The History of 12-Step Programs
Developed by Alcoholic Anonymous in the 1930’s, the 12 Steps help people achieve sobriety from drug or alcohol abuse by turning inward to themselves and then out into the world. At the core of 12-step group is peer support as it is a major component of many people’s addiction recovery stories.
12-step programs have their roots in Alcoholics Anonymous (AA), a community organization whose members provide mutual support to help individuals to achieve and maintain sobriety.
AA was founded in 1935, and its 12 steps were developed in its early years.
The overarching idea of the organization is that people who struggle with a dependence to alcohol can help others facing similar struggles.
Over the years, 12-step programs have expanded. Today, they are popular choices of treatment for drug addiction and other forms of addiction as well. Twelve-step programs allow people to deal with the issues that surround different types of addictive behavior. They help people realize that they are not alone in their thoughts, feelings, and behaviors.
12-Step Support Groups
The 12 steps are a roadmap to guide people along the path to sobriety. They include admitting one has a problem, taking moral inventory to making amends, and paying it forward. Many drug and alcohol rehab facilities will have 12-step meetings on site, so people new to recovery can become familiar with the process before leaving rehab.
This approach introduces clients to the program and helps them work on more difficult steps while in treatment. It also encourages them to continue working on the steps with other like-minded people while building support groups.
The 12 Steps of AA
Alcoholics Anonymous’ 12 steps are rooted in Christian practice, though over the years they have evolved somewhat toward a broader, more spiritual bent. The 12 steps are:
- Step 1 – Realizing that you are powerless over your addiction and that you can no longer manage your life because of it.
- Step 2 – Building belief in a power greater than oneself to restore you to a healthy life without addiction.
- Step 3 – Deciding to turn yourself over to a power greater than yourself.
- Step 4 – Taking inventory of one’s self and examining how addiction has impacted you and others.
- Step 5 – Admitting to someone else, and to a power greater than yourself, the wrongs that you have committed and the impact that they have had.
- Step 6 – Allowing a power greater than yourself to remove your defects.
- Step 7 – Asking a power greater than yourself in a humble way to remove your defects.
- Step 8 – Making a list of the people who you have harmed through your addiction and become willing to make amends to them.
- Step 9 – Reaching out to the people on your list to make amends to them, unless doing so would cause them harm or injury.
- Step 10 – Continuing to take a personal inventory and admitting mistakes when they occur.
- Step 11 – Improving your relationship with a power greater than yourself through prayer or meditation.
- Step 12 – Using what you have learned through the steps and applying this knowledge to help others who are struggling with addiction.
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The 12 Traditions
In addition to the 12 steps of Alcoholics Anonymous, AA also has 12 Traditions. While the steps serve as an individual roadmap, the traditions are more of a guide for the group as a whole. The 12 traditions are.
- Tradition 1 — Unity is the backbone of recovery. The group’s focus is on healing.
- Tradition 2 — The group submits to the authority of a power greater than ourselves. Even the group leaders serve a greater purpose.
- Tradition 3 — The only requirement for joining AA is a desire to stop drinking.
- Tradition 4 –– Every chapter is independent, save for matters that would affect other groups or AA overall.
- Tradition 5 — Each group has one message which is connected to its one goal: To help the suffering alcoholic.
- Tradition 6 — AA should avoid conflicts of interest; no outside entity should be financed or endorsed by AA.
- Tradition 7 — Every AA group should be self-sufficient; no outside funds are accepted.
- Tradition 8 — While AA service centers can employ special workers, the membership itself should maintain a sense of equality. All are on the same path.
- Tradition 9 — AA should not be organized, but committees or boards are allowed to better assist each chapter’s membership.
- Tradition 10 — AA offers no opinion on outside issues, keeping out of politics, and focusing only on recovery.
- Tradition 11 — Any public relations focuses on attracting followers, and not self-promotion, to better hold onto anonymity of members.
- Tradition 12 — Principles take precedence over personalities. This also helps reinforce the message of recovery.
The 12 Steps with Other Treatments
Addiction to drugs or alcohol is a chronic disease where a person continues to seek out and use the substance in question despite the negative consequences. It also brings about changes in the brain, some of which can be long lasting, or even permanent, making it harder (but not impossible) to recover.
Because addiction is such a complex disease, there is no one treatment that works for everyone. The goal is to develop a treatment plan to address the client’s needs, whether there are underlying mental disorders, previous trauma, or a need for medically assisted detoxification.
Treatments can vary widely, but commonly include behavioral counseling, medication, and addressing co-occurring mental illness, both in and out of a treatment facility. Peer support can be helpful too.
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Does the Model Work?
It’s not clear exactly how many members AA has, in part because of the organization’s focus on anonymity. However, AA did share that it had an estimated 2.077 million active members worldwide in 2019. Similarly, it’s not clear how many people are members of 12-step or peer support groups because of anonymity and because it’s easy enough for a person to start a small informal group on their own.
The model does appear to work for many, however. Researchers looked at 35 studies that focused on 10,080 participants, and found that AA was highly effective, in some cases, more effective than psychotherapy. AA and 12-step participation also appeared to dramatically lower mental healthcare costs — in one study, by as much as $10,000.
Social interaction, emotional support, and shared advice on staying sober seem to be key factors in its success.
Determine if 12-Step Rehab is Right for You
It’s hard to say exactly if 12-step is the right option for an individual. It can be a valuable tool in helping a person achieve and maintain sobriety, especially if a person benefits from that sense of community that peer support can offer. It also can depend on the meeting itself. A Thursday evening meeting that’s around the corner may not be feasible, but a Tuesday night’s meet-up three blocks away may be a great fit.
There are many types of 12-step and peer support groups out there, both in-person and online. There are also a wealth of recovery options for the person seeking sobriety, from intensive inpatient treatment to medication-assisted therapy.
- aa.org – Origins
- aa.org – The Twelve Traditions of Alcoholics Anonymous
- drugabuse.gov – Treatment Approaches for Drug Addiction
- aa.org – Estimated Worldwide A.A. Individual and Group Membership
- med.stanford.edu – Alcoholics Anonymous most effective path to alcohol abstinence
- ncbi.nlm.nih.gov – Benefits of peer support groups in the treatment of addiction
Sunshine Behavioral Health strives to help people who are facing substance abuse, addiction, mental health disorders, or a combination of these conditions. It does this by providing compassionate care and evidence-based content that addresses health, treatment, and recovery.
Licensed medical professionals review material we publish on our site. The material is not a substitute for qualified medical diagnoses, treatment, or advice. It should not be used to replace the suggestions of your personal physician or other health care professionals.
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