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Twelve-step program

January 09, 2023

"12 Steps" redirects here. For the song of the same name, see Cxloe.

Twelve-step programs are international mutual aid programs supporting recovery from substance addictions, behavioral addictions and compulsions. Developed in the 1930s, the first twelve-step program, Alcoholics Anonymous (AA), aided its membership to overcome alcoholism.[1] Since that time dozens of other organizations have been derived from AA's approach to address problems as varied as drug addiction, compulsive gambling, sex, and overeating. All twelve-step programs utilize a version of AA's suggested twelve steps first published in the 1939 book Alcoholics Anonymous: The Story of How More Than One Hundred Men Have Recovered from Alcoholism.[2]

As summarized by the American Psychological Association (APA), the process involves the following:[1]

  • admitting that one cannot control one's alcoholism, addiction, or compulsion;
  • coming to believe in a Higher Power that can give strength;
  • examining past errors with the help of a sponsor (experienced member);
  • making amends for these errors;
  • learning to live a new life with a new code of behavior;
  • helping others who suffer from the same alcoholism, addictions, or compulsions.

Overview

Twelve-step methods have been adapted to address a wide range of alcoholism, substance abuse, and dependency problems. Over 200 mutual aid organizations—often known as fellowships—with a worldwide membership of millions have adopted and adapted AA’s 12 Steps and 12 Traditions for recovery. Narcotics Anonymous was formed by addicts who did not relate to the specifics of alcohol dependency.[3]

Demographic preferences related to the addicts' drug of choice has led to the creation of Cocaine Anonymous, Crystal Meth Anonymous and Marijuana Anonymous. Behavioral issues such as compulsion for or addiction to gambling, crime, food, sex, hoarding, getting into debt and work are addressed in fellowships such as Gamblers Anonymous, Overeaters Anonymous, Sexaholics Anonymous and Debtors Anonymous.

Auxiliary groups such as Al-Anon and Nar-Anon, for friends and family members of alcoholics and addicts, respectively, are part of a response to treating addiction as a disease that is enabled by family systems.[4] Adult Children of Alcoholics (ACA or ACOA) addresses the effects of growing up in an alcoholic or otherwise dysfunctional family. Co-Dependents Anonymous (CoDA) addresses compulsions related to relationships, referred to as codependency.

History

Further information: History of Alcoholics Anonymous

Alcoholics Anonymous (AA), the first twelve-step fellowship, was founded in 1935 by Bill Wilson and Dr. Robert Holbrook Smith, known to AA members as "Bill W." and "Dr. Bob", in Akron, Ohio. In 1946 they formally established the twelve traditions to help deal with the issues of how various groups could relate and function as membership grew.[5][6] The practice of remaining anonymous (using only one's first names) when interacting with the general public was published in the first edition of the AA Big Book.[7]

As AA chapters were increasing in number during the 1930s and 1940s, the guiding principles were gradually defined as the Twelve Traditions. A singleness of purpose emerged as Tradition Five: "Each group has but one primary purpose—to carry its message to the alcoholic who still suffers".[8] Consequently, drug addicts who do not suffer from the specifics of alcoholism involved in AA hoping for recovery technically are not welcome in "closed" meetings unless they have a desire to stop drinking alcohol.[9]

The principles of AA have been used to form many numbers of other fellowships specifically designed for those recovering from various pathologies; each emphasizes recovery from the specific malady which brought the sufferer into the fellowship.[10]

Twelve Steps

Several terms ending in "step" redirect here. For other uses, see Scale (music), Eighth Step Coffee House and Ninth Step Station.
Further information: List of Twelve Step alternate wordings

The following are the original twelve steps as published by Alcoholics Anonymous:[11]

  1. We admitted we were powerless over alcohol—that our lives had become unmanageable.
  2. Came to believe that a power greater than ourselves could restore us to sanity.
  3. Made a decision to turn our will and our lives over to the care of God as we understood Him.
  4. Made a searching and fearless moral inventory of ourselves.
  5. Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.
  6. Were entirely ready to have God remove all these defects of character.
  7. Humbly asked Him to remove our shortcomings.
  8. Made a list of all persons we had harmed, and became willing to make amends to them all.
  9. Made direct amends to such people wherever possible, except when to do so would injure them or others.
  10. Continued to take personal inventory, and when we were wrong, promptly admitted it.
  11. 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.
  12. 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.

Where other twelve-step groups have adapted the AA steps as guiding principles, step one generally updated to reflect the focus of recovery. For example, in Overeaters Anonymous, the first step reads, "We admitted we were powerless over compulsive overeating—that our lives had become unmanageable." The third step is also sometimes altered to remove gender-specific pronouns.[12][13][14][15]

Twelve Traditions

Main article: Twelve Traditions

The Twelve Traditions accompany the Twelve Steps. The Traditions provide guidelines for group governance. They were developed in AA in order to help resolve conflicts in the areas of publicity, politics, religion, and finances.[16] Alcoholics Anonymous' Twelve Traditions are:[7]

  1. Our common welfare should come first; personal recovery depends upon AA unity.
  2. 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.
  3. The only requirement for AA membership is a desire to stop drinking.
  4. Each group should be autonomous except in matters affecting other groups or AA as a whole.
  5. Each group has but one primary purpose—to carry its message to the alcoholic who still suffers.
  6. An AA group ought never endorse, finance, or lend the AA name to any related facility or outside enterprise, lest problems of money, property, and prestige divert us from our primary purpose.
  7. Every AA group ought to be fully self-supporting, declining outside contributions.
  8. Alcoholics Anonymous should remain forever non-professional, but our service centers may employ special workers.
  9. AA, as such, ought never be organized; but we may create service boards or committees directly responsible to those they serve.
  10. Alcoholics Anonymous has no opinion on outside issues; hence the AA name ought never be drawn into public controversy.
  11. Our public relations policy is based on attraction rather than promotion; we need always to maintain personal anonymity at the level of press, radio, and films.
  12. Anonymity is the spiritual foundation of all our traditions, ever reminding us to place principles before personalities.

Process

In the twelve-step program, the human structure is symbolically represented in three dimensions: physical, mental, and spiritual. The problems the groups deal with are understood to manifest themselves in each dimension. For addicts and alcoholics, the physical dimension is best described by the allergy-like bodily reaction resulting in the compulsion to continue using substances even when it's harmful or wanting to quit.[17][18] The statement in the First Step that the individual is "powerless" over the substance-abuse related behavior at issue refers to the lack of control over this compulsion, which persists despite any negative consequences that may be endured as a result.[19]

The mental obsession is described as the cognitive processes that cause the individual to repeat the compulsive behavior after some period of abstinence, either knowing that the result will be an inability to stop or operating under the delusion that the result will be different. The description in the First Step of the life of the alcoholic or addict as "unmanageable" refers to the lack of choice that the mind of the addict or alcoholic affords concerning whether to drink or use again.[20] The illness of the spiritual dimension, or "spiritual malady," is considered in all twelve-step groups to be self-centeredness.[17][18] The process of working the steps is intended to replace self-centeredness with a growing moral consciousness and a willingness for self-sacrifice and unselfish constructive action.[18] In twelve-step groups, this is known as a "spiritual awakening."[21] This should not be confused with abreaction, which produces dramatic, but temporary, changes,[22] As a rule, in twelve-step fellowships, spiritual awakening occurs slowly over a period of time, although there are exceptions where members experience a sudden spiritual awakening.[23]

In accordance with the First Step, twelve-step groups emphasize self-admission by members of the problem they are recovering from. It is in this spirit that members often identify themselves along with an admission of their problem, often as "Hi, I’m [first name only], and I’m an alcoholic".[24]

Sponsorship

A sponsor is a more experienced person in recovery who guides the less-experienced aspirant ("sponsee") through the program's twelve steps. New members in twelve-step programs are encouraged to secure a relationship with at least one sponsor who both has a sponsor and has taken the twelve steps themselves.[25] Publications from twelve-step fellowships emphasize that sponsorship is a "one on one" nonhierarchical relationship of shared experiences focused on working the Twelve Steps.[26][27][28] According to Narcotics Anonymous:

Sponsors share their experience, strength, and hope with their sponsees... A sponsor's role is not that of a legal adviser, a banker, a parent, a marriage counselor, or a social worker. Nor is a sponsor a therapist offering some sort of professional advice. A sponsor is simply another addict in recovery who is willing to share his or her journey through the Twelve Steps.[29]

Sponsors and sponsees participate in activities that lead to spiritual growth. Experiences in the program are often shared by outgoing members with incoming members. This rotation of experience is often considered to have a great spiritual reward.[30] These may include practices such as literature discussion and study, meditation, and writing. Completing the program usually implies competency to guide newcomers which is often encouraged.[31] Sponsees typically do their Fifth Step, review their moral inventory written as part of the Fourth Step, with their sponsor. The Fifth Step, as well as the Ninth Step, have been compared to confession and penitence.[32] Michel Foucault, a French philosopher, noted such practices produce intrinsic modifications in the person—exonerating, redeeming and purifying them; relieves them of their burden of wrong, liberating them and promising salvation.[32][33]

The personal nature of the behavioral issues that lead to seeking help in twelve-step fellowships results in a strong relationship between sponsee and sponsor. As the relationship is based on spiritual principles, it is unique and not generally characterized as "friendship". Fundamentally, the sponsor has the single purpose of helping the sponsee recover from the behavioral problem that brought the sufferer into twelve-step work, which reflexively helps the sponsor recover.[25]

A study of sponsorship as practiced in Alcoholics Anonymous and Narcotics Anonymous found that providing direction and support to other alcoholics and addicts is associated with sustained abstinence for the sponsor, but suggested that there were few short-term benefits for the sponsee's one-year sustained abstinence rate.[34][35]

Effectiveness

See also: Effectiveness of Alcoholics Anonymous, Effectiveness of Crystal Meth Anonymous, Effectiveness of Gamblers Anonymous, Effectiveness of Narcotics Anonymous, Effectiveness of Neurotics Anonymous, Effectiveness of Nicotine Anonymous, and Effectiveness of self-help groups for mental health

Alcoholics Anonymous is the largest of all of the twelve-step programs (from which all other twelve-step programs are derived), followed by Narcotics Anonymous[citation needed]; the majority of twelve-step members are recovering from addiction to alcohol or other drugs. The majority of twelve-step programs, however, address illnesses other than substance addiction. For example, the third-largest twelve-step program, Al-Anon, assists family members and friends of people who have alcoholism and other addictions. About twenty percent of twelve-step programs are for substance addiction recovery, the other eighty percent address a variety of problems from debt to depression.[36] It would be an error to assume the effectiveness of twelve-step methods at treating problems in one domain translates to all or to another domain,[37] therefore, readers are directed to relevant sections in each group's Wikipedia article.

The 2020 Cochrane review of Alcoholics Anonymous shows that AA results in more alcoholics being abstinent from alcohol and for longer periods of time than some other treatments, but only as well in drinks-per-day and other measures.[38][39] When comparing Alcoholics Anonymous and/or Twelve Step Facilitation to other alcohol use disorder interventions, at the 12-month follow up, randomized controlled trials show a 42% abstinent rate for AA/TSF treatments, compared to 35% abstinent using non-AA interventions.[40][41] A systematic review published in 2017 found that twelve-step programs for reducing illicit drug use are neither better nor worse than other interventions.[42]

Criticism

See also: Alcoholics Anonymous: Criticism, Gamblers Anonymous: Criticism, Narcotics Anonymous: Controversies, Overeaters Anonymous: Criticism, Self-help groups for mental health: Criticism, and Sexaholics Anonymous: Criticism

The criticisms of twelve-step groups are varied. People have attended twelve-step meetings, only to find success eluded them. Their varied success rate and the belief in a Higher Power suggested in them, are common criticisms of their universal applicability and efficacy.[43]

Confidentiality

The Twelve Traditions encourage members to practice the spiritual principle of anonymity in the public media and members are also asked to respect each other's confidentiality.[44] This is a group norm,[44] however, and not legally mandated; there are no legal consequences to discourage those attending twelve-step groups from revealing information disclosed during meetings.[45] Statutes on group therapy do not encompass those associations that lack a professional therapist or clergyman to whom confidentiality and privilege might apply. Professionals and paraprofessionals who refer patients to these groups, to avoid both civil liability and licensure problems, have been advised that they should alert their patients that, at any time, their statements made in meetings may be disclosed.[45]

Cultural identity

One review warned of detrimental iatrogenic effects of twelve-step philosophy and labeled the organizations as cults,[46] while another review asserts that these programs bore little semblance to religious cults and that the techniques used appeared beneficial to some.[47] Another study found that a twelve-step program's focus on self-admission of having a problem increases deviant stigma and strips members of their previous cultural identity, replacing it with the deviant identity.[48] Another study asserts that the prior cultural identity may not be replaced entirely, but rather members found adapted a bicultural identity.[49]

See also

References

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Further reading

Scholarly publications

  • Borman, P. D., & Dixon, D. N. (Fall 1998). "Spirituality and the 12 steps of substance abuse recovery". Journal of Psychology & Theology. 26 (3): 287–291. doi:10.1177/009164719802600306. S2CID 148676117.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  • Freimuth, M. (199). "Psychotherapists' beliefs about the benefits of 12-step groups". Alcoholism Treatment Quarterly. 14 (3): 95–102. doi:10.1300/J020V14N03_08.
  • Freimuth, M. (July 2000). "Integrating group psychotherapy and 12-step work: A collaborative approach". International Journal of Group Psychotherapy. 50 (3): 297–314. doi:10.1080/00207284.2000.11491011. PMID 10883547. S2CID 43254982.
  • Harris, J., Best, D., Gossop, M., Marshall, J., Man, L.-H., Manning, V.; et al. (March 2003). "Prior alcoholics anonymous (AA) affiliation and the acceptability of the twelve steps to patients entering UK statutory addiction treatment". Journal of Studies on Alcohol. 64 (2): 257–261. doi:10.15288/jsa.2003.64.257. PMID 12713200.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  • Humphreys, K. (May 2006). "The trials of Alcoholics Anonymous". Addiction. 101 (5): 617–618. doi:10.1111/j.1360-0443.2006.01447.x. PMID 16669879.
  • Kurtz, L. F., & Fisher, M. (May 2003). "Twelve-step recovery and community service". Health & Social Work. 28 (2): 137–145. doi:10.1093/hsw/28.2.137. PMID 12774535.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  • Lile, B. (2003). "Twelve step programs: An update". Addictive Disorders & Their Treatment. 2 (1): 19–24. doi:10.1097/00132576-200302010-00004. S2CID 74842059.
  • Morgenstern, J., Bux, D., Labouvie, E., Blanchard, K. A., & Morgan, T. J. (November 2002). "Examining mechanisms of action in 12-step treatment: The role of 12-step cognitions". Journal of Studies on Alcohol. 63 (6): 665–672. doi:10.15288/jsa.2002.63.665. PMID 12529066.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  • Sheehan, T. (2004). "Twelve Step Facilitation: A Necessary Treatment for Offenders". Journal of Forensic Psychology Practice. 4 (3): 71–81. doi:10.1300/J158v04n03_05. S2CID 145564061.
  • Sias, S. M., & Goodwin, L. R. Jr. (April 2007). "Students' reactions to attending 12-step meetings: Implications for counselor education". Journal of Addictions & Offender Counseling. 27 (2): 113–126. doi:10.1002/j.2161-1874.2007.tb00025.x.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  • Simkin, D. R. (January 1996). "Twelve-step treatment from a development perspective". Child and Adolescent Psychiatric Clinics of North America. 5 (1): 165–175. doi:10.1016/S1056-4993(18)30391-2.

January 09, 2023
twelve, step, program, steps, redirects, here, song, same, name, cxloe, international, mutual, programs, supporting, recovery, from, substance, addictions, behavioral, addictions, compulsions, developed, 1930s, first, twelve, step, program, alcoholics, anonymo. 12 Steps redirects here For the song of the same name see Cxloe Twelve step programs are international mutual aid programs supporting recovery from substance addictions behavioral addictions and compulsions Developed in the 1930s the first twelve step program Alcoholics Anonymous AA aided its membership to overcome alcoholism 1 Since that time dozens of other organizations have been derived from AA s approach to address problems as varied as drug addiction compulsive gambling sex and overeating All twelve step programs utilize a version of AA s suggested twelve steps first published in the 1939 book Alcoholics Anonymous The Story of How More Than One Hundred Men Have Recovered from Alcoholism 2 As summarized by the American Psychological Association APA the process involves the following 1 admitting that one cannot control one s alcoholism addiction or compulsion coming to believe in a Higher Power that can give strength examining past errors with the help of a sponsor experienced member making amends for these errors learning to live a new life with a new code of behavior helping others who suffer from the same alcoholism addictions or compulsions Contents 1 Overview 2 History 3 Twelve Steps 4 Twelve Traditions 5 Process 6 Sponsorship 7 Effectiveness 8 Criticism 8 1 Confidentiality 8 2 Cultural identity 9 See also 10 References 11 Further reading 11 1 Scholarly publicationsOverview EditTwelve step methods have been adapted to address a wide range of alcoholism substance abuse and dependency problems Over 200 mutual aid organizations often known as fellowships with a worldwide membership of millions have adopted and adapted AA s 12 Steps and 12 Traditions for recovery Narcotics Anonymous was formed by addicts who did not relate to the specifics of alcohol dependency 3 Demographic preferences related to the addicts drug of choice has led to the creation of Cocaine Anonymous Crystal Meth Anonymous and Marijuana Anonymous Behavioral issues such as compulsion for or addiction to gambling crime food sex hoarding getting into debt and work are addressed in fellowships such as Gamblers Anonymous Overeaters Anonymous Sexaholics Anonymous and Debtors Anonymous Auxiliary groups such as Al Anon and Nar Anon for friends and family members of alcoholics and addicts respectively are part of a response to treating addiction as a disease that is enabled by family systems 4 Adult Children of Alcoholics ACA or ACOA addresses the effects of growing up in an alcoholic or otherwise dysfunctional family Co Dependents Anonymous CoDA addresses compulsions related to relationships referred to as codependency History EditFurther information History of Alcoholics Anonymous Alcoholics Anonymous AA the first twelve step fellowship was founded in 1935 by Bill Wilson and Dr Robert Holbrook Smith known to AA members as Bill W and Dr Bob in Akron Ohio In 1946 they formally established the twelve traditions to help deal with the issues of how various groups could relate and function as membership grew 5 6 The practice of remaining anonymous using only one s first names when interacting with the general public was published in the first edition of the AA Big Book 7 As AA chapters were increasing in number during the 1930s and 1940s the guiding principles were gradually defined as the Twelve Traditions A singleness of purpose emerged as Tradition Five Each group has but one primary purpose to carry its message to the alcoholic who still suffers 8 Consequently drug addicts who do not suffer from the specifics of alcoholism involved in AA hoping for recovery technically are not welcome in closed meetings unless they have a desire to stop drinking alcohol 9 The principles of AA have been used to form many numbers of other fellowships specifically designed for those recovering from various pathologies each emphasizes recovery from the specific malady which brought the sufferer into the fellowship 10 Twelve Steps EditSeveral terms ending in step redirect here For other uses see Scale music Eighth Step Coffee House and Ninth Step Station Further information List of Twelve Step alternate wordings The following are the original twelve steps as published by Alcoholics Anonymous 11 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 Where other twelve step groups have adapted the AA steps as guiding principles step one generally updated to reflect the focus of recovery For example in Overeaters Anonymous the first step reads We admitted we were powerless over compulsive overeating that our lives had become unmanageable The third step is also sometimes altered to remove gender specific pronouns 12 13 14 15 Twelve Traditions EditMain article Twelve Traditions The Twelve Traditions accompany the Twelve Steps The Traditions provide guidelines for group governance They were developed in AA in order to help resolve conflicts in the areas of publicity politics religion and finances 16 Alcoholics Anonymous Twelve Traditions are 7 Our common welfare should come first personal recovery depends upon AA unity 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 The only requirement for AA membership is a desire to stop drinking Each group should be autonomous except in matters affecting other groups or AA as a whole Each group has but one primary purpose to carry its message to the alcoholic who still suffers An AA group ought never endorse finance or lend the AA name to any related facility or outside enterprise lest problems of money property and prestige divert us from our primary purpose Every AA group ought to be fully self supporting declining outside contributions Alcoholics Anonymous should remain forever non professional but our service centers may employ special workers AA as such ought never be organized but we may create service boards or committees directly responsible to those they serve Alcoholics Anonymous has no opinion on outside issues hence the AA name ought never be drawn into public controversy Our public relations policy is based on attraction rather than promotion we need always to maintain personal anonymity at the level of press radio and films Anonymity is the spiritual foundation of all our traditions ever reminding us to place principles before personalities Process EditIn the twelve step program the human structure is symbolically represented in three dimensions physical mental and spiritual The problems the groups deal with are understood to manifest themselves in each dimension For addicts and alcoholics the physical dimension is best described by the allergy like bodily reaction resulting in the compulsion to continue using substances even when it s harmful or wanting to quit 17 18 The statement in the First Step that the individual is powerless over the substance abuse related behavior at issue refers to the lack of control over this compulsion which persists despite any negative consequences that may be endured as a result 19 The mental obsession is described as the cognitive processes that cause the individual to repeat the compulsive behavior after some period of abstinence either knowing that the result will be an inability to stop or operating under the delusion that the result will be different The description in the First Step of the life of the alcoholic or addict as unmanageable refers to the lack of choice that the mind of the addict or alcoholic affords concerning whether to drink or use again 20 The illness of the spiritual dimension or spiritual malady is considered in all twelve step groups to be self centeredness 17 18 The process of working the steps is intended to replace self centeredness with a growing moral consciousness and a willingness for self sacrifice and unselfish constructive action 18 In twelve step groups this is known as a spiritual awakening 21 This should not be confused with abreaction which produces dramatic but temporary changes 22 As a rule in twelve step fellowships spiritual awakening occurs slowly over a period of time although there are exceptions where members experience a sudden spiritual awakening 23 In accordance with the First Step twelve step groups emphasize self admission by members of the problem they are recovering from It is in this spirit that members often identify themselves along with an admission of their problem often as Hi I m first name only and I m an alcoholic 24 Sponsorship EditA sponsor is a more experienced person in recovery who guides the less experienced aspirant sponsee through the program s twelve steps New members in twelve step programs are encouraged to secure a relationship with at least one sponsor who both has a sponsor and has taken the twelve steps themselves 25 Publications from twelve step fellowships emphasize that sponsorship is a one on one nonhierarchical relationship of shared experiences focused on working the Twelve Steps 26 27 28 According to Narcotics Anonymous Sponsors share their experience strength and hope with their sponsees A sponsor s role is not that of a legal adviser a banker a parent a marriage counselor or a social worker Nor is a sponsor a therapist offering some sort of professional advice A sponsor is simply another addict in recovery who is willing to share his or her journey through the Twelve Steps 29 Sponsors and sponsees participate in activities that lead to spiritual growth Experiences in the program are often shared by outgoing members with incoming members This rotation of experience is often considered to have a great spiritual reward 30 These may include practices such as literature discussion and study meditation and writing Completing the program usually implies competency to guide newcomers which is often encouraged 31 Sponsees typically do their Fifth Step review their moral inventory written as part of the Fourth Step with their sponsor The Fifth Step as well as the Ninth Step have been compared to confession and penitence 32 Michel Foucault a French philosopher noted such practices produce intrinsic modifications in the person exonerating redeeming and purifying them relieves them of their burden of wrong liberating them and promising salvation 32 33 The personal nature of the behavioral issues that lead to seeking help in twelve step fellowships results in a strong relationship between sponsee and sponsor As the relationship is based on spiritual principles it is unique and not generally characterized as friendship Fundamentally the sponsor has the single purpose of helping the sponsee recover from the behavioral problem that brought the sufferer into twelve step work which reflexively helps the sponsor recover 25 A study of sponsorship as practiced in Alcoholics Anonymous and Narcotics Anonymous found that providing direction and support to other alcoholics and addicts is associated with sustained abstinence for the sponsor but suggested that there were few short term benefits for the sponsee s one year sustained abstinence rate 34 35 Effectiveness EditSee also Effectiveness of Alcoholics Anonymous Effectiveness of Crystal Meth Anonymous Effectiveness of Gamblers Anonymous Effectiveness of Narcotics Anonymous Effectiveness of Neurotics Anonymous Effectiveness of Nicotine Anonymous and Effectiveness of self help groups for mental health Alcoholics Anonymous is the largest of all of the twelve step programs from which all other twelve step programs are derived followed by Narcotics Anonymous citation needed the majority of twelve step members are recovering from addiction to alcohol or other drugs The majority of twelve step programs however address illnesses other than substance addiction For example the third largest twelve step program Al Anon assists family members and friends of people who have alcoholism and other addictions About twenty percent of twelve step programs are for substance addiction recovery the other eighty percent address a variety of problems from debt to depression 36 It would be an error to assume the effectiveness of twelve step methods at treating problems in one domain translates to all or to another domain 37 therefore readers are directed to relevant sections in each group s Wikipedia article The 2020 Cochrane review of Alcoholics Anonymous shows that AA results in more alcoholics being abstinent from alcohol and for longer periods of time than some other treatments but only as well in drinks per day and other measures 38 39 When comparing Alcoholics Anonymous and or Twelve Step Facilitation to other alcohol use disorder interventions at the 12 month follow up randomized controlled trials show a 42 abstinent rate for AA TSF treatments compared to 35 abstinent using non AA interventions 40 41 A systematic review published in 2017 found that twelve step programs for reducing illicit drug use are neither better nor worse than other interventions 42 Criticism EditSee also Alcoholics Anonymous Criticism Gamblers Anonymous Criticism Narcotics Anonymous Controversies Overeaters Anonymous Criticism Self help groups for mental health Criticism and Sexaholics Anonymous Criticism The criticisms of twelve step groups are varied People have attended twelve step meetings only to find success eluded them Their varied success rate and the belief in a Higher Power suggested in them are common criticisms of their universal applicability and efficacy 43 Confidentiality Edit The Twelve Traditions encourage members to practice the spiritual principle of anonymity in the public media and members are also asked to respect each other s confidentiality 44 This is a group norm 44 however and not legally mandated there are no legal consequences to discourage those attending twelve step groups from revealing information disclosed during meetings 45 Statutes on group therapy do not encompass those associations that lack a professional therapist or clergyman to whom confidentiality and privilege might apply Professionals and paraprofessionals who refer patients to these groups to avoid both civil liability and licensure problems have been advised that they should alert their patients that at any time their statements made in meetings may be disclosed 45 Cultural identity Edit One review warned of detrimental iatrogenic effects of twelve step philosophy and labeled the organizations as cults 46 while another review asserts that these programs bore little semblance to religious cults and that the techniques used appeared beneficial to some 47 Another study found that a twelve step program s focus on self admission of having a problem increases deviant stigma and strips members of their previous cultural identity replacing it with the deviant identity 48 Another study asserts that the prior cultural identity may not be replaced entirely but rather members found adapted a bicultural identity 49 See also EditAddiction recovery groups Drug rehabilitation Effectiveness of Alcoholics Anonymous Group psychotherapy List of twelve step groups Self help groups for mental health Recovery modelReferences Edit a b VandenBos Gary R 2007 APA dictionary of psychology 1st ed Washington DC American Psychological Association ISBN 978 1 59147 380 0 OCLC 65407150 Bill W June 2001 Alcoholics Anonymous 4th ed Alcoholics Anonymous World Services ISBN 1 893007 16 2 OCLC 32014950 Narcotics Anonymous 1987 Chapter 8 We Do Recover Narcotics Anonymous 4th ed Van Nuys CA Narcotics Anonymous World Service Office ISBN 0 912075 02 3 OCLC 14377415 page needed Crnkovic A Elaine DelCampo Robert L March 1998 A Systems Approach to the Treatment of Chemical Addiction Contemporary Family Therapy Springer Science Business Media 20 1 25 36 doi 10 1023 A 1025084516633 ISSN 1573 3335 S2CID 141085303 Hartigan Francis 2001 Bill W A Biography of Alcoholics Anonymous Cofounder Bill Wilson pp 161 162 ISBN 0 312 28391 1 OCLC 42772358 Barefoot s World barefootsworld net Retrieved March 24 2018 a b The Twelve Traditions The A A Grapevine Alcoholics Anonymous 6 6 November 1949 ISSN 0362 2584 OCLC 50379271 Twelve Steps and Twelve Traditions Hazelden February 2002 ISBN 0 916856 01 1 OCLC 13572433 page needed For Anyone New Coming to A A For Anyone Referring People to A A Alcoholics Anonymous World Services Inc Archived from the original on January 17 2008 Retrieved June 15 2006 Vaillant George E 2002 Singleness of Purpose PDF About AA A Newsletter for Professionals Fall Winter Bill W June 2001 Chapter 5 How It Works PDF Alcoholics Anonymous 4th ed Alcoholics Anonymous World Services ISBN 1 893007 16 2 OCLC 32014950 page needed World Service Board of Trustees Bulletin 13 Some thoughts regarding our relationship to Alcoholics Anonymous Narcotics Anonymous World Services February 23 2007 Archived from the original on October 6 2007 Retrieved October 7 2007 NA History Chronology January 13 2006 Archived from the original on March 3 2009 Retrieved October 7 2007 1953 this committee met regularly From the beginning 12 Steps 12 Traditions All Steps had We The 12 Steps of Recovery Archived from the original on November 5 2012 Retrieved August 28 2010 The Twelve Steps of Marijuana Anonymous Retrieved September 28 2012 Bill W April 1946 Our A A Experience Has Taught Us That The A A Grapevine Alcoholics Anonymous 2 11 ISSN 0362 2584 OCLC 50379271 a b Kurtz LF Chambon A 1987 Comparison of self help groups for mental health Health amp Social Work 12 4 275 83 doi 10 1093 hsw 12 4 275 PMID 3679015 a b c Ronel Natti 2000 From Self Help to Professional Care An Enhanced Application of the 12 Step Program The Journal of Applied Behavioral Science 36 1 108 122 doi 10 1177 0021886300361006 ISSN 1552 6879 OCLC 1783135 S2CID 144471066 Alcoholics Anonymous June 1 2001 Chapter 2 There Is a Solution PDF Alcoholics Anonymous 4th ed Alcoholics Anonymous World Services p 21 ISBN 1893007162 OCLC 32014950 At some stage of his drinking career he begins to lose all control of his liquor consumption once he starts to drink Alcoholics Anonymous June 1 2001 Chapter 2 There Is a Solution PDF Alcoholics Anonymous 4th ed Alcoholics Anonymous World Services p 21 ISBN 1893007162 OCLC 32014950 These observations would be academic and pointless if he never took the first drink thereby setting the terrible cycle in motion Therefore the main problem centers in his mind The fact is that most alcoholics have lost the power of choice in drink unable at certain times to bring into his consciousness with sufficient force the memory of the suffering and humiliation of a month or even a week ago He is without defense against the first drink Roehe Marcelo V 2004 Religious Experience in Self Help Groups the neurotics anonymous example Psicologia Em Estudo in Portuguese 9 3 399 407 doi 10 1590 S1413 73722004000300008 ISSN 1413 7372 Marmor J April 1 1980 Recent trends in psychotherapy The American Journal of Psychiatry 137 4 409 16 doi 10 1176 ajp 137 4 409 PMID 6987904 Alcoholics Anonymous June 1 1976 Appendix II Spiritual Experience Alcoholics Anonymous Alcoholics Anonymous World Services ISBN 0916856593 OCLC 32014950 Archived from the original on December 5 2008 Hayes Terrell February 2000 Stigmatizing Indebtedness Implications for Labeling Theory Symbolic Interaction 23 1 29 46 doi 10 1525 si 2000 23 1 29 a b Sponsorship Q amp A pamphlet PDF New York Alcoholics Anonymous World Services a href Template Cite journal html title Template Cite journal cite journal a Cite journal requires journal help NYCMA What is a Sponsor New York Crystal Meth Anonymous Intergroup Archived from the original on March 3 2016 Retrieved October 8 2007 SLAA Online Group of Sex and Love Addicts Anonymous Sponsorship Online February 5 2007 Archived from the original on June 8 2015 Retrieved December 19 2015 Overeaters Anonymous Unity Intergroup Website Sponsorship September 19 2007 Retrieved October 8 2007 Narcotics Anonymous 2004 Sponsorship Revised pamphlet What does a sponsor do PDF Van Nuys CA Narcotics Anonymous Archived from the original PDF on January 17 2009 a href Template Cite journal html title Template Cite journal cite journal a Cite journal requires journal help The A A Group Where it all begins How a group Functions How to get started PDF P 16 The A A Group where it all begins Alcoholics Anonymous World Services Inc Retrieved September 26 2016 Questions amp Answers on Sponsorship PDF P 15 Questions amp Answers on Sponsorship Alcoholics Anonymous World Services Inc Retrieved September 26 2016 a b Kriz Kerri Lynn Murphy May 2002 The Efficacy of Overeaters Anonymous in Fostering Abstinence in Binge Easting Disorder and Bulimia Nervosa Virginia Polytechnic Institute and State University Morenberg Adam July 2004 Governing Wayward Consumers Self Change and Recovery in Debtors Anonymous PDF Master of Arts Sociology Tampa Florida University of South Florida OCLC 56564118 Archived from the original on December 19 2015 Retrieved December 19 2015 Crape Byron L Latkin Carl A Laris Alexandra S Knowlton Amy R February 2002 The effects of sponsorship in 12 step treatment of injection drug users Drug and Alcohol Dependence 65 3 291 301 doi 10 1016 S0376 8716 01 00175 2 PMID 11841900 NCJRS Abstract National Criminal Justice Reference Service Ncjrs gov February 1 2002 Retrieved March 5 2009 Makela Klaus 1996 Alcoholics Anonymous as a Mutual help Movement A Study in Eight Societies University of Wisconsin Press ISBN 0 299 15004 6 page needed Saulnier Christine Flynn 1996 Images of the Twelve Step Model and Sex and Love Addiction in an Alcohol Intervention Group for Black Women Journal of Drug Issues 26 1 95 123 doi 10 1177 002204269602600107 S2CID 147097398 Kelly John F Humphreys Keith Ferri Marica 2020 Alcoholics Anonymous and other 12 step programs for alcohol use disorder Cochrane Database of Systematic Reviews 3 CD012880 doi 10 1002 14651858 CD012880 pub2 PMC 7065341 PMID 32159228 Frakt Austin Carroll Aaron Alcoholics Anonymous vs Other Approaches The Evidence Is Now In The New York Times Becker Deborah New Review Finds Alcoholics Anonymous Is Effective But Not For Everyone NPR Lopez German March 11 2020 A new big review of the evidence found that Alcoholics Anonymous works for some Vox Bog Martin Filges Trine Brannstrom Lars Jorgensen Anne Marie Klint Fredrikksson Maja Karrman January 2017 12 step programs for reducing illicit drug use Campbell Systematic Reviews 13 1 1 149 doi 10 4073 csr 2017 2 ISSN 1891 1803 Brandsma Jeffrey M Dicarli M 1976 Toward a More Rational Alcoholics Anonymous Rational Living 11 1 35 37 doi 10 1016 j nuclcard 2007 06 118 ISSN 0034 0049 OCLC 1763461 PMID 17826317 S2CID 34364695 a b Levine Betsy Kellen Bonnie 2000 Chapter 18 Debtors Anonymous and Psychotherapy In Benson April Lane ed I shop therefore I am compulsive buying and search for shelf pp 431 454 ISBN 0765702428 OCLC 301650820 a href Template Cite book html title Template Cite book cite book a CS1 maint multiple names authors list link a b Coleman P December 1 2005 Privilege and confidentiality in 12 step self help programs Believing the promises could be hazardous to an addict s freedom The Journal of Legal Medicine 26 4 435 74 doi 10 1080 01947640500364713 PMID 16303734 S2CID 31742544 Alexander F Rollins M 1985 Alcoholics Anonymous the unseen cult California Sociologist Los Angeles California State University 17 1 33 48 ISSN 0162 8712 OCLC 4025459 Wright Kevin B 1997 Shared ideology in Alcoholics Anonymous a grounded theory approach Journal of Health Communication 2 2 83 99 doi 10 1080 108107397127806 PMID 10977242 Levinson David 1983 Current status of the field an anthropological perspective on the behavior modification treatment of alcoholism Genetics Behavioral Treatment Social Mediators and Prevention Current Concepts in Diagnosis Recent Developments in Alcoholism Vol 1 pp 255 61 doi 10 1007 978 1 4613 3617 4 14 ISBN 978 1 4613 3619 8 PMID 6680227 Wilcox D M 1998 Chapter 7 Language Culture and Belief Alcoholic thinking Language culture and belief in Alcoholics Anonymous Westport CT Greenwood Publishing Group pp 109 124 ISBN 0 275 96049 8 Further reading EditScholarly publications Edit Borman P D amp Dixon D N Fall 1998 Spirituality and the 12 steps of substance abuse recovery Journal of Psychology amp Theology 26 3 287 291 doi 10 1177 009164719802600306 S2CID 148676117 a href Template Cite journal html title Template Cite journal cite journal a CS1 maint multiple names authors list link Freimuth M 199 Psychotherapists beliefs about the benefits of 12 step groups Alcoholism Treatment Quarterly 14 3 95 102 doi 10 1300 J020V14N03 08 Freimuth M July 2000 Integrating group psychotherapy and 12 step work A collaborative approach International Journal of Group Psychotherapy 50 3 297 314 doi 10 1080 00207284 2000 11491011 PMID 10883547 S2CID 43254982 Harris J Best D Gossop M Marshall J Man L H Manning V et al March 2003 Prior alcoholics anonymous AA affiliation and the acceptability of the twelve steps to patients entering UK statutory addiction treatment Journal of Studies on Alcohol 64 2 257 261 doi 10 15288 jsa 2003 64 257 PMID 12713200 a href Template Cite journal html title Template Cite journal cite journal a CS1 maint multiple names authors list link Humphreys K May 2006 The trials of Alcoholics Anonymous Addiction 101 5 617 618 doi 10 1111 j 1360 0443 2006 01447 x PMID 16669879 Kurtz L F amp Fisher M May 2003 Twelve step recovery and community service Health amp Social Work 28 2 137 145 doi 10 1093 hsw 28 2 137 PMID 12774535 a href Template Cite journal html title Template Cite journal cite journal a CS1 maint multiple names authors list link Lile B 2003 Twelve step programs An update Addictive Disorders amp Their Treatment 2 1 19 24 doi 10 1097 00132576 200302010 00004 S2CID 74842059 Morgenstern J Bux D Labouvie E Blanchard K A amp Morgan T J November 2002 Examining mechanisms of action in 12 step treatment The role of 12 step cognitions Journal of Studies on Alcohol 63 6 665 672 doi 10 15288 jsa 2002 63 665 PMID 12529066 a href Template Cite journal html title Template Cite journal cite journal a CS1 maint multiple names authors list link Sheehan T 2004 Twelve Step Facilitation A Necessary Treatment for Offenders Journal of Forensic Psychology Practice 4 3 71 81 doi 10 1300 J158v04n03 05 S2CID 145564061 Sias S M amp Goodwin L R Jr April 2007 Students reactions to attending 12 step meetings Implications for counselor education Journal of Addictions amp Offender Counseling 27 2 113 126 doi 10 1002 j 2161 1874 2007 tb00025 x a href Template Cite journal html title Template Cite journal cite journal a CS1 maint multiple names authors list link Simkin D R January 1996 Twelve step treatment from a development perspective Child and Adolescent Psychiatric Clinics of North America 5 1 165 175 doi 10 1016 S1056 4993 18 30391 2 Retrieved from https en wikipedia org w index php title Twelve step program amp oldid 1130354543, wikipedia, wiki, book, books, library,

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