you leave here, let it stay here.”
- For many people, 12-step meetings are used in lieu of therapy. This is especially likely with lower-income and disenfranchised individuals. These men and women know they have a problem with addiction, they can’t afford therapy (even on a sliding scale), so they seek help through the only no-cost “addiction therapy” available—a 12-step group. Without the anonymous and confidential support provided by 12-step recovery, this already underserved segment of the population would become even more marginalized. (Also, why should rich people and people with good insurance receive courtroom privilege/confidentiality when less financially fortunate people do not?)
Because 12-step recovery programs are such an essential part of the healing process—often recommended by a professional, other times utilized because a professional is either not available or not affordable—it is imperative that courtroom privilege/confidentiality be extended to 12-step meetings. Without this, we risk a chilling effect on the sharing and trust that is so vital to the process of recovery and healing. We also risk driving people away from recovery altogether.
Robert Weiss LCSW, CSAT-S is a digital-age intimacy and relationships expert specializing in infidelity and addictions—in particular sex, porn, and love addiction. He is the author of several highly regarded books. Currently, he is Senior Vice President of National Clinical Development for Elements Behavioral Health, creating and overseeing addiction and mental health treatment programs for more than a dozen high-end treatment facilities. For more information please visit his website, robertweissmsw.com, or follow him on Twitter, @RobWeissMSW.
Sources
- Understanding Anonymity. Retrieved October 05, 2017 from http://www.aa.org/assets/en_US/p-47_understandinganonymity.pdf.
- Fiorentine, R., & Hillhouse, M. P. (2003). Why extensive participation in treatment and twelve-step programs is associated with the cessation of addictive behaviors: an application of the addicted-self model of recovery. Journal of addictive diseases, 22(1), 35-55; Siegal, H. A., Li, L., & Rapp, R. C. (2002). Abstinence trajectories among treated crack cocaine users. Addictive Behaviors, 27(3), 437-449; Humphreys, K., Huebsch, P. D., Finney, J. W., & Moos, R. H. (1999). A Comparative Evaluation of Substance Abuse Treatment: V. Substance Abuse Treatment Can Enhance the Effectiveness of Self‐Help Groups. Alcoholism: Clinical and Experimental Research, 23(3), 558-563; among other studies.
- Sober recovery: Alcoholism drug addiction help and information. Retrieved July 05, 2017, from http://www.soberrecovery.com/forums/alcoholism-12-step-support/179285-what-you-hear-here-when-you-leave-here-let-stay-here-here-here-2.html.
