There are a number of different therapies experts can use in order to help their clients overcome a very real and very persistent addiction issue. Among all of the choices available, however, those involving the 12 Steps made famous by Alcoholics Anonymous are the most popular. In fact, an article in EverydayHealth.com suggests that there are more than 270 groups that use the 12-Step method, and the “Big Book” that underlies the therapies provided has been translated into 28 languages. It’s remarkable, and understanding how the 12-Step process really works can make this prevalence a little easier to understand and to get behind.
Use in a Treatment Program
When most people think about the 12-Step movement, they think about addicted people coming together in church basements, office buildings and community centers in order to discuss a pressing addiction issue. In other words, they think of the 12-Step movement as an alternative to addiction care. However, it’s common for addiction treatment programs to incorporate the movement into their programs, and by doing so, they may provide clients with the tools they need in order to stay sober when the program is complete.
Programs might introduce the 12 Steps by requiring clients to read the Big Book and attend meetings on a regular basis. Those participating in inpatient programs, for example, might be required to attend a meeting on the campus each day. Those in outpatient programs might be required to attend meetings and show their tokens for sobriety.
There’s a reason that facilities incorporate this movement into their treatment programs: the 12 Steps work. The National Institute on Drug Abuse places 12-Step facilitation therapy into its list of treatments that are supported by research, which allows facilities that focus on research-based treatments to include these concepts while staying true to their message. The way the meetings work, and the benefits they provide, might allow treatment programs to give people insights they might otherwise find impossible to achieve.
Meetings form the cornerstone of the work done in the 12-Step model. These meetings aren’t run by a mental health specialist or counselor, so they can’t really be considered therapy, but they can be intensely helpful.
Meetings often follow a strict schedule that might include:
- An opening prayer
- A motivational speaker or a lesson regarding addiction
- An opportunity for sharing
- The presentation of awards
- A closing prayer
Just going to meetings can be incredibly uplifting for some people, but there’s more work to be done in the model.
Participants are encouraged to find sponsors who are willing to meet on a regular basis to discuss issues one on one. They’re also asked to study the literature regarding the steps and really think about how to incorporate those lessons into their daily lives. Participants are also encouraged to give back to the community through doing some kind of service work.
There’s a lot to be done here, and many different steps to take, and they may not overlap with the work people are doing in their traditional therapy sessions. This doesn’t mean that the steps can be skipped, however, as each different part of the participation process can bring people different kinds of benefits. Some of those lessons may not even be available in regular addiction therapy sessions.
Additional Benefits During Treatment
As people go through a traditional addiction treatment program, they’re learning more and more each day about how their addictions began and what they might need to do to stop them. It’s cerebral work, involving memories, skills and learning. Adding in concepts from the 12-Step movement might make that work yet more effective. For example, a study from the Journal of Studies on Alcohol and Drugs found that people who got both conventional addiction treatment and 12-Step facilitation had greater improvement than people who only got therapy. Blending the two approaches really does seem to be key for some people.
This added benefit might be due, in part, to the unique changes people tend to go through when they really begin to follow the 12 Steps. In traditional addiction therapy sessions, they’re thinking about the past and planning for the future, using the logical parts of their brains in order to make sense of their lives. This can be helpful, but it doesn’t provide people with any kind of spiritual awareness. They’re learning but not necessarily growing.
The 12-Step movement, on the other hand, encourages people to tap into something much more profound. Experts quoted in an article produced by National Geographic call this a “spiritual awakening” that results in a deep shift in both personality and behavior. By focusing on developing a relationship with a higher power and making supportive connections with understanding peers, people develop a whole new way of thinking about the world, and their place within that world, and that could make their healing all the more profound.
Prior to work with the 12-Step movement, addicted people might be exclusively focused on their own hopes, dreams and goals, and they might feel isolated and cut off from others. As they begin to go to meetings and give back to the community, however, they may find that connections are better than isolation, and that giving back is superior to taking. They may also develop a robust spiritual life, feeling a connection with the divine that had eluded them in the past. This spiritual connection might provide them with a form of inner strength and resiliency they can lean on when times are tough. Rather than feeling alone and helpless, they might feel capable of tackling almost anything. It’s a powerful emotional addition to a cerebral form of therapy.
The Help Continues
People who benefit from 12-Step treatment don’t stop achieving healing when their formal treatment programs end. In fact, some people find that the 12-Step movement is particularly beneficial because it allows people to maintain contact with therapy professionals when formal treatment is complete. People who emerge from a treatment center are often provided with a list of 12-Step meetings held in the community in which they live. They might also be provided with the name and contact number of a temporary sponsor. With this information in hand, people can begin to attend meetings on a regular basis, maintaining connection with the recovery movement even when they’re no longer actively working with a therapist.
The more often people go to meetings, the more likely they are to be sober, according to a study in The American Journal of Drug and Alcohol Abuse. Meetings seem to provide people with the opportunity to keep learning about addiction, and keep adding to the arsenal of tactics they can use when the urge to relapse begins to strike. The awards handed out in each meeting can also allow people to feel a sense of accomplishment about the days of sobriety they’ve logged, and the healing they’ve completed.
But just going to meetings doesn’t allow people to really take advantage of the help available through the 12-Step movement.
In order to really find healing, people must also work with a sponsor and do work in the community.
It’s these steps that allow people to feel as though they’re making a difference in life, contributing in a way that they never thought possible before, and a study in the journal Drug and Alcohol Dependence suggests that this added work is more closely associated with a robust recovery when compared to basic meeting attendance. Those who really work and take the lessons to heart tend to do better in recovery than those who give the concepts only a cursory level of attention.
Not for Everyone
While many people can and do benefit from the 12-Step model, there are some people who find the concepts a little disconcerting. For example, some people find that the idea of relying on a higher power for assistance seems a little like asking for help from a deity, and that may conflict with their atheism. Some would rather heal without leaning on any kind of supernatural power.
Similarly, some people resist the idea that an addiction can’t be cured and that they’ll always need to work hard to keep cravings under control. That’s a central tenet of the 12-Step movement, and most participants are encouraged to adopt that belief and adhere to it always. Some people find this concept depressing, as they’d like to believe that they could overcome their troubles in time. Some people get around these concerns by finding a 12-Step support group that hews closely to their opinions and lifestyles. They might look for groups that:
- Define “higher power” in non-religious terms
- Encourage self-help techniques
- Embrace alternative medicine
- Contain members of the same gender, culture or worldview
However, some people simply don’t like the concepts in the 12-Step model, and they avoid addiction treatment programs that use these concepts. There’s nothing wrong with that approach either, as long as addict does decide to get help.