Sometimes our readers are sharper than us professional word pushers. One of them just dismantled a New York Times feature with the skill of a soldier field-stripping a rifle. The article in question looks at the Center for Motivation and Change, an anti-addiction program that favors secular counseling, therapy and medication. Well and good, as far as that goes.
But the article also notes how CMC shuns the 12-step method of Alcoholics Anonymous. No, more than that. It tries again and again to prove the superiority of the secular method, via biased wording, cherry-picking research and mainly quoting one side.
Again and again, CMC is held up as the enlightened, proven, "evidence-based" approach to kicking substance abuse:
It is part of a growing wing of addiction treatment that rejects the A.A. model of strict abstinence as the sole form of recovery for alcohol and drug users.
Instead, it uses a suite of techniques that provide a hands-on, practical approach to solving emotional and behavioral problems, rather than having abusers forever swear off the substance — a particularly difficult step for young people to take.
And unlike programs like Al-Anon, A.A.’s offshoot for family members, the C.M.C.’s approach does not advocate interventions or disengaging from someone who is drinking or using drugs. “The traditional language often sets parents up to feel they have to make extreme choices: Either force them into rehab or detach until they hit rock bottom,” said Carrie Wilkens, a psychologist who helped found the C.M.C. 10 years ago. “Science tells us those formulas don’t work very well.”
We'll get to that question of how well the CMC works in a moment. For now, let's note the code words of "strict" and "traditional," as if AA and Al-Anon are based on some Amish settlement. Those and other forms of gaming raised the ire of our friend Jean Lahondere.
Underneath the psych talk and success anecdotes, Lahondere says, the Times article is a standard parable on the alleged triumph of science over faith.
The article "treats recovery as either a completely 'faith-based' (Alcoholics Anonymous) or 'evidence-based' (C.M.C.) ordeal," she writes. "As if A.A. is a stand-in for religious belief and the new method is firmly rooted in the empirically correct foundation of SCIENCE. It really is more effective as an insight into the writer's world view than as a story about addiction recovery."
The Times does muster some scientific allies of CMC:
Researchers elsewhere have come up with similar findings. In 2006, the Cochrane Library, a health care research group, reviewed four decades of global alcohol treatment studies and concluded, “No experimental studies unequivocally demonstrated the effectiveness of AA or TSF approaches for reducing alcohol dependence or problems.” Despite that research, A.A.’s 12-step model is by far the dominant approach to addiction in America.
"Dominant" -- that's another code word. As Lahondere, says, the reporter could have used something like "most widely used" or "the most common" or even "the typical." And the writer makes no attempt to explain the persistence of the 12-step model. How does AA wield its supposed dominance?
And how does AA answer the CMC claims? No idea. In its 2,500 words, the Times article cites not one person from AA, either its leaders or any of its estimated two million-plus members.
Jean Lahondere also takes issue to the statement: "In contrast to A.A., which stresses a drinker’s lack of power in the presence of alcohol, M.M. encourages personal responsibility for drinking."
"Is this implying that A.A. discourages personal responsibility?" she asks.
Good question. In fact, the organization has had a Responsibility Statement since 1965, committing members to take responsibility for themselves and one another. Said AA trustee Jack Norris:
"It is in taking responsibility that real freedom and the enduring satisfactions of life are found. AA has given us the power to choose – to drink or not to drink – and in doing so has given us the freedom to be responsible for ourselves. As we become responsible for ourselves, we are free to be responsible for our share in AA, and unless we happily accept this responsibility we lose AA."
The Times article does acknowledge that CMC's approach is "controversial," citing a naysayer:
David Rotenberg, executive vice president of treatment at the nonprofit Caron Treatment Centers, a large drug and alcohol rehabilitation provider with branches in several states, cautioned against approaches that do not set abstinence as a goal.
“The majority of people who are chemically dependent would love to be able to drink and drug in a more moderate fashion,” Mr. Rotenberg said. “Most drug addicts and alcoholics would love to drink just a couple of drinks, and they try to do so, with poor results.”
What do the CMC folks say about that? No answer.
Now, it's true that AA has gotten mixed reviews from those who have studied it. Still, when a newspaper criticizes the organization -- mentioning it 14 times, in fact -- that other side should be represented. And I found examples, with little trouble.
One is a 2011 article in Scientific American. It took a skeptical approach but ended with cautious approval.
"The AA-based approach seemed to work and compared favorably with the other therapies," the Scientific American article said. "Various studies have found that a combination of professional treatment and AA yields better outcomes than either approach alone."
And in 2013, scholars with the National Institutes of Health released an overview of 12-step programs, including AA. They concluded that the 12-step methods work because of the fellowship and bonding at the meetings. Therefore, people will more likely stay clean and sober if they continue to attend.
One CMC alumnus does voice some humility: “M.M. doesn’t profess to work for everybody. It has a scientifically based approach that works for some people." Good comment. But the overall tone of the Times article was more like "Secular is superior."
For some news media, shedding that attitude seems harder than fighting alcoholism.