Twelve-step programs have been a key part of many rehabilitation facilities for decades. No matter what the addiction is—drugs, alcohol, food, gambling or sex—the 12-step program is an important part of the recovery process. When combined with other treatment modalities (such as residential recovery programs, counseling and sober living) in a comprehensive rehabilitation plan, the 12-step program increases the chances of long-term sobriety.
The original example of a 12-step program is perhaps the one that is still the best known to most people. Alcoholics Anonymous® took hold in America in the 1930s thanks in large part to Bill W., an alcoholic whose life was transformed by the 12-step principles. Since then, it has been used to help people battling not just with alcohol, but also drug abuse and other addictive or dysfunctional behaviors.
This widely used form of treatment combines group support and a set of guided principles (the 12 steps) to help a person obtain and maintain sobriety. A central belief of 12-step programs maintains that addiction is a progressive disease that is based on physical, emotional and spiritual factors. In order to recover from an addiction, all three of these areas must be healed for a person to move forward in their sobriety.
The basic principles of the 12 steps are:
* Admitting that you’ve become powerless over your addiction and that your life has become unmanageable.
* Recognizing that a higher power can give you strength.
* Examining past errors and making amends for them.
* Learning to live a new life with a new code of behavior.
* Helping others who suffer from addiction.
For some people, the first basic principle of the 12 steps—relying on a higher power—is a huge turnoff because they have a strong philosophical objection to organized religion. For those people, a “higher power” can be interpreted as anything they want it to mean. You don’t have to believe in God or organized religion in order to benefit from the 12 steps.
In addiction rehabilitation centers, 12-step programs are integral to patient treatment plans. When these programs are combined with other types of treatment methods, people may have a greater chance of success with long-term sobriety. Also, by introducing the 12-step support group concept early on in a patient’s recovery, it allows the patient to develop a habit of attending meetings, a behavior that is crucial for maintaining sobriety. Twelve-step group meetings can take place during residential treatment with other patients staying at the facility; they can also be held as part of an outpatient program or a person may opt to go to meetings on their own. These meetings can also take place in a sober living home, where a group of recovering addicts live together in a clean and encouraging environment. Finally, Casa Palmera offers weekly support group meetings as a part of its Continuing Care services for its alumni.
There are many variations on 12-step programs, but the two that most people know about are Alcoholics Anonymous® and Narcotics Anonymous.
12 Steps of AA
The foundation for Alcoholics Anonymous® can be found in what is called the “Big Book of Alcoholics Anonymous.” Published in 1939, this book lays out the 12 steps. As stated by the organization, these steps are:
- 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 to have God remove all these defects of character.
- Humbly asked Him to remove our shortcomings.
- Made a list of all persons we had harmed, and became willing to make amends to them all.
- Made direct amends to such people wherever possible, except when to do so would injure them or others.
- Continued to take personal inventory and when 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 of 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 practice these principles in all our affairs.
Accountability is a major precept of the AA steps, and a major aspect of that accountability is choosing a “sponsor.” A sponsor is a recovered alcoholic with experience in sobriety who can provide guidance and support to someone as they try to gain sobriety.
In addition to accountability, another major component of Alcoholics Anonymous® is in the name: anonymity. There are two reasons why this is important. The first is that it offers a level of security to people as they openly share about their lives and addiction struggles with the other group members. This can be especially comforting to people who are in the early stages of their recovery and are not used yet to this deep level of sharing. The second reason is that anonymity prevents individuals from putting themselves above their Alcoholics Anonymous® support group for their own personal gain. The group and its 12 steps are the most important thing, and anonymity is a sacred trust.
Alcoholics Anonymous® group meetings can be open or closed. Open meetings mean anyone can attend, even those without a drinking problem; closed meetings are for recovering alcoholics only. Membership is not limited by a person’s age, race, or societal status—all are welcome if they are seeking to get help maintaining their sobriety. Open meetings can feature speakers who are Alcoholics Anonymous® members sharing their stories of alcoholism and recovery, or they can be discussions, in which one member shares, then leads a discussion about topics related to recovery or alcohol use issues. Closed meetings usually follow that discussion format, although there can be times when the meeting will focus on one of the 12 steps. Meetings are free and can be held anywhere, in order to provide help to anyone who needs it.
12 Steps of NA
Like Alcoholics Anonymous®, Narcotics Anonymous has an international scope, with meetings available for those in need of support in 139 countries. Founded in 1953, Narcotics Anonymous has adapted the AA format and concepts for a focus on drug use (which can also include alcohol), specifically on staying clean.
The 12 steps of NA are the same as those for AA, with one key difference: any references to alcohol have been changed to addiction. Narcotics Anonymous does not focus on any particular type of drug, although other support groups have formed to act as a kind of subset of NA, such as Marijuana Anonymous or Cocaine Anonymous. Narcotics Anonymous meetings generally follow the same formats as AA meetings.
If you or someone you know has an addiction that requires more than group support, a rehab center can provide addiction treatment combined with the 12-step program to increase the chances of sobriety. When deciding on a rehab center, you should focus on which types of treatment are offered, staff credentials, proper licensing, and availability of aftercare programs to prevent relapse. You’ll want to decide if you need residential or outpatient rehab, assisted detox and treatment for a dual diagnosis of a co-occurring disorder. Talking to a medical doctor about your symptoms can help you determine which type of treatment you’ll need. Casa Palmera’s compassionate and knowledgeable staff members can also answer any questions you have and discuss how we implement 12-step programs into a treatment plan tailored to your needs.