What is a 12 Step Program?

Twelve-step programs are support groups for people battling a variety of destructive behaviors, including substance use disorders. These meetings are readily available, easily accessible, and often free to join. They consist of men and women who share their experience, strength, and hope with each other.

Used by millions of people internationally, 12-step programs encourage members to adopt a set of guiding principles called the 12 Steps. Following the steps has helped people achieve and maintain long-term sobriety, and abstinence from behavioral problems such as substance use disorders, gambling addiction, and eating disorders. The bonds formed and lessons learned during these meetings can last a lifetime.

Where Does a 12-Step Program fit in Treatment?

Many rehab centers in the United States use 12-step programs in combination with evidence-based treatment, which often includes medical detox. Individuals who complete rehab often continue attending meetings because the 12 Steps help them focus on sobriety.

The most popular 12-step support groups, Alcoholics Anonymous and Narcotics Anonymous, host meetings every day throughout the United States.

Examples of 12-step programs include:

Through the 12 Steps, people learn how to cope with addiction, avoid triggers and live sober lives. Support group members admit their powerlessness over addiction, examine past mistakes and make amends with those they’ve wronged. In each meeting, they share support and learn ways to apply the 12-step principles to their lives.

The goal is to help members experience a spiritual awakening, a phrase used by Alcoholics Anonymous to describe the personality change required to overcome addiction.

Meetings often are held in public facilities such as schools, churches, or community centers. They offer a forum for individuals to share their stories, including past struggles and triumphs, with those in similar situations. Together, participants learn and work on the 12 Steps of recovery.

Origin and History of 12-Step Programs

Bill Wilson had experienced success as a stockbroker on Wall Street in the early 20th century before alcohol addiction ended his career. He frequented medical treatment at Towns Hospital in New York City, but he continued to drink afterward.

Edwin Thacher was a friend of Wilson’s who was later known in Alcoholics Anonymous circles as Ebby T. He spoke with Wilson about the Oxford Group’s blueprint of self-improvement and how it helped him quit drinking.

After re-entering treatment at Towns Hospital in December 1934, Wilson experienced a spiritual awakening that caused him to stop drinking. Shortly after, in 1935, he co-founded AA with Dr. Bob Smith, a physician in Akron, Ohio, who struggled with alcoholism. In 1939, Wilson published The Big Book, which describes how to recover from alcohol addiction.

AA uses the 12-step formula outlined in The Big Book to ask members to take responsibility for improving their behaviors and assisting others in their recovery. Since the development of AA, many other self-help groups have incorporated the 12 Steps into their program.

Today, support groups use these principles to address addictions to cocaine, crystal meth, heroin, marijuana, and prescription painkillers.

For decades, countless individuals have used 12-step meetings to recover from substance use problems. Every day members overcome their problems and become healthy, productive community members with the help of the 12 steps.

Are 12-Step Programs Religious?

Twelve-step groups often reference a higher power, but these programs are not just for religious people. Two multisite studies found that nonreligious individuals who commit to 12-step programs seem to benefit from these groups, as much as, religious individuals.

Some support groups may interpret a higher power to be something other than a religious deity. For example, AA Agnostica, a secular self-help organization for agnostics and atheists with drinking problems, offers alternative steps that omit references to a higher power.

“There are references to God [in 12-step programs], but they are not religious programs,” Drew Dyer, former secretary of an AA program in Boulder, Colorado, told DrugRehab.com. “A higher power can be anything. A higher power is something bigger than you.”

Although the 12-step philosophy involves spirituality, many support groups are compatible with evidence-based treatment approaches such as psychotherapy. Many mental health experts encourage people with substance use disorder to join a 12-step program.

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