Twelve-Step Programs are fellowships for various types of problems adopted from the 12-step recovery philosophy initiated by Alcoholics Anonymous (AA) in 1939. These mutual support groups offer assistance in coping with an addiction, compulsion, disease, or some other destructive stimulus in members’ lives.
The 12 Steps
The original 12 Steps from the AA regime are summarized as follows:
- Admitting being powerless over alcohol.
- Believing in a higher power that can help.
- Deciding to give one’s life over to the higher power.
- Making a moral inventory of one’s life.
- Admitting to oneself, the higher power, and others, the nature of one’s wrongdoings.
- Being ready for the higher power to eliminate one’s personal flaws.
- Asking the higher power to eliminate one’s personal flaws.
- Listing all persons one has wronged.
- Making amends to those one has wronged.
- Continuing to make a moral inventory and admitting wrongs.
- Improving one’s relationship with the higher power through prayer and thought.
- Carrying the message of the 12 Steps to other alcoholics.
Advocates for other causes who have adopted AA’s philosophy often modify AA’s 12 Steps in various ways to fit their unique circumstances, goals, and spiritual foci. These now join AA in a broad category generally referred to as 12-Step Programs.
The use of steps in the philosophy is to signify a sequential progression of the stages toward recovery. The opening three steps are cathartic in focus. The first step in the recovery process is to admit being powerless over the problem. Accepting the existence of a higher power comes next, followed by consciously embracing the higher power’s control. Some programs focus the reference to the higher power on a specific religion or identify their religious ideology. Other programs, though, view the higher power concept more broadly as representing spirituality in general. Invoking the higher power and acknowledging the higher power’s control is meant to reduce individual self-blame and self-criticism concerning one’s problem.
Steps 4 through 9 regard taking a moral inventory of one’s life, confessing wrongs, and making amends. In steps 4 through 6, members are encouraged to be honest with themselves and others about their shortcomings. By admitting their shortcomings, they free themselves to be rid of them. Then they make amends, via steps 7 through 9, for when their failures negatively affected themselves, their families, or others.
Steps 10 through 12 are about continued self-evaluation and being of service to others. Doing “12th-step work” involves teaching and helping others with the same problem. Through this last step, group membership is maintained and solidified as those who may have recovered continue in the program and help socialize new members into the program’s philosophy. This step is consistent with the 12-Step philosophy that the addiction, disease, or other problems will never be entirely cured or overcome. For instance, an alcoholic may remain sober for years, but retains the status as an alcoholic with the concomitant daily struggle to remain sober. Although the steps are seen as a progression, lapses are common, and a program member may have to retreat a step or two or even to restart at Step 1. Members are often encouraged, therefore, to live one day at a time.
Twelve-Step Programs generally are open to anyone who wishes to stop or otherwise control a harmful influence. Often the fellowships are loosely organized, nonprofit institutions. Group meetings are a common format for providing peer support, information, and a forum to offer members opportunities to publicly share their personal stories. The opening statement, “Hi, I’m Mary, and I’m an alcoholic,” has spread to other programs where alcoholic is replaced with whatever problem is associated with the group. Traditionally, 12-Step groups revolved around faceto-face contact. With the proliferation of the Internet, 12-Step Programs are actively using electronic communication, such as e-mail, online chatting, electronic bulletin boards, and blogs, as devices to foster interaction and provide support. Despite members’ public admissions and sharing, privacy remains a cornerstone to the 12-Step philosophy. The identity and personal stories shared by members are expected to remain confidential within the group.
Variety Of 12-Step Programs
The 12-Step Program philosophy has expanded beyond alcohol to other types of addictions and disorders. These efforts have included using the 12 steps to fight a range of problems tied to issues with eating, gambling, deviant sexual practices, violent tendencies, medical diseases, and mental health problems, among others. The list of various groups that use the 12-Step Program tenets include Batterers Anonymous, Cancer Anonymous, Cocaine Anonymous, Compulsive Eaters Anonymous, Diabetics Anonymous, Incest Survivors Anonymous, Narcotics Anonymous, Marijuana Anonymous, Sex Addicts Anonymous, and Sexual Ritual Abuse Anonymous.
Criticisms Of 12-Step Programs
Critics point to several problems associated with 12-Step programming. First, the programs generally do not offer holistic services or other assistance. For instance, someone with an addiction may also need help from mental health professionals, while a person with a medical disease could benefit from medical care. The fear is that members may feel that the 12-Step Program is all they need to recover from their disease. Second, there is very little empirical support for these programs. Even for AA, the longest running and largest of the 12-Step Programs, available research indicates mixed results, with a number of studies showing no or negative impact on certain populations. Third, the emphasis on a higher power and on religiosity is a drawback for some. Finally, the emphasis on identifying oneself with an addiction, compulsion, disease, or other condition can have long-term stigmatizing impacts.
- Alcoholics Anonymous. (2002). Alcoholics Anonymous—Big book (4th ed.). New York: Alcoholics Anonymous World Service.
- Alcoholics Anonymous. (2002). Alcoholics Anonymous: The story of how many thousands of men and women have recovered from alcoholism (4th ed.). New York: Alcoholics Anonymous World Service.
- Phillip, Z. (1990). A skeptic’s guide to the 12 Steps. Center City, MN: Hazelden.
- Swora, M. G. (2004). The rhetoric of transformation in the healing of alcoholism: The twelve steps of Alcoholics Anonymous. Mental Health, Religion & Culture, 7, 187–209.
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