United States Department of Veterans Affairs
Mental Health

Self-Help Toolkit: Solutions to Patient Concerns about Attending Self-Help

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Solutions to Patient Concerns about Attending Self-Help

To help you and your patient address specific concerns, we have compiled the following list of possible solutions.

Making Time
  • Your patients may think that going to meetings is taking up a great deal of their time. This is especially true given the number of things they may have and want to do. The crucial thing to do at this time is to help your patients set their priorities. If they bring this problem up at meetings, please give them feedback concerning the importance of going to meetings in order to maintain sobriety. Sobriety will give them energy and time to devote to the rest of their life. Additionally, you should help them understand that meetings and formal treatment can all be used to come up with ways for managing their time so that they can attend the necessary number of meetings and do the other things they need do as well.
Getting There
  • By the time some people are ready to do something about their substance abuse problem, they may have the additional problem of a revoked license to deal with. If this is the case for your patients, you should help them to learn that they are not alone and other group members are willing to help them with this problem. Many of them had the same problem to deal with when they came into AA or NA. Many are happy to provide rides as a way to repay the help that was given to them. If your patients have not lost their license but have a problem with transportation for any other reason, the same help can be found. It is very important to help your patients understand that they should take responsibility for asking for rides, and not expect others to know their problem and offer the solution. This is difficult for many newcomers or returning members, but is an important part of learning how to take care of their needs, even when that means requiring the help of others. It is also not uncommon for your patients to feel anxious about accepting rides or any other form of help from others. This takes practice like anything else new that they try to do, and it will become easier with effort and time.

    There are several ways to handle asking for rides. Tell your patients to feel free to use any of the following suggestions or come up with ideas on their own.

    • As always, they can ask you to solve their problems or any other barrier to getting to meetings.

    • Getting to the meetings can be done by calling the AA or NA answering service that is listed in the phone book. They will put you in contact with someone in the program who has volunteered to help with rides for newcomers. It is best to call the answering service during business hours to avoid getting the evening telephone operators, who are not group members. It is also a good idea to call at least one day before you want to go to a meeting so that there is time to make the arrangements.

    • Once they have gotten to their first meeting, they can either approach individuals to explain their need for a ride, or they can make a general request when announcements are asked for by the chairperson. Help your patients remember that it is their responsibility to follow up on their announcement and get a ride home and to the next meeting. Once they get to know more members they might try asking different people for rides; this may ease some of their discomfort in asking for help and is a great way to get to know more people.
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  • One of the things that happens to most AA/NA members after they have stopped drinking/using and their life is looking better, is that they begin to get overly confident. Confidence in their ability to take care of themselves and stay sober is not a bad thing, but when it starts to take the form of finding excuses not to go to meetings then it is time to help them remember their priorities. If you listen to your patients at meetings, you may hear someone talk about this problem. While it is understandable that they might feel that they are doing fine and don't need to go to meetings, you should help them remember that going to meetings was one of the tools that contributed to their doing so well in their recovery. You should encourage your patients to bring this up at a meeting so that they can find out how others have dealt with these feelings. One thing that you should point out is that sobriety needs and deserves as much commitment as did using, and that few drug addicts were too tired, busy, happy, sad, etc. to go out in search of drugs.
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Negotiating Family Time
  • It is important to help your patients learn how to balance their family life with going to meetings. Twelve-step programs suggest that newcomers and returning members attend many meetings each week so that they might become involved in the program as soon as possible. You should help your patients understand that it will be necessary for them and their partners to spend time discussing and negotiating a schedule that allows everyone's needs to be met as much as possible. Effective problem solving requires certain communication skills that your patients may not have developed or used in some time. You will be able to help them learn how to express any feelings, such as frustration, and work toward a balance between program time and family time.
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Religious/Spiritual Orientation
  • Some patients may report feeling uncomfortable with the amount of emphasis placed on God or a higher power within the self-help philosophy and at meetings. For some, that part of the program may discourage them from listening to what others have to say or prevent them from attending meetings.

    You can explain to your patient that there are quite a few atheist or agnostic newcomers, and that a belief in a Higher Power is not a requirement of AA or NA. It is true that programs emphasize the importance of developing a belief in something greater than yourself. However, the definition of that something is left up to the individual. AA and NA very clearly state that they are not allied with any sect, denomination, politics, organization, or institution. The emphasis is on the development of spirituality rather than religion. For some people, the self-help group in and of itself is seen as a Higher Power.

    Emphasize to your patient that less religious individuals can derive as much or more benefit from the groups as religious individuals do as long as they fully engage with the program. You can help your patient by conveying that participation in self-help groups improves substance use outcomes, regardless of the strength of their religious beliefs or belief in God.
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