Health Realization Compared to 12-Step Programs in Drug Rehab

It has been widely said that “AA is the only thing that works” when it comes to alcohol recovery. The 12-step model of Alcoholics Anonymous (AA) is now applied to other substance use disorders in drug rehab centers around the world. However, research shows that AA is not the only approach that works. In fact, many studies have shown that other drug treatment approaches are just as effective as 12-step programs. Banerjee et. al. found that a relatively new approach known as Health Realization offered comparable benefits for women in a residential drug rehab program as compared to a 12-step program (2007).

You might also be interested in: What is the Best Alcohol Treatment?

Health Realization (HR) is an approach to psychology first developed by Roger Mills and George Pransky in the 1980s. It is based on the ideas of author Sydney Banks. HR teaches that the nature of thought affects the experience of reality and that individuals can change how they react to their circumstances by becoming aware that they create their own experiences through their thinking.

According to HR, individuals tend to experience a stressful reality when they are having negative thoughts – but the negative thoughts do not have to be taken seriously. By realizing that the source of stress is negative thinking and refusing to take negative thoughts seriously, an individual may calm the mind and allow positive thoughts and feelings to emerge. HR teaches that individuals have a natural state of well being or “innate health” that will spontaneously emerge when negative thinking subsides.

HR views substance abuse as a lack of sense of self-efficacy rather than a disease. HR drug treatment aims to make individuals aware of their own roles in creating stress through negative thinking, as well as their own innate health that will appear once self-generated negative feelings are relieved. There are no specific steps or techniques taught by HR counselors or trainers, and HR focuses on present thinking rather than past errors and problems.

Twelve-step programs, on the other hand, are based on 12 specific steps and involve admitting powerlessness over addiction, recognizing a higher spiritual power, examining past errors, and making amends for errors.

Banerjee et. al. compared Health Realization and 12-step approaches offered in women’s residential drug rehab programs. The study was sponsored by the Department of Alcohol and Drug Services in a large California county. This study is the first systematic evaluation of HR as a substance abuse treatment program for adult women in a residential treatment setting.

The randomized study consisted of two observations points: admission and 9 months post-admission. Results indicated that both HR and 12-step approaches exhibited comparable outcomes for substance use, criminal justice involvement, employment, housing, adverse effects of substance use, and psychological wellbeing. Substance use and adverse effects of substance use had declined significantly for both groups at the 9-month follow-up.

“These results are consistent with the general findings in the substance abuse literature, which suggests that treatment generally yields benefits, irrespective of approach,” noted the authors of the study.

Different mutual help groups such as AA may appeal to different individuals in need of drug treatment. Fortunately, non-12-step options such as HR and SMART Recovery are becoming more accessible to those seeking treatment.

See also: What is the Best Alcohol Treatment?


Banerjee K, Howard M, Mansheim K, Beattie M. Comparison of health realization and 12-step treatment in women’s residential substance abuse treatment