Distinct criticism of self-help groups from mental health professionals.

There has been distinct criticism of self-help groups from mental health professionals. Katz and Liu believe that groups working to a Twelve Step program are harmful because they do not promote the possibility of a full recovery, personal responsibility or self reliance. Instead the groups encourage life long membership in fear that the Codependent will not have learnt their lessons and are able to help themselves through any future difficulties. In contrast to this view they explain that many people who experience addictive or destructive behaviour do not go for treatment or to self-help groups, that they manage to break free of their behaviour via their own volition and commitment to getting better. They feel that recovery can only be made possible by a person's realisation that they have suffered enough and their own self motivation/commitment to their recovery. Once they have made the choice to get better the mode of treatment is not necessarily the most important factor in recovery.

They also stress that many people who join self-help groups "are not true addicts. They are people with problems who need guidance and support and acceptance, but they are not powerless. They can recover completely. They can achieve self-reliance. For these people self-help programs may provide the best way to begin the recovery process but in the long run they do more harm than good." (Katz and Liu pg. xiv -xv of Introduction).

Katz and Liu also argue that self-help groups do not place enough emphasis on the conditions that members experience as being a result of their own choices and actions. That in self-help groups they are told "something" has happened to affect the individual, that someone or something else was responsible. "The overriding lesson of the Steps is not personal responsibility and morality, but conformity and dependence." pg. 48. They compare self-help groups to cults who "maintain that salvation lies in the ability to give yourself up to a Higher Power. But that the real key to salvation is not relinquishing the control to a treatment program or guru or your Inner Child. The highest power lies within your own fully developed Self." pg. 23. They also identify through a number of patient cases that sometimes the groups views are so ingrained in the minds of its members that it appears like brainwashing. Members can rattle off chapter and verse of the Twelve Steps program and treat anyone who does not wish to succumb to its teachings/help as being in "denial".

They also feel that the Codependency movement places too much emphasis on relationships in the home being the only factor in creating people with behavioural/addictive problems. They do not look at wider influences such as friends, colleagues or the media. They highlight that studies have also shown that growing up in a dysfunctional family doesn't necessarily mean a child born in to it will grow up requiring psychological treatment in adulthood. That sometimes things work out all on their own and the adult is able to work out their own issues to build a happy life for themselves.

Katz and Liu further criticise self-help groups for perpetuating "disease theory" and unnecessarily pathologising people who are essentially normal but may need a little guidance to help them get through stressful situations and bad times. They state the groups help to keep members in the past, focusing on the need to control old behaviours that may or may not appear again in the future. The repetitive nature of the discussions they have in groups keeps the memory of how it felt in the past when someone abused them in the forefront of their minds and as a result members will relate to those feelings in all future relationships. They argue that this doesn't promote self-reliance because people are still clinging to old situations, old partners, old feelings etc. where they were reliant on something or someone else.

All people are different; they react differently to different events and to different treatments. Some psychologists have concerns that self-help groups do not provide individual treatment. Katz and Liu advise that other conditions and issues are not discussed in self-help groups concentrating on a specific area and as a result even minor incidents can linger as a "reason" for the pain. In addition the Twelve Steps were adapted from guidelines to help those specifically suffering from Alcoholism a very different condition at a time when religion was still prevalent in society.

One of the most obvious and damming criticisms of self-help groups are that they are not regulated by an official body. There is no measure of the standard of care that participants are receiving as a result of "working the program". The groups are not lead by professionally trained Therapists. Usually the only requirement to being a group leader is that you have experienced the condition personally and that you are knowledgeable in the workings of the Twelve Steps program. Katz and Liu maintain that just because someone has experienced the same conditions and feelings as you doesn't necessarily mean that they are the best people to guide you through your recovery. They feel that people who have themselves been successful in areas you are not are probably in a better position to be able to do this.

The second option open to a Codependent is therapy. By this means Katz and Liu feel a person is more likely to receive a non biased evaluation of their condition from a trained professional who is objective (hopefully having a healthy sense of Self and a respect for others) and can provide them with individual treatment to address their problems and issues. They are also more likely to get help that is focused on self-reliance as opposed to dependence on a group dynamic for future support. They do accept that mixing a group dynamic with Therapy can be beneficial in allowing the patient to identify with others who have gone through similar experiences but they do not see self-help groups as being a suitable long term treatment.

Medication can also be prescribed by a doctor for symptoms that a Codependent experiences such as depression, high blood pressure etc. in conjunction to any other therapy that is chosen.