Motion: 'mutual aid and fellowship support replace the need for treatment services'

For...

You need to establish rapport before you can talk about the substance use and its treatment. If there is no rapport then there is no point to any kind of intervention; service users will not take in anything that is said to them, they will probably dislike their practitioner, and are likely to drop out.

Against...

Establishing rapport is important and needs to be part of dealing with the problem the service user wants help with. It is no good wasting time just trying to strike up some rapport. Service users want to know that they are going to get the help they need and that their practitioner has that as their focus.

For... Mutual aid meetings are available 24/7, are free and conditional only on participants wishing to give up their addiction. Meetings are more flexible and more widely available than addiction services. There are no time limits and support can be there throughout the lifespan. Against... Mutual aid groups are very important and, indeed, provide a kind of DIY Social Behaviour and Network Therapy. However, a lot of problem drinkers and drug takers have complicated medical and psychological conditions that require someone who knows how to treat these aspects of addiction. The level of involvement with mutual aid groups in the UK contrasts with the United States where 12-step programmes in particular are much more deeply embedded in society and where, perhaps, the population as a whole has a greater interest in spirituality. The study cited below reports on the attitudes of UK addiction practitioners (n=364) toward AA and NA and the 12-step philosophy. It found: When asked to estimate the percentage of their clients who attend either AA or NA, the response was an average of 10.6%. This figure was lowest for workers who only treated primary drug users, mean 3.5%, and higher for those treating just primary alcohol users, mean 10.4%. 39% said they felt positive about AA and NA meetings. 33% had attended at least one AA or NA meeting. 33% said that they thought their service users were suitable for an AA or NA approach. 28% said they were likely to suggest attending AA or NA Find the full text of the article here… Day E, Gaston RL, Furlong E, Murali V and Copello A (2005) United Kingdom substance misuse treatment workers’ attitudes toward 12-step self-help groups. Journal of Substance Abuse Treatment 29: 321–327 doi:10.1016/j.jsat.2005.08.009 Decide which side of the debate you support and then Make Your Own Case