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12-Step Therapy

Addiction is a widespread problem in the United States and, with the current epidemic of addiction and overdose, the problem is only growing. According to the 2014 National Survey on Drug Use and Health, over 21 million people struggle with some form of a substance use disorder. Recovery from addiction isn’t always like it’s portrayed in the movies. It’s not enough to just go through detox and then return to normal life. Recovery is a long-term progress and a continued commitment to recovery is the most effective way to prevent relapse.

While there is no cure for addiction, it is a treatable disease. Still, there is no one-size-fits-all treatment option. Addiction is complex and so are the people who suffer from the disease. Everyone is different and different people respond to different approaches to treatment. However, the fact remains that, once you get help, it’s important to continue your recovery process through ongoing addiction therapies. It’s often said that you go through a treatment center rather than to one—recovery is a lifelong commitment. 

12-step therapy is an option that helps people continue to pursue recovery, even after completing a treatment program. It also happens to be one of the oldest modern addiction recovery services in the world. Twelve-step programs are among the most recognizable approaches to substance use assistance. Just as it often makes its way into pop culture, the program has made its way into treatment centers all over the world. Many facilities base programs on the steps or refer clients to a program following treatment.

However, the fact that 12-step therapy is so pervasive may cause some to overlook it as a cliché or outdated. But it can be of great value to someone seeking accountability, community, and spiritual healing in recovery. Continue reading to learn more about 12-step therapy, its history, and how it might help you stay on the road to lifelong recovery.

What Is 12-Step Therapy?

People in a circle discussing involuntary commitment into addiction treatment

The 12-steps are an approach to addiction treatment that is centered on connecting you to a community of people with similar goals and challenges, addressing your need for spiritual healing, and giving you access to a network of support and accountability. Some of the more popular 12-step programs, like Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) can be found in almost every major city in the US.

The immediate goal of 12-step therapy is to help members achieve or maintain sobriety and total abstinence from drugs or alcohol. However, it has another goal that goes beyond simply ceasing substance use. In a 12-step program, you will learn to live by a set of spiritual principles and the ultimate goal is for you to learn to pursue a meaningful life, take ownership for your mistakes, help others, and build positive life goals. The overarching pursuit in a 12-step program is personal, spiritual growth.

While 12-step programs acknowledge that addiction is a disease of the mind and body, it also believes that it is a disease of the spirit. This spiritual stagnation is often rooted in self-centeredness, especially when life doesn’t go our way. Instead of living life on life’s terms, many people struggle to cope when life subverts our expectations. Bill Wilson, the founder of AA, the first 12-step program, said, “Selfishness—self-centeredness!

That, we think, is the root of our troubles. Driven by a hundred forms of fear, self-delusion, self-seeking, and self-pity, we step on the toes of our fellows and they retaliate. Sometimes they hurt us, seemingly without provocation, but we invariably find that at some time in the past we have made decisions based on self which later placed us in a position to be hurt.”

The 12-step model is designed to help individuals step out of self-centeredness by taking responsibility for wrong-doings, making amends, and helping others. The spiritual nature these programs often cause people to ask, “Is 12-step a religion?” or even, “Is 12-step a cult?” However, 12-step programs are actually focused on spirituality apart from any specific religious creed.

Though the 12-steps were originally rooted in Christian principles, they avoid close religious, political, and even business associations. One of their main principles is to be accessible to anyone who is seeking abstinence from drugs or alcohol. Still, the spiritual component does require the acceptance of some sort of higher power.

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The History of 12-Step Therapy

Alcoholics Anonymous was the first 12-step recovery program and was founded in 1935. The original 12-steps were published in founder Bill Wilson’s book titled, Alcoholics Anonymous: The Story of How Many Thousands of Men and Women Have Recovered from Alcoholism, or more commonly known as “The Big Book.” AA was born out of the need for a community designed to come alongside alcoholics and help them toward recovery. In the 1930s, alcoholism and addiction were still widely seen as a bad habit and moral failing.

Bill Wilson’s own alcoholism forced him to end a promising Wall Street career and he began to seek help in a Christian fellowship called the Oxford Group. This group was designed to help people overcome sins they struggled with through community, accountability, and brotherhood. Many of the tenants of the Oxford Group would later become core components of Alcoholics Anonymous.

After a dramatic spiritual experience, while undergoing medical treatment for alcoholism, Wilson gained a new-found commitment to the Oxford Group and, more specifically, helped other alcoholics. His movement within the group began to grow and during this time, he met and helped Dr. Bob Smith, who would later become the co-founder of AA. That day in 1935, Smith’s last drink is considered to be the founding date of AA.

After Wilson was criticized by fellow Oxford Group members for focusing too exclusively on helping alcoholics, he left the fellowship to form a new group that would come to be known as Alcoholics Anonymous. Wilson was also critical of the Oxford Groups tendency to seek publicity, which is apparent in AA’s philosophy of anonymity. Still, he would later credit the group as being instrumental in his sobriety and the formation of AA.

After the formation of Alcoholics Anonymous, the group’s popularity began to grow. Today, the AA groups meet all over the globe. While there are no official records as to the number of active members, there are some estimations. AA reported an estimate of over 2 million active members worldwide and over 118,000 active groups.

The 12-step therapy model has since been applied to dozens of other forms of addiction, starting with Narcotics Anonymous in 1953. Today, programs are available for everything from crystal meth addiction to overeating.

How 12-Step Programs Work

The 12-step process is centered on going through each of the steps, discussing them with peers, and helping other people achieve their goals. There are a variety of elements in a 12-step recovery program but they are all ultimately focused on guiding you through the process of taking responsibility for failings, accepting help from others, and giving it in return.

The Steps

12-step therapy works by walking members through each of the steps with plenty of help and support along the way. Each of the steps is designed to help you meet a specific goal but they can be broken up into sections with overarching goals. The first section is intended to increase your awareness that addiction is out of your control and that you will need help, outside of your own willpower, if you hope to overcome it.

Woman looking out a window contemplating 12-step rehab

To remove self-centered and self-reliant thinking, the steps lead you to the idea that God, a power greater than yourself, can restore you “to sanity” or sobriety, and facilitate spiritual growth. This is about as specific as AA gets when it comes to their idea of a higher power. For those who struggle with the idea of God or a higher power, Bill Wilson address how agnostics can approach the 12-step model in the Big Book’s chapter called, “We Agnostics.”

The second set of steps is intended to promote self-examination through a process that is referred to as moral inventory. It’s often suggested that an objective approach is best. The process is not intended for you to lower your self-esteem or dwell on your mistakes. Rather, it’s designed to help you diagnose your shortcomings and root out the things you need to make amends for. Next, you will attempt to make amends for all of the wrongs you’ve done to the people in your past. This is a challenging but ultimately spiritually rewarding process.

Finally, the last steps are never truly complete, as they involve ongoing commitment. In the last step, you commit to helping others through the process just as other people helped you.

The following is the original wording of the 12-steps as applied to AA:

  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.


Though the steps are a core component of the model, meetings are really what make a 12-step program. Wilson believed that fellow recovering alcoholics were crucially important to the recovery of another alcoholic. In fact, he met Dr. Smith while on a business trip when he was having cravings and wanted to speak to someone who would understand what he was going through. In the Big Book, he writes, “No society of men and women ever had a more urgent need for continuous effectiveness and permanent unity. We alcoholics see that we must work together and hang together, else most of us will finally die alone.”

Meetings are where group members come together to discuss challenges, celebrate achievements, share insight, and air grievances. The goal is to keep them free of judgment and as welcoming as possible. Anyone is allowed to attend open meetings, including family members. 

However, closed meetings are reserved for people actually seeking to achieve abstinence from the substance that the group addresses. If you are a member of a program like AA, you can attend meetings anywhere they are held, even when you are traveling. However, it is recommended that you maintain a “home group” or a meeting that you regularly attend.


In a 12-step recovery program, a sponsor is a person who helps other members achieve more through the steps and achieve their goals. Sponsors are usually experienced members who have either completed the steps or made significant progress. When you enter a program, you will have a chance to choose your sponsor or, if you aren’t sure, someone may direct you to a sponsor that might be a good fit for you.

You can also change your sponsor at any time. Sponsors may offer advice in dealing with cravings, be available to answer texts and phone calls throughout the week, offer practical life advice, and generally guide you through your life of sobriety.


Alcoholics Anonymous. (n.d.). HOW IT WORKS R – Alcoholics Anonymous. Retrieved April, 2018 from

Alcoholics Anonymous. (2017, August). SMF-132 – Estimates Worldwide A.A. Individual and Group Membership. Retrieved April, 2018 from

Narcotics Anonymous. (n.d.). Twelve Steps of Narcotics Anonymous. Retrieved April, 2018 from it Works.pdf

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