Frequently Asked Questions
What Makes The Non 12-Step Alcohol Treatment Program Different?
You’ll receive the most advanced, effective, and research based alcohol treatment in America. Instead of focusing on your “disease,” we focus on proven behavior change models and the medication support that has proven effective helping end your alcohol cravings. This, and the assimilation of our own research and work of the past twenty years, provides you with the best individual treatment available anywhere at any price.
We are different in other important ways as well. You won’t be fobbed off on interns, other clients, outside groups, or former clients. We have a staff of two experienced, competent, well educated and involved individuals. You will get our direct and continuing attention.
We aren’t true believers in one-size-fits-all models that blame client failure on s/he “didn’t work her/his program.” We work with you to learn what does work for you, not why you resisted being crammed into someone else’s ineffective mold.
Additionally, we do not recycle flawed men’s programs that are especially ineffective for women. We are interested in differences, regardless of the basis, and how these influence outcomes.
Finally, we want you to regain your life, a new, exciting, and rewarding one, not one dedicated to the dreary rituals and tokens of lifelong “recovery.”
Can a 5 day alcohol treatment program really be enough?
Yes, actually it is. That’s because you spend your time with us, not in groups, meetings, classes, doing step-work or other fillers that have nothing to do with overcoming alcohol abuse. Instead, you’ll spend approximately 20 hours with both Dr. Barnes and Dr. Wilson callaboratively exploring your problems, your issues and solutions.
You’ll see our medical doctor for evaluation for using Naltrexone, the anti-craving medication, that most of our clients find helpful through the first 3-6 months.
This is followed by 12 weeks of scheduled and “as needed” 1-hour phone session support with us, not on-line chat rooms or AA meetings or most commonly – nothing. Altogether this amounts to over 40 hours of experienced, professional and effective help.
Compare this to the typical 30-Day residential program where you may receive as little as 4 hours of individual attention (one hour per week), and that from a “recovering” counselor who, according to a recent survey, is probably still relapsing!
Remember, ending your alcohol abuse happens in your day-to-day life. With the 5-Day Program, you get all of the individual help you need to build a solution tailored specifically to you. Then you get the on-going support you need to successfully implement the change over the coming months.
What does the 5- day alcohol treatment program cost?
The 5-Day program, with the doctor’s evaluation and 12 weeks of follow-up is $8750. This includes over 40 hours of professional time with us, far below the $275/hr rate charges by individual practitioners.
Aren’t You Just Like Other Non 12-Step Programs?
No, we’re not. While we appreciate the hospitality and perspectives we have shared over the years with programs in Phoenix, Atlanta, Montreal, Santa Monica, and elsewhere, our services are not based on any of their models. While we have some common program elements – primarily the use of CBT and supportive medications – the delivery and philosophy are completely different.
Our treatment program philosophy and research are based on twenty years of work by Dr. Ed Wilson, Program Director, and an early pioneer in the field of Alternative Alcohol Treatment. As a result, our program is truly customized to you, your problems, and your desired outcomes. We offer far more individual counseling than any other program – residential or outpatient – total confidentiality (partially because we do not engage in group work, nor exposure to other clients), and 90 days of follow-up with your counselor, not just a referral to a group or an online chat room.
What’s Your Success Rate?
As you can imagine, success rates vary, but the following rates reflect client outcomes over the past two years: Abstinence: 82% of these clients have achieved their goal. Of the remaining 18%, half continue to make good progress.
Moderation: 73% of these clients achieved their goal and about half of the remaining 27% have switched to an abstinence focus.
Finally, we want to tell you a true story that happened to co-founder and Clinical Director, Dr. Ed Wilson, over twenty years ago. We still find it chilling because of what it said (and still says) about the treatment industry in our country. Dr. Wilson says “I was in my first position as a substance abuse counselor in a nationally known and still operating Minnesota residential treatment program. I thought I was doing very well with my clients. Most of them were getting sober, getting their lives back and moving on to greener pastures. All was going well or so I thought. Nine months into my job, the director of the program called me into his office and fired me, because my clients weren’t relapsing at the required 90% rate. Turns out they depended on a high relapse rate to keep the business going. I was messing up their business model. Unfortunately, this is still a consideration at many programs, where recycling clients is a major part of the business.”
So, please ask questions carefully and persistently when looking into treatment program. Take “success rates” with a grain of salt. Maybe ask about how many clients return for a second or third round of treatment or how many staff are former clients (not a good sign). The answers to these questions will tell you a lot about the program you are considering.
How Does Your Non 12 Step Alcohol Treatment Program Differ From 12-Step Programs?
|Non 12 Step Alcohol Treatment Program||12 Step AA Programs|
|Non 12-Step believes in empowering people to overcome their addiction; that people are capable of change, improvement and building a better life unhampered by alcohol’s hold.||Call all alcoholics powerless. Do not believe they can ever really be recovered.|
|Non 12-Step recognizes that nothing works for everyone and that it can be very difficult to figure out what will work for you.||Blames clients “you didn’t work the program” when they fail.|
|Non 12-Step has no steps. Imagine that?!!
Supports you in the development and design of your life. Holistic in approach; addresses thinking, nutrition and physical health.
|The 12 steps as a treatment model.|
|Non 12-Step uses cognitive behavioral therapy. The National Institute of Alcohol Abuse and Alcoholism (NIAAA) reports that Cognitive Behavioral Therapy is an effective and recommended treatment for alcoholism.||Started as a marketing strategy. AA wasn’t going to market itself so someone else did. It never was intended to create a workable solution to chronic alcoholism.|
|Non 12-Step creates new lives that leave no room for alcohol; lives that squeezes alcohol use out and leave no interest in a return to the bad old days.||Creates a vacuum. The time, energy and money formerly spent on alcohol are now freed up without there being anything, other than endless meetings, to fill the void. That void sucks people back to the familiar.|
|Non 12-Step uses a common sense approach that respects and leaves your religious beliefs to you.||Christian approach dominants.|
Why Should I Consider Outpatient Alcohol Treatment Rather Than Residential Treatment?
We provide out-patient treatment because we believe that your success depends upon changing your alcohol based behaviors while maintaining and enhancing your life, not by taking a vacation from real life and expecting that to last. Anyone can change most any behavior given the right surroundings, but few can maintain change when they return to the usual realities of daily life. Vacations are nice, but it’s cheaper and more fun to take them as such.
Out-Patient services are integrated into your usual life. We become a detour away from your drinking patterns while maintaining the other aspects of your life. Treatment is a change process that occurs and accommodates to the realities of your life. When you stop drinking other areas of your life will be affected and out-patient allows for the necessary micro-adjustments success will require. Residential isolates you, and those around you, from the effects of change thus leaving everyone ill-prepared for your return. It is hardly surprising that relapse is the rule, not the exception.
What is Cognitive Behavioral Therapy?
Cognitive Behavioral Therapy or CBT is based on a few simple principles
- You are responsible for your own emotions and actions,
- Your harmful emotions and dysfunctional behaviors are the product of your irrational thinking,
- You can learn more realistic views and, with practice, make them a part of you,
- You’ll experience a deeper acceptance of yourself and greater satisfactions in life by developing a reality-based perspective.
A difficult part of the recovery process is learning how to be happy without the use of alcohol or drugs. To assist individuals in this, we use many of the tools of Cognitive Behavioral Therapy (CBT) to address the psychological and social components of alcohol dependence. These tools are designed to assist individuals in their recovery process. They include, but are not limited to:
- Enhancing motivation to quit drinking and to remain abstinent
- Risk/Reward Analysis (costs/benefits of drinking/quitting)
- Setting sensible, measurable, achievable, reasonable, and timed goals and working towards achieving them.
Learning how to refuse to act on urges when they arise.
- Understanding triggers and where they
- Understanding “slippery” social situations
and how to deal with them.
Learning how to manage life’s problems in a sensible and effective way.
- Using CBT to identify irrational beliefs.
- Learn self-acceptance and other-acceptance.
Developing a positive, balanced and healthy lifestyle.
- Recognizing the importance of exercise and nutrition in the recovery process.
- Replacing destructive habits with constructive habits.
- Avoiding replacing one bad habit with another bad habit.
Do you accept medical insurance payments?
No, we do not take insurance. We feel very strongly that using insurance to pay for any substance abuse treatment so endangers your privacy and confidentiality that we are unwilling to put you in that sort of jeopardy.
How do I start?
Call us toll free at 888-541-6350. Come in for a free consultation if you are in the Los Angeles area, or call us and schedule a phone consultation if you are out-of-the area. Let’s get to know each other a bit and see what possible. A lot is, you know.
How do I decide on an alcohol treatment program?
Deciding on an alcohol treatment program that’s right for you is a decision making process.
First, should you select an outpatient alcohol treatment program or a residential program? Research suggests that outpatient programs are both much cheaper and much more effective than residential treatment programs.
Second, all treatment programs can be divided into those that are 12 Step/AA based and those which are Non 12 Step or research based. Those based on AA have, of course, the same “success” rate as AA – about 3%. Those based on research can have rates as high as 70% depending on closely their program matches their client demographic.
Third, as we alluded to above, you need to pick a program that matches your circumstances in terms of age, needs, presenting problems, and so on. We, for example, only deal with alcohol abuse (and certain common co-occuring disorders); generally restrict our clients to those between the ages of 35 and 75; and only work with individuals and couples (ie, NO GROUPS).
Finally, there are the matters of price. Outpatient treatment is far less expensive than residential “rehab” and confidentiality. which programs using groups or accepting insurance, are not. Neither of those are matters of small consideration.
Are non 12 step alcohol treatment programs as good as 12 step programs?
12 Step/AA treatment programs are stuck with the same outcome or success rates as AA itself – about 3% according to all available estimates. Non 12 Step treatment programs vary widely depending on what they are based on. Some are simply based on a variation of the 12 Steps, or other personality cults, while a few of us are based on the actual research.
Obviously those treatment programs based on the past fifty years of research and experience, and those careful to match their program offerings to specific clients – and we are the only program in the country, 12 Step or Non 12 Step, to do this, will have better outcomes.
3% success vs. 65+% success? What odds do you want for your time, money, and effort?
Will my doctor help me find an alcohol treatment program?
Generally speaking, your physician will not help you find an effective treatment program.
Unhappily he or she is in a bind. Most doctors have little or no training in so-called “addiction medicine” which in some medical schools amounts to as little as a requirement to attend a few AA meetings.
Additionally, if your doctor knows anything, they know that AA doesn’t work, at least it doesn’t even work as well as doing nothing. But the 12 Step treatment industry has succeeded in making AA based treatment the “standard of care” so your doctor is effectively prevented from recommending what actually works – Non 12 Step, research based treatment.
This is the case even when you bring up the question. Do not expect you doctor to know of any really good, research based treatment programs because there are so few of us around and your doctor needs to protect himself from liability, so, if he refers you at all, it will be to a 12 step treatment program.
My therapist told me I had to go to an alcohol treatment program before she could work with me. Why?
Most therapists still believe that alcohol abuse is a “disease” rather than recognizing it as the symptom it is. They therefore want you to fix the disease before addressing other factors in your life.
Of course the reality is that if they helped you address the anxiety, loneliness, boredom, and imbalances in your personal relationships and marriages that cause you to drink, then the drinking would go away on its own.
This is a case of the symptom - alcohol abuse – being mistaken for the cause and the effective order of treatment being reversed.
My family said that AA is the only thing that works? Is this true?
Not only is AA not the “only thing that works,” it’s not even close to being the most effective. According to AA’s own research, the 12 Step approach has a long term effectiveness rate of less than 3%! Consider that the “spontaneous remission” rate, people just stopping, exceeds 5%, you can see that AA not only doesn’t work well, it actually prevents people from getting over their alcoholism.
What does work is: brief counseling, individual therapy, cognitive behavioral therapy, motivational enhancement, medication support with Naltrexone, diet, exercise, and improved social, recreational, and marital relationships – all of which AA actively opposes.
You can also read more at Ending Alcohol Abuse: What Works.
Are non 12 step alcohol treatment programs better for women than 12 step programs?
Women seeking help for alcohol abuse are already, for the most part, feeling powerless and victimized. To be told that you are a powerless alcoholic, which isn’t ever the case, and told to label yourself as such, repeatedly, and in front of others, is counter-productive in the extreme – unless what you really want is to keep on drinking.
Good research based alcohol treatment programs, on the other hand, build on women’s strengths, interests, and abilities and develop these. It’s not hard to see that an alcohol treatment program that focus and encourages weakness is going to do more harm than good, while one that focuses on developing strengths is going to improve women’s lives all around.
Wondering what to do? Pick services that treat you as the competent individual you are, not as a label – an alcoholic, a mythologically diseased latter day leper, or a moral degenerate.
You drifted into alcohol abuse for understandable reasons and you can work your way back out just as systematically.
Are there any alcohol treatment programs that will treat us as a couple?
All 12 Step/AA based treatment programs and most Non 12 Step treatment programs refuse to treat couples. In the case of 12 Step based treatment, it fits neither the disease model nor the goal of having 95% of clients relapse.
But the real problem is that treating couples requires staff with real skills and can’t be done in a setting that relies on groups as their primary format.
We, on the other hand, working with you as a team, and never doing groups of any sort, can customize treatment to enhance your relationship, teach you to be both independent and mutually supportive, and how to remove the alcohol while enhancing the intimacy.
No other program in the world has the staff, expertise, experience, and research to achieve this.
Don’t people need to go away for 30 days or more in order for alcohol treatment to really work?
“Going away” is another of those profit-enhancing but results-diminishing myths that the alcohol treatment industry has perpetrated on people across the country over the past 50 years. 95% of the time it’s nonsense and research has repeatedly shown that outpatient treatment is far more cost effective and has far better outcomes (See Anne Fletcher’s “Inside Rehab” for details).
It is true that in a few cases going off for awhile can help stabilize an individual who is too deeply enmeshed in the habits, culture, and fog of alcoholism to be able to get enough of a grip to begin to emerge. But that’s rare and about the only reason for a person to “go off to treatment.”
Remember that most treatment programs have nothing to offer beyond AA, which is available to you for free at a church near you, and the only follow-up these programs offer is AA, and the end result is a long term success rate of less than 5%.
AA alternatives, the non 12 step research based programs, can have success rates exceeding 65% and with a far better quality of post-treatment life.
Residential alcohol treatment programs use a lot of group therapy, is this because it is better for alcohol treatment than individual therapy is?
Individual and couples therapy is far superior to group therapy in the treatment of alcohol abuse. Residential rehab programs use group therapy because it is exceeding cheap to provide, especially when the groups are “led” by volunteers and poorly trained para-professionals.
The bottom line is the bottom line.
Again, as with most of the activities in residential treatment programs, the motivations are to fill time as cheaply as possible while pretending the activities – equine therapy, ropes courses, helicopter therapy, etc – are beneficial. Let’s be clear, these are fun, diverting, time-fillers. But effective services, the Non 12 Step Alternatives – CBT, Motivational Interviewing, Individual and Couples Counseling,Assertiveness Training – are expensive, are best delivered one-on-one, require skilled professional staff, and actually work.
What should I look for in selecting an alcohol treatment program?
When selecting an alcohol treatment program, and assuming you do not require medically supervised detox, look for research based outpatient programs that employ the proven effective components:
- Short term intensive individual counseling;
- Anti-craving medication support;
- Motivational Enhancement;
- Assertiveness Training;
- Couple Counseling;
- Social, Vocational, and Recreational Considerations;
- Age Appropriate Staffing;
- Professionally Trained and Experienced Staff.
If they recommend, or you request, group support, look at programs that recommend AA Alternatives such as Smart Recovery or Women For Sobriety. Avoid those that refer you to AA or Alanon.
Are alcohol treatment programs for women different than alcohol treatment programs for men?
The best treatment programs will address the differences in women’s alcohol treatment needs from those generally more commonly found in working with men. While the differences are not always gender specific, the two most common ones are:
- Women need more support in actually doing the things that work rather than simply talking about doing them;
- Men need more help in sorting out what it makes sense to do.
Obviously AA alternative programs that deal with individuals have a much easier time doing this than programs that delivery treatment in groups.
Don’t be fooled, however, by programs that describe themselves as “women only” as these programs tend to perpetuate the myth that women are weak and unable to deal with a world where half the population is male. As with couples counseling, the best and most effective programs use a team of counselors, regardless of the client’s gender, to provide balanced, supportive, and realistically focused services that are the opposite of the disempowering AA/12 Step models.
How do I go about finding a Non 12 Step Treatment Program?
To find a non 12 step program, or an AA alternative program, use the search phrases “Non 12 Step” or “AA Alternative” or look at the preferred provider recommendations at the following organizations and/or websites:
Many of these sites will list solo providers as well as programs and you will find us among the recommended intensive outpatient treatment programs.
Remember too, we are the only program that combines the best features of outpatient programs and individual therapists. These include:
- Life Coaching.
Aren’t all alcohol treatment programs confidential? Why should I be concerned anyway, I’m not famous?
We are the only alcohol treatment program in the U.S. or Canada that offers truly confidential services.
We are able to do this because:
- We do absolutely no group work (groups are not confidential);
- We do not accept insurance (insurance information is never confidential);
- The only staff you see are the two of us (and possibly Scruffy, the office canine, but he doesn’t tell);
- You maintain your own case records so there is nothing in our files to subpoena;
- Such modest case notes as we do keep are destroyed at your request, whenever you request, or automatically after discharge;
- You see our physician who does not release records;
- You use the private pharmacy we work with to keep prescription information from entering the national data base that insurance companies maintain and where they share information and sell information – including yours.
This lack of confidentiality will come back to haunt you in the years ahead should you ever:
- go through a divorce;
- hold a professional license or certification;
- apply for health or life insurance;
- apply for a mortgage;
- apply for a security clearance;
- run for public office;
- or do anything else where treatment records can be used against you!
Every time I try to quit drinking, my spouse starts drinking more than ever, and that makes it harder for me to be successful. Why is this happening?
This form of spousal sabotage is common and is the usual reason people return to drinking. While it is not always conscious – after all, they’ve been pressuring you to fix your drinking problem for years – but the reasons are readily apparent upon examination.
Consider the real benefits of your alcohol abuse. Alcohol provides a fast, effective, easy, affordable, and legal “cure” for anxiety, loneliness, boredom, low blood sugar, and numerous other conditions and concerns.
Now also consider the benefits your spouse derives from your alcohol abuse – benefits they rarely recognize until they are pointed out. With you as the designated “problem” they end up with all of the power in the relationship. Yes, you lose your vote in family decision making because you’re a drunk.
Additionally, your alcohol abuse covers up their own problems. After all, as long as you and your drinking are “the problem” they don’t have to look at their own over-eating, or aggression, or anything else.
Finally, they get to be the saint who puts up with you.
Those are a lot of benefits to lose when you fix your drinking problem so it’s not surprising that many spouses begin to actively sabotage your progress.
It’s also why we prefer to work with couples whenever possible in order to head off this sort of “dance” and help both of you to end up happier with alcohol removed from the equation.
Remember – others “treat” alcoholism in isolation in order to enhance relapses. We treat it in conjunction with your spouse and day-to-day life. Is it any wonder that our clients succeed in our alcohol treatment program at over twelve times the rate of traditional programs, residential rehab or outpatient?
You seem really down on AA but it has helps millions of people get and stay sober. Why are you being so harsh in your criticism?
We doubt that there is more deeply ingrained myth in our culture than the one that “AA has helped millions to get and stay sober.” The reality is probably more along the lines of “AA has helped some people to get and stay sober, but it’s a tiny percentage of those who have tried it – maybe 3% – and it has certainly prevented even more people from getting sober by doing the things that actually work (see; Ending Alcohol Abuse: What Works).
The first very real problem with AA is the claim that AA is the only thing that works – it isn’t. It’s not even in the top 30!
Secondly, we have no complain about people trying AA and seeing if it works for them, but we do object to people being ordered to AA as punishment by the courts or under the false notion that it’s an effective solution.
Third, we really object to traditional Minnesota Model alcohol treatment programs that sell AA as “treatment.” Selling you something, at $1,000/day or more, that’s available for free at many locations near you, is a con game, not treatment, even if it “worked” which, mostly, it doesn’t.
And finally, it’s pretty easy to determine whether or not someone is “AA material” – we’ve been doing it for over 20 years and others could too. But that wouldn’t fit their business model, would it?
I don’t know the terminology used in the treatment industry. What search terms would I use to find good, research-based alcohol treatment programs.
If you’re looking for effective alcohol treatment, not AA or 12 Step based rehab, then use the search terms associated with AA alternative or non 12 step based programs. These terms would include:
- · AA Alternatives (or AA Alternative);
- · Non 12 Step;
- · Smart Recovery recommended providers;
- · Moderations Management recommended providers;
- · Life Ring recommended providers;
- · Alternative outpatient alcohol programs;
- · 12 step alternative rehab
- · AA alternative rehab;
- · Intensive alcohol outpatient – not AA;
- · Intensive alcohol outpatient treatment – non 12 step;
- · Research based alcohol treatment programs.
You can also click on Non 12 Step News Subscriptions to subscribe to our weekly Non 12 Step Newsletter for more information and suggestions.
Why do so many educated, intelligent women develop alcohol abuse problems?
Smart, educated women – whether professionals or stay at home wives/mothers – develop alcohol problems for much the same reason we all do – it works.
Whether the underlying problem is anxiety, loneliness, boredom, diet management, unbalanced personal relationships, or a myriad of other problems, women drink to ease the frustrations of these and other conditions.
But let’s also face the fact that educated and intelligent women and also driven to excel and exceed, both at home and professionally, in ways that neither most men nor more traditional women are. More pressure equals more reasons for the fast effective short term relief alcohol offers.
Additionally, professional women also face the pressure to keep up with male colleagues, role models, and mentors and that includes matching them drink for drink. But women’s bodies can’t handle the same amounts of alcohol nor can they endure the alcohol‘s assaults over the same period of time.
Finally there is always the behavior habit factor – we tend to keep on doing what we’ve always done, no matter how smart we are.
For more detail, read our Smart Women and Alcohol Abuse report and see how you can start learning to change.
What makes your alcohol treatment program so special and different?
There are several factors that make our intensive, accelerated alcohol treatment program unique:
- We only work with individuals and couples – no groups;
- We are research based and used the methods that are proven to work (see: Ending Alcohol Abuse: What Works).
- We work with you as a team;
- We provide actual follow-up – not referrals to AA or other so-called support groups;
- We are confidential and no one else is, no matter what they claim;
- We are affordable.
There are other qualities that benefit you and are available only when you work with us. You can read more about them by clicking on: Our Expanded Program Description
Why don’t you take medical insurance as payment in your treatment program, like other programs do?
We do not accept insurance for the following reasons:
- Insurance records are not confidential, regardless of what others claim, and we do not want you to create permanent records that will come back to haunt you;
- Third part payments sap motivation and your motivation needs to be enhanced, not diminished;
- We would have to triple our fees in order to stay in business at insurance company reimbursement rates, slow pays, and paperwork requirements (which would also jeopardize your confidentiality).
Remember, you want outpatient alcohol abuse treatment that is confidential, effective, affordable, and individually focused. That’s what we offer. Does one else offers those factors for you to select.
Is binge drinking different from other types of alcohol abuse? Do you treat it differently?
Binge drinking is essentially the “pressure cooker release valve” method of alcohol abuse. The binger manages the frustrations or anger of the underlying “heat source” (i.e., loneliness, anxiety, boredom, etc.) until they become too great and then they explode, the pressure is released for a week or a month or more, then the cycle repeats itself.
This pattern will continue until the underlying causes that fuel the binges are identified and addressed. In this case, binges tend to have less of a “ habitual behavior” component, but solutions still tend to come down to resolving underlying issues and replacing old dysfunctional day-to-day activities with new behaviors that actually reduce the flame under the pressure cooker or which create new and better release valves.
As an example, many women find kick boxing to be an excellent pressure reduction and self-esteem enhancing activity. We help you find your own mosaic of personally effective ways of controlling your own emotional heat.
I went to a well known substance abuse treatment program and they told me, on the phone, they were not a 12 step program, but when I got there, they were. That is all they did. Do you think they lied to be deliberately or do you think I just spoke to a misinformed staff member when I called them?
They lied to you deliberately.
As Dr. Barnes noted in Ten Things I Wish I’d Known Before I Sent My Brother Off To Rehab, 90+% of all rehab programs have nothing to offer except AA/12 Step based approaches but they don’t want to lose clients.
They justify this deception by saying, “but AA is the only thing that works so if we have to lie to people to save them, then that’s what we have to do!”
Of course this is just con game smoke and mirrors. Not only is AA and the 12 Steps not the “only thing that works,” it’s not even in the top 30!
So if you want to protect yourself, first read Ending Alcohol Abuse: What Works, then, before signing up for a rehab program, ask for a signed money back guarantee that you will not be subjected to any 12 Step/AA content in any form and that their program will only consist of the proven components and approaches.
Fewer than 5% of the programs in the U.S. and Canada will agree to sign that promise.