Dear Samaritan Counseling,
I am writing today in good faith to inform as many Samaritan Counseling Centers as possible of a very serious problem that needs to be addressed but has not been in any way shape or form by Samaritan Counseling Center of the Capital Region, the state licensing board, or Samaritan’s accrediting body, Samaritan Institute.
A few of you may be aware that I have taken to
– Twitter (Stop2Hatters, Calling_Out_AA),
– FaceBook ,
– blogs ( notpowerless.com ),
– letter campaigns and petitions ( Petition to Health Workers and Academics about Alcoholics Anonymous , Letter Campaign )
– and promoting awareness of documentary films related to the issues presented here: ( The Business of Recovery, The 13th Step )
Here is the problem in a nutshell:
– There is much evidence that 12-step programs are often ineffective in ‘treating’ addiction ( The Sober Truth by Lance Dodes ), often psychologically damaging when ineffective (“keep coming back” to hear that you are “constitutionally incapable”, which has often lead to suicide), illegal and unethical to coerce participation in (according to 1st Amendment legal precedents and all social work professional ethics codes), and that the organization of Alcoholics Anonymous itself seems completely uninterested in promoting safety information for its members or alternative views, scientific data, or health information regarding drug use (which would seem to be its fiduciary responsibility as the ‘hub’ of ‘addiction treatment’.)
– I was (and this is corroborated by records on my website), repeatedly ‘recommended’ to attend 12-step meetings after having attended AA daily on my own for a full year, and finally seeking professional help at Samaritan Counseling. My termination from Samaritan Counseling, based on my records, seems to have been based on my not following these ‘recommendations’ well enough during a full year of therapy.
I understand that some people feel at home in a 12-step environment. My intention is to bring awareness to the fact that not everybody is, and that state-licensed therapists have a responsibility to acknowledge social and public health problems rather than pretend they don’t exist as part of a ‘faith-based’ approach.
It may also seem that I am complaining about nothing, since I did finally decide AA was not for me, and Samaritan is no longer ‘treating’ me. I want to explain, though, why I feel that this has not been addressed, and why it is still a big deal and a serious public health problem.
1. The very real option of leaving AA and thinking of alcohol dependence as a phase in my life (a very common life event backed up by NIAAA’s 2002 epidemiological survey of over 40,000 people representative of the US population) was never presented to me. Even after I had lost all faith in AA, I was still compelled to pay AA members and somehow ‘make it work’.
2. I was discouraged from exploring alternatives. I started SMART Recovery, and was then referred to 12-step rehab. I was terminated for refusing any more 12-step treatment. There may have been other factors in my termination, but the official position of Samaritan was that I had been properly referred to a 12-step interventionist, that they could not help me and refused to try because I hadn’t ‘followed the recommendations’.
3. Therefore, I was cut off from my therapist, which was one of the most meaningful relationships in my journey. Records show that 12-step ‘boundaries’ and ‘tough love’ strategies imposed by 12-step ‘experts’ were involved in preventing me from discussing the situation directly with her.
4. There are several indications that my own therapist was not particularly fond of repeatedly referring me to AA. Her own frustration could have been another factor in my termination. The Clinical Director also indicated frustration with the ‘program’.
5. What this means is that the whole culture/environment of not being allowed or able to openly discuss the failures of AA (which is nothing more than a set of religious ideas that assume they are perfect treatment for just about anything, and deny any role in confusion) shifted blame to actual people: my therapist was being considered unsuccessful in transferring me happily into 12-step treatment, and I was failing to ‘work the program’, which is clearly a Christian or heretical Christian program, while I’m a Buddhist. Faith-sensitive therapy should be able to understand that these views aren’t necessarily compatible.
6. Even more importantly than the fact that referring and re-referring to the same failed treatment is not a very reasonable method, I believe that the dynamics of coercion, dependence, shunning (or ‘blocking’ which is used to protect members from outside information and is supposedly a ‘natural consequence’ of ‘disturbing the recovery community’), invalidating thoughts and experiences, and ‘leverage and consequences’ led to strong transference and countertransference reactions between me and my therapist.
7. It is my contention that trying to ‘treat’ a ‘transference issue’ largely caused BY the 12-step treatment WITH the same treatment can do nothing but compound the problems, and is itself a primary form of mishandled transference.
Those are the reasons I think it is important to address the issue directly. Here is why I feel that Samaritan Counseling of the Capital Region has done the opposite:
1. My simple complaint was never addressed. I was terminate-referred to the same 12-step interventionist. I was told that a therapist has the right to her ‘preferred mode of treatment’. To me, it didn’t seem to be her preference; it seemed to be her job.
2. My extended complaint detailing the problem based on records was never addressed. I was instead told ‘under no circumstances’ was I to have any further contact with Samaritan. This not only cut me off from resolving the relationship issues with my therapist, but felt to me as if I was being told that my experience did not matter to them at all, and they would continue doing this to others as if they just could do nothing about it.
3. My Yelp review was removed by ‘community request’.
4. My complaint to the licensing board was seen as not ‘making any sense’, and I was not allowed to see who was involved in the investigation or what the investigation involved.
5. My second complaint to the licensing board was met with ‘this case is closed’.
6. The first set of records I requested (before filing a complaint to the licensing board) included my complaint correspondences. The second copy of records I requested (after) were missing those documents. (Meaning that much contextual information that might have been sent to a new provider or investigator would simply not be there.)
7. I was told by the licensing board that this is a ‘personal issue’ between therapist and client, but I don’t think that is correct, because it was a systems issue very much related to the business of therapy and the ‘recovery’ industry. Either way, my therapist is not willing to discuss this with me on the personal or the professional level, even though I think it is a resolvable issue (but not to be resolved by me simply shutting up and disappearing into a psychiatric hospital).
Satisfying my concerns would seemingly be a simple thing to do: acknowledge facts about my case dynamics, acknowledge evidence of problems with 12-step culture and treatment, assure me that more options and less coercion will be involved in similar client interactions in the future. Unfortunately, I see zero evidence that any of these reasonable requests have been taken seriously, and this applies mainly to Samaritan Counseling Center of the Capital Region (my experience being anecdotal with evidence that it is a broad policy failure across healthcare systems in America) I want to do my best to raise awareness system-wide so that human and constitutional rights are honored and people can get the care they need without having to convert to or shoehorn certain religious ideas; I hope you appreciate these efforts and do not see this as another offense.
For anyone interested in this topic, I encourage you to look at my blog notpowerless.com (there is a lot of good information there; please excuse and understand that I am indeed very frustrated with my therapist and her supervisors’ handling of this on many levels. It has been my concern for future Samaritan clients seeking help upstairs from the AA meeting, and my refusal to write these therapists off as people that has allowed me to find patterns that go far beyond any of the individuals involved in my case).
Please see my cartoon about 12-step coercion in therapy:
and please consider what Samaritan Institute might be able to do policy-wise to prevent this kind of situation in the future. If this issue can be addressed at the organizational level, it will be a much better resolution than messy termination or attempting to scapegoat any particular therapist (or client).
I have heard that there is a growing number of therapists who find 12-step treatment problematic, and I’m sure there are more than a few in Samaritan Counseling Centers. Please do not hesitate to ‘friend’ me if you would like to continue the conversation or just to show me some good will. There is a lot of interesting information out there beyond the AA conference-approved literature.