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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.
Descriptions of the specific steps are outlined below.
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.
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:
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.
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.