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Even if you’re just starting recovery, you’ve probably heard of the 12 Steps. This philosophy started in Alcoholics Anonymous (A.A.), and has grown into countless other 12-Step groups and rehab programs. For many people, the 12 Steps are central to the process of healing.
But how effective are the 12 Steps, really? Some people swear by them—but they’re not right for everyone. When you’re planning your recovery, it’s important to choose the best possible approach for you. That could include 12-Step rehab, alternative treatment, or something else entirely.
Alcoholics Anonymous (AA) is an international fellowship of men and women who have struggled with alcohol addiction. AA is a non-profit organization that operates on a voluntary basis, and its members support each other in their journey towards sobriety.
The program is based on the twelve steps, which are spiritual principles that guide individuals towards a new way of living. The steps involve admitting powerlessness over alcohol, making a moral inventory of oneself, making amends to those harmed by addiction, and seeking spiritual guidance.
AA meetings are held regularly and provide a supportive environment for members to share their experiences, strength, and hope with each other. Members are encouraged to work with a sponsor, who is someone further along in the program and can provide guidance and support.
AA does not endorse or promote any particular religion or belief system and is open to anyone who wants to stop drinking. The anonymity of members is respected, and the organization is self-supporting through contributions from its members.
Alcoholics Anonymous (A.A.) began in the 1930s.1 It was co-founded by Bill Wilson—or Bill W.—and his colleague Dr. Bob. Both men were in recovery from alcohol addiction when they met. Through their friendship, they realized how crucial peer support was for their sobriety. Over time they developed the 12 Steps and began hosting meetings for other people in addiction recovery.
The 12 Steps themselves are specific actions a person can take to heal from addiction. Step 1, for example, reads “We admitted we were powerless over alcohol—that our lives had become unmanageable.” Members of these groups encourage each other to follow these steps toward ongoing sobriety.
Sponsorship is another core tenet of A.A.2 and other 12-Step groups. Members with some experience in recovery can sponsor newer participants. In these 1:1 relationships, sponsors offer support and fellowship. You’ll cultivate a close relationship with your sponsor, so you can call on them for help at any point in your healing journey.
This approach is faith-based, meaning that participants express their faith in a higher power. Despite its roots in Christianity, the 12-Step philosophy welcomes people of any and all religious backgrounds. In Step 3, for instance, members submit themselves “to the care of God as we understood Him.” If you find comfort in spirituality, the 12 Steps might be a good fit during addiction treatment.
12-Step groups like A.A. are best known for their free, peer-led meetings. According to the A.A. website, anyone who “wants to do something about their drinking problem”3 is welcome. During a meeting you might pray, listen to a guest speaker, share your story, or hear from other members. Every meeting is a little different, and there are countless sessions to choose from. These meetings take place all over the world—you can even find them online.
You can follow the 12 Steps on your own, in a peer-led meeting, or in formal addiction treatment. Many rehab programs are based on these ideals. Patients talk about the Steps in individual therapy and in group sessions. You might even attend peer-led meetings, either in your rehab or in the nearby community. If you start following the 12 Steps in rehab, you can easily join a local group once you complete treatment and return home.
Data shows that A.A. is as effective as other types of addiction treatment.4 But it’s not right for everyone. For example, one study found that A.A. had a 42% success rate, compared to the 35% success rate of cognitive behavioral therapy (CBT). But Deborah Becker, a correspondent for NPR, explains that there’s a lot of nuance behind these numbers. “The thing that the researchers point out is that AA is free,” she says. “You don’t have to make an appointment. It’s open to everyone. And I think that is what they’re saying, is that it saves money, it’s very accessible, and it’s showing these long rates of continuous abstinence.”
Other experts agree that the length of treatment plays a role. While A.A. and other approaches have similar success rates in the short term, the 12 Steps have higher long-term success rates.5 But researchers are still gathering data on this issue. We don’t know, for instance, whether other free, peer-led support groups are as effective as A.A.
Not everyone draws strength from spirituality, or from fellowship with groups of people. You might prefer 1:1 relationships with care providers or a small circle of loved ones. What’s more, A.A. encourages members to be completely sober.6 If you’re taking a harm-reductionist approach to recovery, A.A. might not be a good fit. There are many other free, peer-led recovery groups to choose from.
In SMART Recovery, SMART stands for Self-Management and Recovery Training. These groups are based on scientific principles instead of encouraging faith-based recovery. Members work toward self-empowerment through behavioral techniques.
Like A.A., this is a fellowship of people seeking recovery from addiction. Unlike those in A.A., SMART recovery facilitators have some formal training.7 They’ll offer concrete advice to help you plan your recovery. As member Jan L. writes, “If you are ready to do the work, and that’s a very big IF, SMART Recovery tools begin to work on day one.8 You do not have to come for weeks before you see progress.”
Secular Organizations for Sobriety, or S.O.S., is a network of groups that take place online and around the world. This non-profit also helps people begin new meetings to support people through addiction recovery. While not every group in S.O.S. shares the same ethos, none of these meetings are religious.
Members of this organization heal “through the lens of LifeRing’s 3-S philosophy of Sobriety, Secularity, and Self-Help.” They support each other by candidly sharing their experiences and practical tips for recovery.
LifeRing participants strive to “strengthen the Sober Self” in free meetings,9 which take place both in person and online.
Unlike other non-12-Step groups, Women for Sobriety (WFS) offers far more than free, peer-led meetings. WFS is a non-profit organization that also performs addiction research, outreach, and helps establish mutual aid networks. They also hold meetings for women in recovery, both in person and online, as well as online chat rooms. Their services are open to all women, including trans women.
Moderation Management (MM) takes a harm-reductionist approach to recovery. In other words, these groups don’t require or even recommend that members be totally sober. As one member of their online community writes, “MM has given me something I’ve been missing10 for a long time: Hope. Hope that I can do this. I can’t imagine a life entirely without alcohol, and now I know I don’t have to. Armed with the tools necessary to feel empowered, I can abstain. And I can moderate. And I can make that decision for myself.”
MM specifically focuses on moderating alcohol use, rather than drug use. These meetings are a good fit for people trying to drink less, who don’t want to cut alcohol out of their lives entirely.
While group meetings can be helpful, they’re just one part of an effective recovery plan. Many people also need more formal treatment. That could be as simple as seeing a therapist, or as comprehensive as attending residential rehab.
If the 12 Steps align with your values, you’ll have many rehab programs to choose from. But just as many rehabs take a different approach to addiction treatment.
This type of care is founded on robust scientific research. Western medicine includes countless evidence-based treatments for physical and mental health. For example, an evidence-based rehab program might offer:
Most evidence-based care follows predefined treatment protocols. But your provider may still recommend changes based on your exact needs. If you’d like to take this scientific approach to recovery, talk to your doctor or therapist about which specific therapies might be the best fit.
Also called integrated, complementary, or alternative treatment, holistic rehab incorporates a variety of therapies. From acupuncture to naturopathic medicine, these modalities honor each client’s mind, body and spirit.
Holistic therapies come from global traditions of healing. Some of them, like meditation, are also evidence-based treatments for addiction.11 Others are available in rehab while experts continue to research them. These approaches aren’t offered as a substitute for evidence-based care. But in combination with other treatments, they can be crucial parts of your recovery process.
The 12 Steps work well for people who draw strength from their faith and community. If these values fit well with yours, A.A. or a similar group might be the right way to approach healing.
If this philosophy is central to your process, you can begin recovery in a 12-Step rehab program.
The success rate of A.A. is comparable to other types of addiction treatment. One study found that A.A. had a 42% success rate, compared to the 35% success rate of cognitive behavioral therapy (CBT). However, the length of treatment plays a role, and the 12 Steps have higher long-term success rates. It is important to note that A.A. is free and open to everyone, and shows long rates of continuous abstinence.
A.A. is as effective as other types of addiction treatment. However, it’s not the right approach for everyone. It’s important to choose the best possible approach for you, which could include 12-Step rehab, alternative treatment, or something else entirely.
Yes, there are many non-12-Step support groups for addiction recovery. These include SMART Recovery, which is based on scientific principles instead of faith-based recovery, and Secular Organizations for Sobriety (S.O.S.), a non-profit organization that helps people begin new meetings online and around the world.
A.A. Timeline | Alcoholics Anonymous. https://www.aa.org/aa-timeline. Accessed 19 Apr. 2023.
“Questions &Answers on Sponsorship.” Alcoholics Anonymous World Services, Inc. 2017. https://www.aa.org/sites/default/files/literature/p-15_en_0722.pdf
What Is A.A.? | Alcoholics Anonymous. https://www.aa.org/what-is-aa. Accessed 19 Apr. 2023.
Kelly, John F., et al. “Alcoholics Anonymous and Other 12‐step Programs for Alcohol Use Disorder.” Cochrane Database of Systematic Reviews, no. 3, 2020. www.cochranelibrary.com, https://doi.org/10.1002/14651858.CD012880.pub2.
“Evidence for Alcoholics Anonymous Effectiveness and Cost-Effectiveness.” Recovery Research Institute, 28 Dec. 2020, https://www.recoveryanswers.org/research-post/update-evidence-alcoholics-anonymous-participation/.
What Is A.A.? | Alcoholics Anonymous. https://www.aa.org/what-is-aa. Accessed 19 Apr. 2023.
“Becoming SMART Facilitator: What it Means to Become a SMART Recovery Facilitator.” SMART Recovery Self-Management and Recovery Training. https://www.smartrecovery.org/wp-content/uploads/2019/03/PDF-Becoming-a-SMART-Recovery-Facilitator.pdf
“Jan L’s Story.” SMART Recovery, https://www.smartrecovery.org/success_stories/janl-addiction-recovery-story/. Accessed 19 Apr. 2023.
LifeRing Recovery Menu - LifeRing Secular Recovery. https://lifering.org/lifering-recovery-menu/. Accessed 19 Apr. 2023.
“Testimonials.” Moderation ManagementTM, https://moderation.org/about-mm-support-overview/program-member-testimonials/. Accessed 19 Apr. 2023.
Priddy SE, Howard MO, Hanley AW, Riquino MR, Friberg-Felsted K, Garland EL. Mindfulness meditation in the treatment of substance use disorders and preventing future relapse: neurocognitive mechanisms and clinical implications. Subst Abuse Rehabil. 2018 Nov 16;9:103-114. doi: 10.2147/SAR.S145201. PMID: 30532612; PMCID: PMC6247953.
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