Since it was established in the 1930s, the 12-step approach has become widely used. 12 Step was designed by Bill Wilson – founder of Alcoholics Anonymous (AA). Wilson founded the model during his own rehabilitation for addiction, perhaps becoming one of the most commonly known interventions for addiction. In Great Britain, there are an estimated 4,661 dedicated AA groups. This indicates that 12 Step and its associated practices remain, for many, a cornerstone of addiction help and support.
However, we know that different people take different approaches. We are all individuals with our own beliefs, needs, and idiosyncrasies. This is perhaps never clearer than within the context of healthcare. This means that although 12 Step benefits many people across the nation – and indeed, across the globe – it does not mean that it will suit everyone. This is why rehabilitation centres offer a range of support options to help you find a type of addiction treatment that feels relevant, comfortable, and true to you.
The 12 step approach
A study in 2019 described the approach of Alcoholics Anonymous as ‘faith meets science.’ AA began in 1938. The founder of AA, Bill Wilson, was struggling with alcoholism. Wilson described the change in the trajectory of his life when he began to understand addiction as a holistic concept: something that exists as a ‘malady of mind, emotions and body.’ In this sense, Alcoholics Anonymous began to popularise the disease model of addiction.
The following year, AA was already growing. This led to the penning of text at the movement’s core: Alcoholics Anonymous in 1939. The book covered a range of information, including the core philosophy behind the movement, supported by the stories of 30 already recovered members. Central to this text was the outline of the 12 Steps – 12 key stages that chronologically chronicle the movement from addiction to recovery.
The 12 steps are as follows:
- We admitted we were powerless over alcohol – that our lives had become unmanageable
- Came to believe that a Power greater than ourselves could restore us to sanity
- Made a decision to turn our will and our lives over to the care of God as we understood him
- Made a searching and fearless moral inventory of ourselves
- Admitted to god, to ourselves, and to another human being the exact nature of our wrongs
- Were entirely ready t have God remove all these defects of character
- Humbly asked Him to removed out shortcomings
- Made a list of all persons we had harmed, and became willing to make amends for them all
- Made direct amends to such people wherever possible, except when to so would injure them or others
- Continued to take personal inventory and when we thought we were wrong promptly admitted it
- Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge or His will for us and the power to carry that out
- Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics, and to practise these principles in all our affairs
Put simply, the goal of 12 steps is to use faith as a mechanism to move forward, to make active changes and take accountability for your actions both past, present, and future. Following recovery, the aim is to use this knowledge in order to lift up others who may be in a similar situation to you prior to beginning the programme.
Benefits of 12 step
The 12 Step method has been in practice for just short of 100 years. The well-established nature of the approach has made the model a very important part of addiction support. But how else does 12 Steps benefit people?
There are a range of benefits individuals can glean from this programme. These include:
- Community support and networking (in person groups lead to socialisation, which can reduce isolation and depression)
- Taking accountability for our actions (this can lead us to become more self-aware and acknowledge the effects of what we do or say)
- The steps have a clear order (suggesting that linear recovery is not only possible, but attainable)
- The steps foreground faith (this can be empowering for some individuals, and offer a new kind of solace)
- Leads to a community-centred approach to life, rather than an individualistic one
- Encourages the development of new coping skills
- Encourages the celebration of progress
The role of community
The steps are written in plural third person. For some people, this kind of language can signal a shared experience, and in effect, be a linguistic assertion of community. This can help people feel less alone – and perhaps, less guilty – in their experiences of addiction.
The Role of faith
The steps also foreground the role of a ‘Power greater than us.’ Perhaps at its establishment, this ‘Power’ would have been conceived by many as a kind of Christian God, a monotheistic figure. However, the 12 Steps are keen to remind us that this ‘God’ can be imagined in any way that ‘we understood Him.’ This means that the faith element of 12 Steps is not necessarily linked to Christianity but can be more fluid and individual than this. This means that you could use a range of stand-ins as your higher power, including:
- A specific figure from religion, history or culture
- A particularly inspirational family member or friend who may have passed away
- The idea of ‘karma’ as your greater power
- The idea of ‘nature’ as your greater power
- The idea of ‘fate’ as your greater power
This means that it is perhaps more possible to personalise the 12 Steps than it may first appear. This allows the mode to be more accessible for individuals of more diverse backgrounds, including people who may identify as agnostic or atheist.
Statistics
A survey of AA members in 2020 suggests that:
- 75% of members were sober for at least 2 years
- 10% of members were sober for less that 6 months
The data suggests that the longer individuals were members of AA – and therefore, engaging with the 12 Steps – the longer their period of sobriety.
As these statistics are self-reported, we must consider that on some level, some of this data may not be fully accurate; however, it is helpful at offering an assessment of the effectiveness of 12 Step in broad terms.
What if 12 steps isn’t for me?
Whilst a large number of people celebrate 12 Step, this does not mean that it has not come up against criticism from researchers, addiction professionals or individuals struggling with addiction themselves.
Problems of faith
One of the key issues identified in 12 Step is the foregrounding of religiosity. While this can be beneficial for some people, for others this focus on spirituality can be somewhat alienating. This can be particularly difficult in marginalised groups, who, research suggests, perhaps do not find 12 Steps as helpful in recovering as non-minority groups.
Assumptions around shared experiences
The 12 Steps, as we have seen, are written in a collective voice. They speak in terms of ‘we’ instead of ‘you’ or ‘I’. This can be reassuring and, for some people, garner a welcome sense of unity. For some people, however, this kind of address may be somewhat uncomfortable; it can suggest that all in attendance at AA have the same or very similar sets of experiences, which, for some people, can feel reductionist. This can risk specific experiences feeling unaccounted for: for example:
- the experience of women
- disabled people
- black and minority ethnic individuals
- individuals with diagnoses of mental health conditions
- neurodivergent individuals
- people with experiences of trauma
For example, the idea that being faithful and accountable is enough to bring recovery could be dangerous for an individual with schizophrenia, who may need to use medication or other forms of intensive treatment in order to combat symptoms that may lead to addictive behaviours.
Lack of professional support
Most AA groups are not chaired by clinical professionals, meaning that community experiences of 12 Step can be coloured by anecdotal evidence and support rather than research-based approaches to addiction treatment. Some people, particularly people with a dual diagnosis, may need more structured treatment in order to feel adequately supported.
Sharing in a community space
For some people, the idea of divulging your thoughts, feelings and actions to peers can be daunting. This is especially so if groups take place near where you live. More structured support is typically confidential, meaning that this type of sharing is not required, or may be more limited.
Alternative types of Addiction Treatment
12 Step is a mode of support with a rich history; thousands of individuals pin their recovery success on their engagement with the steps. However, this does not mean that you need to engage with this form of support. There are a wide range of other treatments available in rehabilitation centres across the country, including:
- Acceptance and Commitment Therapy
- Addiction Counselling
- Art Therapy
- Cognitive Behavioural Therapy (CBT)
- Dialectical Behavioural Therapy (DBT)
- Drama Therapy
- Drumming Therapy
- Group Therapy
- Holistic Therapy
- Interventions
- Music Therapy
- Nutrition and Healthy Eating
- Physical Health Therapy
- Trauma therapy
- Yoga and Meditation
Each type of therapy offered has different applications, approaches and techniques. If you are interested in engaging with addiction therapy, it may be worthwhile looking into the therapeutic interventions that are offered in order to get a sense of what type of support could be best for you.
Access support at addiction rehab
Addiction is overwhelming. This can sometimes be amplified even further when you seek help – there can be a slew of information. It can be hard to know who to turn to. At UKAT, our team of industry experts are here to help. Whether you are looking for advice on how to begin rehab or want to learn more about the range of treatments available at our centres, you can contact us for more information. Your contact will remain confidential. Our clinical team will offer you non-biased advice. You may be asked to answer some questions about your current situation to help staff speak to you in a tailored way. Rehab is not a one-size-fits-all. At UKAT, we understand that support comes on a case-by-case basis, and therefore, we endeavour to meet your needs by designing bespoke treatment plans.
