What Is the 12-Step Program?
A twelve-step program is a set of 12 guiding principles that serve as a framework for people seeking to recover from substance abuse. Originally developed by one of the founders of Alcoholics Anonymous (AA), it became the basis of the organisation’s method of supporting people struggling with alcoholism in the recovery process.
The 12 step approach has since been adopted by other fellowship-based recovery groups that support people dealing with substance abuse disorders and, in recent years, other behavioural problems.
Some organisations have modified versions of the original 12 steps tailored to the specific needs and situations of their membership group. However, these 12 step programs remain grounded in the basic guiding principles of the original AA text which are as follows:
- Admitting that you have no control over your addiction
- Recognising a higher power that can help achieve lasting abstinence
- Evaluating mistakes you committed in the past with the help of a sponsor
- Committing to make amends for all of your past mistakes
- Adopting a new code of behaviour, enabling a new life emerge
- Helping other people who are struggling with the same addiction
Organisations that offer 12 step program run weekly meetings which are open to anyone committed to having a life free from alcohol. Attendees can give each other support, advice, and companionship and help each other conform to the 12 steps.
The History of the 12-Step Program
The original 12 step program was developed in 1939 by A.A. founder Bill Wilson which he wrote about in the book, Alcoholics Anonymous: The Story of How More Than One Hundred Men Have Recovered from Alcoholism – also known as “The Big Book”. Wilson, whose career as a Wall Street businessman was destroyed by alcoholism, joined a spiritual movement espousing abstinence. It was there that Wilson met Robert Holbrooke Smith or “Dr. Bob” and both later became co-founders of A.A. in 1935. Wilson and Dr. Bob developed methods to help fellow alcoholics attain and sustain sobriety.
With the publication of “The Big Book”, A.A. began to expand across the U.S., followed by an international fellowship. The “Twelve Steps”, as presented at the beginning of the book’s fifth edition, became the foundation of A.A.’s approach to addressing alcoholism. Along with the 12 steps, the book also includes the “Twelve Traditions”, a set of guidelines in the administration of A.A. group meetings which is still being followed to this day across the world.
As A.A. grew as an organisation grew, its reputation for giving effective support to alcoholics in recovery became widely recognised as well. People suffering from addictions to other substances began to express their desire to attend A.A. meetings, and this consequently led to the establishment of Narcotics Anonymous in the early 1950’s in California. Narcotics Anonymous was established to provide support to people specifically struggling with drug addiction. From the very start, N.A. employed a 12 step program and a system of administration patterned after that of A.A..
Other recovery organisations that focus on specific substances such as Cocaine Anonymous, have adopted a similar approach as well as as groups that address behavioural disorder with no substance abuse (such as eating disorders, gambling, and love and sex addiction). At present, only 20% of 12 step groups cater to people struggling with substance addictions.
The 12 Step Program of Alcoholics Anonymous
Here are the original twelve steps as published by Alcoholics Anonymous:
- Step one
We admitted we were powerless over alcohol – that our lives had become unmanageable.
- Step two
Came to believe that a Power greater than ourselves could restore us to sanity.
- Step three
Made a decision to turn our will and our lives over to the care of God as we understood Him.
- Step four
Made a searching and fearless moral inventory of ourselves.
- Step five
Admitted to God, to ourselves and to another human being the exact nature of our wrongs.
- Step six
Were entirely ready to have God remove all these defects of character.
- Step seven
Humbly asked Him to remove our shortcomings.
- Step eight
Made a list of all persons we had harmed, and became willing to make amends to them all.
- Step nine
Made direct amends to such people wherever possible, except when to do so would injure them or others.
- Step ten
Continued to take personal inventory and when we were wrong promptly admitted it.
- Step eleven
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.
- Step twelve
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.
The 12 Traditions of Alcoholics Anonymous
Here are the original twelve traditions as published by Alcoholics Anonymous:
- Tradition one
Our common welfare should come first; personal recovery depends upon AA unity.
- Tradition two
For our group purpose there is but one ultimate authority — a loving God as He may express Himself in our group conscience. Our leaders are but trusted servants; they do not govern.
- Tradition three
The only requirement for A.A. membership is a desire to stop drinking.
- Tradition four
Each group should be autonomous except in matters affecting other groups or A.A. as a whole.
- Tradition five
Each group has but one primary purpose — to carry its message to the alcoholic who still suffers.
- Tradition six
An A.A. group ought never endorse, finance, or lend the A.A. name to any related facility or outside enterprise, lest problems of money, property, and prestige divert us from our primary purpose.
- Tradition seven
Every A.A. group ought to be fully self-supporting, declining outside contributions.
- Tradition eight
Alcoholics Anonymous should remain forever non-professional, but our service centers may employ special workers.
- Tradition nine
A.A., as such, ought never be organised; but we may create service boards or committees directly responsible to those they serve.
- Tradition ten
Alcoholics Anonymous has no opinion on outside issues; hence the A.A. name ought never be drawn into public controversy.
- Tradition eleven
Our public relations policy is based on attraction rather than promotion; we need always maintain personal anonymity at the level of press, radio, and films.
- Tradition twelve
Anonymity is the spiritual foundation of all our traditions, ever reminding us to place principles before personalities.
Is the 12-Step Program Faith-Based?
Some of the original 12 steps developed by the founders of A.A. mention the word God and a “higher power”, and some individuals find this problematic, particularly those who do not believe in such power or whose personal religious beliefs are non-monotheistic. However, most 12 step organisations do not classify themselves as “faith-based”, and many addiction specialists advise those struggling with the steps in question to adapt those steps according to their own convictions.
Many of those who have gone through 12 step programs for substance use acknowledge that key elements of such programs are the meetings, specifically the fellowship and support provided by the group members, rather than the aspects that involve a “higher power”. There are now 12 step programs for people who find issues with the spiritual aspects of the original format, such as the SMART Recovery methodology, which does not have spiritual elements and does not require the existence of any higher power.
At the end of the day, 12 step programs are design to suit your needs and it is entirely up to each individual to use the steps however they see best working for them. An addiction specialist can provide more information about the 12 steps and also the alternative support approaches available.
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The 12 Step Program During Treatment
Participation in 12 step programs may be a part of, during or outside a structured addiction treatment program. People undergoing outpatient addiction treatment are required or advised to join support groups, including ones that have their own 12 step programs. Some inpatient treatment programs integrate the 12 step approach and possibly including sessions aimed at acquainting patients with the 12 steps in preparation for their attendance in 12 step based groups after their initial treatment plan is completed.
The manner in which a given treatment facility incorporates the 12 step approach within the treatment depends largely on the nature of the facility. Although a large majority of addiction professionals are familiar with the 12 steps, not all of them integrate it into their addiction treatment approach partly because some of the steps (particularly those that involve the concept of a “higher power”) may go against clients’ personal beliefs.
A twelve-step meeting is basically a coming together of people suffering from addiction with the purpose of sharing the challenges they face, offering advice, and providing support and sponsorship. It is a social gathering of like minded people without the involvement of substance abuse.
Meetings are conducted in roundtable format with attendees taking turns to speak anonymously. An appointed group chairperson takes care of moderating and guiding the discussion according to the traditions.
Inpatient vs outpatient 12-step programs
The main difference between inpatient and outpatient approaches to the 12 step model is the treatment set-up. Inpatient treatment requires an individual to stay at a treatment facility on a residential basis while going through the 12 step program, whereas outpatient treatment involves scheduled appointments at a treatment facility allowing an individual to incorporate their therapy into their daily routine.
Meetings involving inpatients are focused on the challenges related to the treatment itself, with group members sharing common issues that come from living in a treatment facility and supporting each other through the treatment process. Being within the confines of a secure and substance-free rehab facility, participants in 12 step groups are able to avoid the pressure of temptation. This safe environment allows them to focus on encouraging each other through the recovery treatment and helping each other prepare for life beyond the rehabilitation setting.
Individuals in outpatient addiction treatment, meanwhile, are more vulnerable to the possibility of relapse, thus group meetings are focused on helping members who have relapsed or are having problems resisting the temptation to do so. Instead of treatment progress, outpatient 12 step program meetings mainly involve providing support to members as they struggle to avoid relapsing and face the challenges of living daily life in the outside world.
Though no one can go back and make a
brand-new start, anyone can start from
now and make a brand-new ending
The 12 Step Program After Rehab Treatment
People who have completed an addiction treatment program must never think that they have completely recovered because they have finished the treatment. In fact, the most difficult part of the healing process begins the moment they step out of the safe environment of rehab. In the more dangerous environs of the outside world, they must make use of the coping strategies and lessons they have learnt during rehab to sustain their recovery. Many choose to consider themselves still addicted despite years of abstinence from substance use. This mindset helps them remain vigilant and dedicated to protecting their abstinence, their precious reward after a long and hard battle.
Twelve-step organisations can play a critical role in a person’s continuing recovery long after the treatment has been completed. Many rehabs that provide aftercare require clients to attend 12 step meetings as part of their aftercare programs. Some people start attending meetings regularly right after completing the treatment, while others join meetings occasionally such as when the temptation becomes overwhelming. Some just want to maintain the habit of attending meetings to support others in recovery.
Staying Clean and Sober Using the 12 Step Program
Successful recovery is an ongoing process achieved by continuously avoiding relapse. However, one relapse does not mean that the treatment has failed or that the individual is on his way back to becoming a full-blown addict. It should be seen as a stumble while one is going through the path leading to a life of health and happiness. One should be careful with his steps to keep it from happening again, but it doesn’t mean that the journey is destined to fail.
Regularly attending 12 step meetings and closely following the 12 steps do not guarantee immunity to temptation. Many regular meeting attendees continue to struggle with temptation, with some even relapsing despite their and their sponsors’ best efforts. However, the fellowship aid – support and companionship of others in the same battle, can make a huge difference when one finds himself caught between resisting or giving in to temptation or between a solitary relapse or deciding to fall headlong into full-blown addiction once again.
Sponsors play a crucial role when it comes to these matters. Many people, both in and after treatment, benefit tremendously from having a sponsor they can count on for support, especially during those times when the temptation to relapse becomes overwhelming. Sponsorship is a primary aspect of the 12 step program, and many find significant reward in eventually taking the role of sponsor to people in the early stages of their journey to lasting abstinence.
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