12 Step Programs

12-step groups often have meetings and support group sessions.

Most people who have spent time in a treatment program already are well aware of the 12-steps and how they work; but for those who have never been in treatment before, 12-step programs are often the beginning steps towards sobriety and recovery from drug or alcohol addiction. These programs, under the correct circumstances and when properly applied, have the ability to help those who suffer from various stages and types of substance abuse to restore balance and stability into their lives.

12-step programs have been used in the treatment of drug and alcohol addiction for almost 100 years. Beginning with Alcoholics Anonymous, 12-step programs now comprise the foundation for many different types of support groups and treatment offerings throughout the world. Since 1935, when Bill Wilson and Dr. Bob Smith founded Alcoholics Anonymous, 12-step recovery programs have been actively doing their part to provide those in recovery with hope, help and support for a new, sober, way of life.

What is a 12 Step Program?

According to Health Psychology, “the twelve-step program is intended to be a guide for recovery of alcoholism.” These programs are now used in a number of different support groups and treatment settings focused on helping people to heal from a wide array of substance use disorders, behavioral disorders, mental health conditions and even traumatic experiences. Today, 12-step programs include:

Alcoholics Anonymous
Narcotics Anonymous
Food Addicts Anonymous
Overeaters Anonymous
Al-Anon / Alateen
Nar-Anon
Cocaine Anonymous
Co-Dependents Anonymous
Gamblers Anonymous
Crystal Meth Anonymous
Heroin Anonymous
Marijuana Anonymous
Methadone Anonymous
Sexaholics Anonymous
Sexual Recovery Anonymous

How do Twelve-Step Programs Work?

The rationale behind the twelve-step process of recovery is based on a set of guided principles that are designed to help people achieve sobriety or behavioral peace from various disorders through a series of steps. Each of these steps is designed to bring the individual close to recovery and happiness. The first step, also the most influential and important, is to recognize and admit that there is a problem. Each subsequent step focuses on personal enrichment, spiritual development, acceptance, change and growth.

While 12-step programs do outline a series of steps that an individual can take to enrich himself and grow toward happiness in sobriety or recovery, there is no dictation that the steps must be performed in order. As such, some people will go through various steps over and over again, refer back to previous steps before moving forward, and even reach subsequent steps prior to completing goals in the previous steps. The idea here is that each of the steps will help the individual to work toward achieving recovery but there is no specific order in which the steps must be undertaken in order for recovery to occur.

What are the 12-Steps?

Each of the different 12-step programs listed above is generally based off of the same set of steps that are taken in the direction toward achieving recovery from a compulsive disorder, addiction or similar condition. The original twelve-steps were developed for Alcoholics Anonymous, but other twelve-step programs have since modified the steps slightly in order to meet the individual needs of those in recovery from various other ailments such as addiction to prescription drugs, recovering from the trauma left behind as a result of a loved one’s addiction or recovering from physical or mental abuse.

The original 12 steps, as outlined by Alcoholics Anonymous are:

We admitted we were powerless over alcohol- that our lives had become unmanageable.
Came to believe that a power greater than ourselves could restore us to sanity.
Made a decision to turn our will and our lives over to the care of God as we understood Him.
Made a searching and fearless moral inventory of ourselves.
Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.
Were entirely ready to have God remove all these defects of character.
Humbly asked Him to remove our shortcomings.
Made a list of all persons we had harmed, and became willing to make amends to them all.
Made direct amends to such people wherever possible, except when to do so would injure them or others.
Continued to take personal inventory, and when we were wrong, promptly admitted it.
Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of his will for us and the power to carry that out.
Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics, and to practice these principles in all our affairs.

When the 12-steps are used in other means of recovery, such as the recovery from marijuana addiction, food addiction, or some other condition, the references made in the first and twelfth steps are typically altered. These references would note the type of drug, substance use problem or condition and may also replace certain elements that reference him or his in particular for gender neutral references in the event that the 12-step group is for men or women only.

The Role of Spirituality in 12-Step Programs

According to the American Psychological Association, “seven of the 12 steps at the heart of Alcoholics Anonymous feature spirituality.” Steps ask followers to make use of prayer and meditation in an effort to improve their relationship with God. As such, these programs are highly effective for those who are involved spiritually but can be difficult to fathom for those who are not highly religious or who do not believe in a “higher power.”

Studies conducted by the National Institute on Drug Abuse have found that, “with notable consistency, almost everyone who’s ever studied religiousity has found it to be a protective factor for adolescents.” Children and teens who have a close relationship to God and who are involved in Church are less likely to abuse drugs or alcohol. The same is true in many cases for those in recovery. 12-step programs focus much of the recovery process on healing the spiritual side of the individual as this healing has been found to be directly correlated to improved outcomes in recovery.

Aside from Religion, what Else is Involved in the 12 Steps?

Spiritual awakening is a foundation for the twelve step recovery model but it’s not the only element. While it is vital that those who take part in the twelve step program are willing to recognize and accept that a higher power, such as God, is responsible for the ultimately ability to heal from the substance use disorder or condition, there are many other steps to the process. In addition to the spiritual side of the twelve step programs, participants will also:

work on developing new habits and hobbies that do not involve drugs or alcohol
work on growing their connections and friendships with others who are share similar goals
meet others in various stages of recovery who can both support and provide a need for support that helps to evolve the overall community sense
be encouraged to take a deep, honest inventory of themselves
learn how to work together, integrate back into society and be comfortable with the norms of the way that others are always “different” from you
be accepting, nonjudgmental and comforting to others in need

Evidence Backing the 12-Step Program

There are many different viewpoints that either completely agree with or completely disagree with the effectiveness of twelve step programs. While there is evidence to support the effectiveness of 12-step programs, there is also sufficient evidence to support the premise that these programs are not for everyone. Some people simply do not respond well to the offerings and sense of community that is provided by a 12-step program of treatment. Alcoholics Anonymous has released the following data regarding the overall effectiveness of the 12-step program when used in their community for the healing and recovery of alcoholism:

Surveys show that an estimated 50% of people who attend AA remain sober for an average of 8 years.
36% of those who participate and achieve sobriety remain sober for 10 years or more.
Many of the members of AA groups have been sober for somewhere between 5-10 years.
Most of the members, 70%, have a sponsor who helps them to achieve their sobriety and recovery goals.
Most members attend regular weekly meetings, an average of twice per week.
Outside of AA meetings, most members do their own exploration of the steps and methods that they can use to further achieve sobriety.
More than half of all people who have come to AA later receive further treatment for their addiction, often times in response to their learned value from the AA meetings.
More than 80% of all members of AA claim that the twelve step program has played a key role in their recovery from alcoholism.

Do 12-Step Programs Really Work?

Overall, whether or not a twelve step program is going to be effective in helping you to overcome addiction or another disorder will depend on a variety of factors. You may need further treatment in order to back up the skills and coping mechanisms that you learn in a twelve step program. You may find that you don’t really get along well with some of the members in a particular group while you do better in another group. You may find that the religious requirements or the spiritual growth that is expected in a twelve step program is too much of a burden for you to focus on your recovery—all of these things can jeopardize your ability to achieve the ultimate effects of the program.

Likewise, you may find that you really enjoy the religious and spiritual growth that occurs in twelve step recovery programs, you may have fun with the other members of the group and you may find that this program really helps you. There’s no easy or definitive way to determine whether 12-step programs will help you or how effective they will be—this will be determined by you based on your enrichment and growth that comes from attending the program and working toward achieving your recovery goals through the utilization of the 12 steps.

Critics proclaim that 12-steps are not effective and that they don’t work—but AA alone has groups and fellowships throughout 180 countries worldwide—that doesn’t really sound like a program that “doesn’t work” or “isn’t effective.”

Importance of Follow Up Counseling & Care

While programs like AA and NA can be effective at helping people to overcome many of the challenges associated with recovering from drug or alcohol addiction, it’s important to keep in mind that recovery is about more than just actively participating in a support group. For most people, active participation in counseling and therapy must also take place in order for recovery to be achieved. Even if you are taking part in a twelve step program, consider the following additional actions to ensure your best possible chance for sobriety and a full, lasting recovery:

participate in individual counseling with a licensed substance abuse counselor
participate in regular group counseling sessions with a licensed counselor and others who are in recovery from similar conditions
participate in regular therapy sessions such as CBT or motivational interviewing that is provided by a licensed therapist
seek support from friends, family and others outside of the twelve step group
consider seeking other methods of help such as SMART or Rational Recovery which do not utilize steps
if you are already faithful or religion already plays a strong role in your life, consider furthering your spiritual strength by talking with your local pastor or priest about ways that you can achieve happiness and reduce your desire to drink or use drugs
don’t be afraid to try out other methods of treatment—more importantly, don’t be afraid to seek help

Benefits of 12-Step Programs

If you’re considering interaction or participation in a twelve-step program, consider the great benefits that can come from being involved in a community that is working toward a common goal—a goal of happiness, sobriety and recovery. Not only can you benefit from the camaraderie that comes from 12-step recovery, you can also find great solace in the stories that others will share, in their hope and in their ability to reach varied levels of recovery. This strength that comes from twelve step communities will provide a foundation for you upon which you can grow and heal from the pain that addiction or trauma has caused in your life.

12-step programs have the following additional benefits:

community
friendships
support
improved self-confidence
encouragement from others
education
guidance

For more information about how twelve step programs can help you recover from addiction and restore stability and balance into your life, contact our helpline.