In principle, the common philosophy of all Twelve Step-based programs emphasize the psychological acceptance of the problem, the extent of its detrimental effects on the lives of addicts and their families, acknowledgement of the inability of the addict to solve the problem without help, and the development of self responsibility and a social support network to help them overcome residual (or recurring) negative impulses or behaviors. Much of that is achieved through the group discussion format that allows individuals with very similar problems and experiences to express their feelings and frustrations openly and in a confidential setting.

While there are differences, those types of substance abuse programs are particular applications of the more general group therapy technique in combination with specific underlying therapeutic philosophies (Gerrig & Zimbardo, 2008).

Patient-centered substance abuse programs typically emphasize one-on-one counseling in behavioral, cognitive, or psychodynamic (psychoanalytical) psychological approaches. In many respects, the goals of this approach are identical to those corresponding to group therapy models; the difference is in the manner in which they strive to reach those objectives (Gerrig & Zimbardo, 2008).

Barriers to Substance Abuse Treatment Program Effectiveness

Barriers to the effectiveness of substance abuse treatment programs are substantially similar (Hajema, Knobbed, & Drop, 1999; McCoy, Metsch, & Chitwood, 2001). In virtually all programs, the failure of the patient to overcome psychological denial, a natural and predictable impulse, is the primary independent predictor of success in the program, with success being defined as continued sobriety after the program concludes. Other significant factors that contribute to barriers to success...

Specifically, exposure to people social environments associated with substance abuse is a common barrier to success through relapse. That is a particular concern in certain professional environments where social etiquette or convention tend to provide a link back to alcohol abuse, for one of the most common examples encountered (Hajema, Knobbed, & Drop, 1999; McCoy, Metsch, & Chitwood, 2001).
Conclusion

Generally, contemporary substance abuse treatment consists either of Twelve Step and group therapy programs in the addiction-as-disease model, or individual counseling programs in the person-centered model. While their methods are substantially different, their ultimate objectives and the potential barriers to their success are substantially similar. In virtually all cases, psychological denial is the most significant potential barrier at the outset, and social support and environmental factors after program completion are the most important predictors of long-term individual success.