12-Step Coercion

Nurses General Nursing

Published

the following presentation was given at the may 21, 2004 open forum of the north carolina board of nursing meeting:

http://www.angelfire.com/journal/forcedaa/ncbon.html

whether one agrees with aa/na or not is a moot point. why not consider it as part of the punishment?

Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac.
i, too, have been a member for 18 years. if anyone interested would read the beginning of the 5th chapter of "alcoholics anonymous", aka the big book, they would learn that "... these are the steps we took, which are suggested as a program of recovery". i've known several rns who, as part of keeping their licenses (after committing drug-related offenses on the job), are mandated to attend a certain number of aa/na meetings, and are given an attendance slip which is to be signed (first name only, of course) by the chairperson of the meeting. the notion of a higher power is a power greater than myself who can restore me to sanity. if you've ever been ensnared by any chemical addiction for any length of time, you know what insanity is:doing the same thing over and over, and expecting different results. i'm sure i'll sliced and diced for my stance :chair: , but it literally saved my life.

congrats!!! i think those who have been sincerely ensared by chemical addiction have an easier time with aa/na. it's those who aren't addicts, but get thrown into the system because a narcotic count/waste error, or those who are opposed to the religious aspect who are having the problem. why throw someone who made a count error and has a clean drug screen into aa/na for five years?

when people's live's are in danger perhaps the "beyond a shadow of a doubt" isn't the best idea, but treatment should be a little more individualized.

yes, we all know it's suggested, and you only have to choose a higher power which could be anything, but that's not the point. the point was choice, some people and programs believe the power comes from within. didn't work for you and that's fine.

Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac.
Participation in alternative programs(and receive treatment) IS voluntary.

The nurse has a choice:

alternative program and do as they say to prevent board discipline

or

board (disciplinary/"punishment") route, and have permanent license action. And still "do as they (the board) say" to ever have that license again.

The nurses here who complain about having to go to meetings they don't want to go to have a choice to not go and lose the license.

Meetings are a small price to pay.

z~

True they can accept the treatment offered or loose their license. Most of them go along with whatever it takes to keep their license. But the point is that to force people into the religous programs of AA/NA is illegal.

True they can accept the treatment offered or loose their license. Most of them go along with whatever it takes to keep their license. But the point is that to force people into the religous programs of AA/NA is illegal.

Dear me :uhoh3: The preamble that is read at the beginning of all AA meetings in the NW Indiana area states: "AA is not allied with any sect, denomination, politics, organizations, or institutions; does not engage in any controversy, neither endorses or opposes any causes. Our primary purpose is to stay sober, and to help other alcoholics achieve sobriety." :angryfire

i have been a member of aa and can tell you that it is not religious, it simply states to refer to your higher power, and never once tells you what that higher power is, it can be your inner self, a tree, etc.

the following presentation was given at the may 21, 2004 open forum of the north carolina board of nursing meeting:

http://www.angelfire.com/journal/forcedaa/ncbon.html

i have been a member of aa and can tell you that it is not religious, it simply states to refer to your higher power, and never once tells you what that higher power is, it can be your inner self, a tree, etc.

anyone who might believe that aa is not religious can read chapter 3 of this book:

http://www.morerevealed.com/books/resist/index.html

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not to mention that numerous federal and state courts have ruled aa to be religious.

How do you know it "works so well for so many people". What statistical studies are you gaining this information from? Propaganda?

As for making this argument a way out of participation in a program, "being in denial" or "rationalization"..all I can say, is you folks are ignorant to facts.

If you've done your "homework", you would find very poor statistics for the success rate of the 12 steps and high stats of relapse. You would also find countless other successful programs that are not offered by any state board for nurses--while physician's, pharmacists, etc in some states do have options.

Are "we" looking for a way out? Am I in denial? Hardly. You have, as 12 steppers famously do, twisted the argument and turned it back on those of us that have been forced to participate in a religious cult. That's very typical, but very sad that a group of nurses--nurses!--would do this. Would you make this same comment to a patient that expressed difficulty with these groups?

There are nurses that have stayed clean for years without 12 steps, and in some cases, despite the mind games of these groups.

If you've not been there, you cannot understand. If you've been there and it has help you--good for you. But to deny there are some serious issues within the 4 walls of these groups that ARE NOT MONITORED IN ANY FASHION, you are ignorant. How can this group spout out "but we help so many" when it is an unmonitored, anonymous organization? That is an oxymoron to the highest point. There are COUNTLESS other issues with the forced participation in these programs in addition to the religious issues. Do you realize that these programs are used by the courts for just about anything deemed an "addiction"...as in sexual addictions, etc. Yes, a judge, and in some cases, some state nursing boards, have ORDERED a sexual predator to 12 step meetings...AA meetings! The same meetings that a 17 year old young lady may be forced by the court to attend, following a first time offense. If you want to argue that point, I will post several links to support it. These meetings that nurses are forced to, are not limited to drug or alcohol problems..the 12 steps tout itself as useful to ANY type of addiction and the courts and boards feed on that..therefore, you could be exposed to some very dangerous situations, again, IN AN UNMONITORED ENVIRONMENT. And all in the name of protecting a license.

Another poster made a comment on "anonymity"...Although the meetings are supposed to be "anonymous"...hardly. There is no creed, signing in blood or any other way to enforce this. Therefore, we are FORCED to attend meetings and FORCED to participate--if we don't, a fellow 12 stepper is required to send a letter to the Board regarding our participation--if we don't participate, it's considered a relapse indicator, hence, we very well may NOT get our licenses back. So, we participate--only to be pointed out at the town grocery store, the county fair, etc by fellow 12 step members as the "nurse that did drugs".

In addition, what some of you are failing to recognize, is not every nurse is there for committing a crime or even endangering the lives of patients. If the board does not "like" the fact that you take narcs for chronic pain conditions, regardless of the fact that you do not use them while on the job--you too could be forced in to a "program" to protect your license.

There are nurses in these programs under false allegations--nurses that did not appropriately sign out narcs, accused of stealing them.

These are just a few examples of those that did NOT endanger a patient or do anything illegal.

For those that support the forced participation, I have a few questions.

How safe are these meetings? Do they force religion? How successful are they?

After you answer the questions, please back it up with statistics. And please, tell me how you know, for a fact, the answers when these thousands of meetings are not monitored, have a continually rotating and changing membership, do not keep attendance, and do not follow up with any participant on a long term basis.

Who runs the meetings? Not a trained mental health professional. There may never be a trained mental health professional unless they happen to be in recovery themselves. These meetings are run purely by the "been there, done it" class and "this is the only thing that works" mindset. So, as NURSES, would you do this to any other patient with a "disease" or physical condition? Would you sit a schizophrenic in a room full of schizophrenics for "therapy" and "support"? Without a capable, mental health trained professional in attendance? Would you send a pregnant patient to have a c/section performed by a mother that had one previously? Without a professional in attendance to MONITOR and FACILITATE the process?

If you would, you deserve a license far less than I do. Key point...THESE MEETINGS ARE NOT MONITORED BY ANY PROFESSIONAL. THESE MEETINGS HAVE ABSOLUTELY NO PROFESSIONAL GUIDELINES. THESE MEETINGS ARE NOT GOVERNED BY ANY ENTITY AND DO NOT HAVE TO REPORT TO ANY AGENCY. And most importantly--it is NOT just for support..there is a "plan" of the 12 steps that the nurse MUST "work through" with another AA participant--and this process IS reported to the Board by the fellow AA member--wether he/she be a factory worker, topless dancer or maintenance man--is this who you would want to be forced to share you most intimate and damning "secrets" with? Sorry folks, but I'll take the professionally trained mental health professional that is bound to confidentiality laws and best knows how to guide me through a process....

I am a mental health professional and have been so for 27 years. I also am a recovering alcoholic of 18 1/2 years. What I have found in my practice and at 12 step meetings is that "when the pupil is ready, the teacher will appear" Also "until the pupil is ready, you can't say anything right, and when they are ready, you can't say anything wrong"

I am a mental health professional and have been so for 27 years. I also am a recovering alcoholic of 18 1/2 years. What I have found in my practice and at 12 step meetings is that "when the pupil is ready, the teacher will appear" Also "until the pupil is ready, you can't say anything right, and when they are ready, you can't say anything wrong"

Are you the teacher? If so then I am the pupil and I am ready to ask you some questions.

Are you the teacher? If so then I am the pupil and I am ready to ask you some questions.

If you are honest, open minded and willing, the teachers are all around you.

I quit posting in here several days ago becasue I realized that nothing is going to be said to make an individual who is looking for any excuse he/she can, including religion or lack of it, to not accept they have a problem and in order to keep their license they must follow the rules which may be uncomfortable or even down right disgusting!

You can lead a horse to water but you can not make him drink. You can lead a human to AA but you can not make him NOT drink! He/she will complain about everything they can find to complain about until they talk themselves into drinking and it's all AAs fault for trying to force them to believe in a higher power.

I've never been there, and am glad my only habit (cigarettes) is still legal. However, I do know a couple of alcoholics and it won't work unless they want it to. One is dry, he hasn't been in a church in his entire life (except for friends weddings and funerals) thanks to AA. The other, who proffesses to be a Christian is drunk just about every day of the week and never dry.

I have been a member of AA and can tell you that it is not religious, it simply states to refer to your higher power, and never once tells you what that higher power is, it can be your inner self, a tree, etc.

I, too, have been a member of AA and can tell you that it most certainly IS religious. Chapter 5, How It Works, in the book Alcoholics Anonymous (Big Book) states:

"Remember that we deal with alcohol - cunning, baffling, powerful! Without help it is too much for us. But there is One who has all power - that One is God. May you find him now!" (p.59)

"Our description of the alcoholics, the chapter to the agnostic, and our personal adventures before and after make clear three pertinent ideas:

(a) That we were alcoholic and could not manage our own lives.

(b) That probably no human power could have relieved our alcoholism.

© That God could and would if He were sought." (p.60)

"We hope you are convinced now that God can remove whatever self-will has blocked you off from Him." (p.71)

The term "God" is referenced in the first 164 pages of the Big Book many more times than the term "higher power". Furthermore, the word "God" and any references to "Him" are capitalized, indicating reverence or veneration. Courts have repeatedly determined that "A fair reading of the fundamental A.A. doctrinal writings discloses that their dominant theme is unequivocally religious, certainly in the broad definitional sense as "manifesting faithful devotion to an acknowledged ultimate reality or deity" (Webster's 9th New Collegiate Dictionary 995 [9th ed 1990])", and that "While A.A. literature declares an openness and tolerance for each participant's personal vision of God "as we understood Him" (Steps 3 and 11), the writings demonstrably express an aspiration that each member of the movement will ultimately commit to a belief in the existence of a Supreme Being of independent higher reality then humankind." In light of these facts, the courts have ruled that "... the A.A. basic doctrinal writings clearly express a preference for and a conviction favoring a concept of God and prayer which is not merely a conscientious social belief, or a sincere devotion to a high moralistic philosophy but one based upon a person's belief in his responsibility to an authority higher and beyond any worldly one. These expressions and practices constitute, as a matter of law, religious exercise for Establishment Clause purposes, no less than the nondenominational prayer." So while the religiosity of the AA program may remain open to interpretation and debate on the personal level, on the societal level AA has been deemed a religious program. Therefore, any state or governmental agency (including the Board of Nursing) that mandates or coerces someone to participate in A.A. or any other 12-step program is acting in direct opposition to the principle set forth in the Establishment Clause of the First Amendment of the United States Constitution.

I will not deny that many people find comfort in the religious aspect of the 12-step program. They have no qualms about turning their will and their lives over to the care of God. They are able to maintain their sobriety, one day at a time, by relying on the "spiritual principles" of the program and by maintaining conscious contact with God, "praying only for knowledge of His will for [them] and the power to carry that out." However, there are many other people who do not believe in God, or a spiritual reality, and find the religious undertones of AA to be disagreeable and counterproductive to their recovery. Generally, these folks may attend a meeting or two and decide that the program is not for them. They have no animosity toward AA, just a realization that, for them, AA is not the solution. They are free to move on and continue their search for a recovery path that is more compatible with their personal and philosophical beliefs. Unfortunately, when these people are mandated to participate in AA in order to maintain their livelihood, then both their personal freedom of choice and their constitutionally guaranteed freedom from religion are violated. The first violation (freedom of choice) is unethical, the second (freedom from religion) is unconstitutional and, as such, unlawful. A person who is subjected to this unethical and unlawful coercion will likely find their unchosen path to recovery fraught with obstacles and uncertainties. No one should be expected to modify their religious beliefs in the name of recovery. Perhaps this is why the BON alternative programs for nurses that mandate 12-step recovery have a such a disheartening success rate and have become the subject of open criticism.

Specializes in LTC, assisted living, med-surg, psych.

Great post, Dixiedi! I too gave up on this thread a long time ago.......it just wasn't worth the aggravation to try to open some peoples' minds. Human beings will go to amazing lengths to avoid taking responsibility for their own failings, admit they need help, and do whatever it takes to get it. Now, I'm just as stolidly in favor of the separation of church and state as anyone who's posted here, but the 12-step programs have helped millions of people the world over (myself included); otherwise state BONs would not mandate attendance as a condition of keeping or regaining nursing licenses when substance abuse---or the appearance of it---is a problem.

YES, there should be alternatives offered to those for whom the mere mention of a higher power is anathema. But as an alcoholic myself, I believe that the public trust---not to mention patients' lives---are too important to give an impaired nurse the choice NOT to undergo some kind of treatment, whether it's AA/NA, Serenity Lane, or whatever is available locally. Dixiedi is right in that no program can force a person to stop drinking/using; however, if s/he is not forced to at least confront the possibility of having a problem, s/he will just go on doing whatever s/he was doing. What motivation is there to change when there are no consequences to one's poor choices or bad behaviors? And how can one even begin to change when s/he doesn't even recognize that a problem exists?

That's one of the things 12-step programs do best: they work at breaking through the denial. Only when the barriers are down can any program work, and that's why AA/NA is the gold standard for substance abuse treatment. 'Nuff said.

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