12-Step Interventions and Mutual Support Programs for Substance Use Disorders: An Overview PMC

Twelve-Step programs are often incorporated into rehab treatment settings. In fact, 65% of facilities use 12-Step facilitation as one of their therapy offerings.1 Some facilities may also offer 12-Step mutual support groups. 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. Believing in this higher power may help someone find meaning in their life outside of addiction. For instance, they may find a greater sense of community by joining a spiritual or religious group. These can be healthy coping mechanisms someone turns to as they progress through recovery.

Koenig [35] underscores the importance of allowing individuals to define spirituality for themselves. Findings consistently show that those who attend 12-step meetings regularly and actively participate in the program have better substance use and quality of life outcomes [53, 54]. Alcoholics Anonymous (AA) is the longest-running mutual aid group for people with alcohol use disorders, and AA turned 85 years old in 2020. Though https://trading-market.org/when-drinking-after-work-becomes-a-problem-alcohol/ there has been much criticism regarding AA and other 12-step programs, there has been an equal amount of evidence to support their efficacy. This chapter explores the history of AA and other 12-step approaches, the foundational philosophy of the 12-steps, the key elements that support recovery, cultural considerations for special populations, and a review of the criticisms as well as strengths of 12-step approaches.

Spiritual Connection

For members who attain multiple years of recovery, they often receive a special medallion. 12-step programs are powerful peer support groups that help people recover from substance use disorders, behavioral addictions, and sometimes other co-occurring mental health conditions. 12-step programs also help people achieve and maintain abstinence from substances. Though 12-step programs aren’t the right tool for everyone, they do tend to help those struggling with substance abuse issues acquire new coping skills, feel the support and acceptance of Three Inspirational Recovery Stories a loving community, transition into sobriety, and foster long-term recovery from addiction. The former of these approaches is built on the notion of a “buddy system.” One of the potential barriers to attending meetings is not knowing anyone who is there. Alcoholics Anonymous has developed a program called “Bridging the Gap” in which members of community-based AA groups will come to institutions such as correctional facilities or residential programs, meet with the substance abusers, and take them to a meeting in the community (AA, 1991).

This is the crux of AA – we can only keep what we have by giving it away. What happened in the following six months formalizes the beginning of AA. He and Ebby embarked on a mission to share this spiritual process with as many alcoholics as possible. They report 77,000 meetings weekly in 144 countries across the globe.

Recommendations for integrating 12-step mutual aid programs

We do not impose our experience with problem drinking on others, but we do share it when we are asked to do so. We know our own sobriety depends on connecting with other alcoholics. When practiced as a way of life, they can expel the obsession to drink and enable the sufferer to recover from alcoholism. Alcoholics Anonymous is a fellowship of people who come together to solve their drinking problem.

Contact with a sponsor and a strong sponsorship relationship contribute to increased 12-step participation and abstinence. Compared to the usual referral practice in the clinics, those in the intensive referral group intervention attended more substance-focused and dual-disorders-focused self-help meetings and had less drug use and better psychiatric outcomes at a 6-month follow-up. Researchers have also explored whether ethnic minorities participate in and/or benefit from traditional 12-Step groups in the same way as Whites. Similar to described for women, ethnic minority groups also may view 12-Step group meetings comprising primarily majority White members as less welcoming and supportive. However, there does appear to be evidence that ethnic minorities may involve themselves to the same extent in and derive comparable benefits as Whites from 12-Step programs (Hillhouse & Fiorentine, 2001).

What Are the 12 Steps of Addiction Recovery?

This program is focused on helping people overcome addictions by focusing on their values and integrity rather than embracing a higher power. It encourages members to make sobriety the top priority in their life and take whatever steps they need to stay on the path to recovery. Compared to the clinical intervention groups (e.g., CBT), AA/TSF participants demonstrated higher rates of complete abstinence, and this effect held over time.

Instead of manipulating the content of one’s thoughts, the client might learn to accept and float through them. Before concluding this section, the Wellbriety Movement deserves mention. It is described as “a sustainable grassroots movement that provides culturally based healing for the next seven generations of Indigenous people” [61]. Though an oversimplification, Wellbriety is an integration of traditional 12-step philosophy and Native cultural practices, such as the Medicine Wheel.


The Big Book in Alcoholics Anonymous (AA) is a foundational text outlining the principles of recovery for individuals struggling with alcohol use disorder (AUD). Published in 1939, the AA Big Book contains 11 chapters that include personal stories and spiritual insights. Many addiction treatment programs incorporate 12-Step programs or 12-Step facilitation therapy into their services.

  • Each of the three main 12-Step programs conducts periodic surveys of its members to assess demographic characteristics and to determine the length of members’ abstinence.
  • White further explicates that for those whose goal was moderation rather than abstinence, other groups formed such as Businessman’s Moderation Society in 1879.
  • These transformations led to cultural and religious reformations, which included the rejection of alcohol.
  • Because he is a member of a support group that stresses the importance of anonymity at the public level, he does not use his photograph or his real name on this website.

The volunteer in turn would talk to the person about the meeting, offer to provide a ride to the meeting, and later call to remind the person about the meeting and encourage attendance (Sisson & Mallams, 1981). Subsequently, an individually administered three-session intensive referral procedure has been developed which more fully standardizes this process (Timko et al., 2006). The initial session, which lasts between 45 to 60 minutes, provides information about 12-Step approaches, explores concerns and expectancies the person may have, and facilitates the linkage between client and community volunteer. Also, as noted previously, one of the most prominent barriers to involvement is the individual’s ambivalence and fluctuating readiness and commitment to give up alcohol or drug use (Laudet, 2003).

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