The 12-Step program is a model that helps people suffering from addiction by giving them a set of structured steps to follow to achieve recovery. The steps are designed to help them achieve and maintain ongoing sobriety. Since its beginnings in the 1930s as the basis for Alcoholics Anonymous (AA), the 12-Step approach has become one of, if not the most, recognized programs to address alcoholism and addiction in all forms.
The 12-Step model is based in a spiritual approach to addiction treatment, although the person undergoing treatment doesn’t necessarily have to be a religious person to benefit. The steps reference a “higher power.” This can be God in the traditional sense or anything else that the person believes to be their higher power, essentially just a power that is greater than the person.
Overall, the 12-Step format fosters a strong sense of group support. Meetings are member-led. Since official therapists don’t lead the group, it isn’t a form of group therapy, but rather a form of social support. Many treatment programs have their basis in the 12-Step approach.
What Are the Specific Steps?
Descriptions of the specific steps are outlined below.
- In the first step, the person must admit that the substance has taken over their life. The individual must admit that they are powerless over the addiction, and life has become unmanageable as a result. During this stage, the person is accepting the fact that there’s a problem.
- In the second step, the person must come to the conclusion that there’s a greater “power” than the person (the idea of a higher power), and this particular being or force is able to restore the person’s life back to a healthy state.
- In the third step, the person is encouraged to turn their will and life over to the higher power. The belief is that the higher power will take care of the situation, and this gives the person faith that things will get better.
- The next step consists of making an inventory of the person’s morality. This is the first step where the person has to take action. During this phase, the person outlines any personal flaws on paper. Basically, this step is when the person is truly honest and no longer in denial, and it involves is an assessment of the person’s life.
- The next step is when the person has to admit to their higher power, themselves and another individual the nature of their wrongdoings. Admitting the problem to themselves and others helps the person to take responsibility and begin taking action to resolve the problem.
- In Step 6, the person puts faith in their higher power and states that they are ready to remove their character defects. The person is to have faith that their higher power is going to help remove their flaws, which will eventually lead to recovery.
- This step consists of the person actually asking the higher power to remove the flaws. These are character defects that led to the addiction or arose as a result of the addiction.
- Step 8 is an actionable step that consists of developing a list of every person the addict harmed while abusing a substance or throughout the addiction. The individual must become willing to make amends with every person on the list.
- In Step 9, the person has to make amends with everyone who was on the list made in the previous step. This helps the person to repair damaged relationships with others. It also assists the person by alleviating some of the guilt they may feel. If attempting to make amends with someone would cause that person harm or hurt them, no attempt should be made.
- The individual must continuously take a personal inventory and always admit to any shortcomings.
- For Step 11, the individual is asked to pray and meditate in order to contact their higher power. During this step, the person asks for knowledge from their higher power and the ability to complete the recovery process.
- The last step involves the person having a spiritual awakening due to the previous steps taken.
The phases of 12-Step programs are flexible. While a person is advised to do them in order, they are able to repeat a step or go back to a step at any given time. The program’s flexibility allows the person to recover at a pace tailored to their specific needs.
Oftentimes, in 12-Step groups, new members will have sponsors; these are members who have several years of experience in recovery, and they serve to mentor new members. If a new member feels like giving up or relapsing, they can call their sponsor for advice and support.
Generally, at the end of a meeting, an announcement will be made for those who wish to be matched with a sponsor. In some instances, the sponsor/sponsee relationship might not be a good match. These relationships are always viewed as temporary, so if a particular partnership isn’t working out, there’s no harm in ending it and finding someone new to work with.
What Groups Utilize the 12-Step Approach?
The 12-Step approach is most commonly associated with Alcoholics Anonymous, which has an estimated 1,262,542 members in the United States alone. However, those who suffer from an alcohol addiction aren’t the only ones who can benefit from a 12-Step program. Some of the other programs that utilize the same approach include the following:
- Debtors Anonymous (DA)
- Narcotics Anonymous (NA)
- Gamblers Anonymous (GA)
- Co-Dependents Anonymous (CoDA)
- Cocaine Anonymous (CA)
- Crystal Meth Anonymous (CMA)
- Workaholics Anonymous (WA)
- Sex Addicts Anonymous (SEA)
- Sex and Love Addicts Anonymous (SLAA)
How Do 12-Step Programs Work?
Twelve-Step programs can greatly improve a person’s psychosocial function, as reported by the American Society of Addiction Medicine, and this contributes to their ability to maintain ongoing sobriety. The actions involved with many of the steps are associated with certain types of behavioral therapy. Essentially, 12-Step programs help individuals accept that they have a problem and identify their shortcomings in an effort to treat them. It’s similar to the principles of many types of therapy – aiming to identify issues and thought patterns related to those issues, and then altering the thought pattern in order to change the resulting behavior.
The anonymous nature of most 12-Step groups makes it difficult to pinpoint success rates; however, the long history of the model is a testament to its effectiveness. There isn’t enough published research to conclude the percentage of people who achieve and maintain sobriety as a result of one of these programs. Some sources indicates only about 10 percent of individuals who undergo a 12-Step program recover while other research states up 75 percent of people do. Narcotics Anonymous states that members have a mean average of 9.1 years in recovery, as of 2007.
There are 12-Step programs that are focused on specific demographics, such as particular genders or age groups. In some instances, it can be helpful to target these groups as it may be easier to relate to other members.
How Does a 12-Step Program Help with Aftercare?
Relapse following withdrawal is common, especially without any aftercare. According to the National Institutes of Health’s National Institute on Drug Abuse,40-60 percent of people relapse back into substance abuse. It’s recommended that individuals complete a comprehensive addiction treatment program following detox, and then participate in ongoing aftercare after that point.
Peer support groups, especially those in the 12-Step model, can reduce the likelihood of relapse. Addiction treatment programs often incorporate attendance at 12-Step meetings into their treatment regimes, getting clients accustomed to an attendance schedule that they can continue into ongoing recovery.
In meetings, group members can share their difficulties with ongoing recovery and get tips on how to avoid relapse in the sensitive time directly following treatment. Once they are matched with a sponsor, they have someone to call if they feel tempted to pick up again. Social support is vital to sustaining sobriety, and 12-Step programs help newly sober individuals to begin to build this important network of support.