12-step Treatment Program

What is the 12 steps program?

12 steps treatment is one of the most popular treatment methods available for addiction. It is a mutual-aid program for all types of addictions and compulsions. Many rehab centres in India incorporate this approach into their treatment plan. 

It is conducted through a support group system. This helps them connect with people who are going through similar problems and get support from them. These groups provide support right from the first day and throughout reaching sobriety. After maintaining abstinence, these people can then help other people in their recovery journey. 

These are some essential elements in the 12 steps program:

• Believing that a higher power can help them in their recovery journey and surrendering to it
• Apologising to oneself, others and the higher power for any wrong things a person might have done
• Taking personal inventory regularly
• Taking this message forward to other people who might need assistance in their journey

The steps are arranged in order. But many people in their recovery journey realise that they continue to work on the steps lifelong. They might keep coming back to some steps or even working on multiple steps at a time. 

Many of the steps have a spiritual element. Surrendering oneself to a higher power is seen as an essential step in this process. There are specific guidelines that the groups are required to follow; these are called the 12 traditions. Most of this information is given in the Big Book. 

According to these 12 traditions, “the only requirement for an AA membership is a desire to stop drinking.” It emphasizes the group’s welfare as a whole which aids in the personal recovery of each member. Each group is autonomous and functions independently. The program is conducted by people who have recovered and people who are on their recovery journey. The basic idea behind this is that people can assist each other in their recovery. 

Maintaining anonymity is a significant part of this program, as is emphasized in the name of the program itself. Another vital aspect is acceptance of the problem. In most 12 steps meetings, when they introduce themselves, they say, “My name is so and so, and I am an alcoholic.” 

There are no professionals involved in these groups, but they are usually present at the organizing centres for personal counselling. The 12-step approach views all human beings as a combination of the physical, mental and spiritual elements. Any problems that they face are then divided into these three. 

The physical aspects are the bodily reactions that occur due to the substance. The mental aspect is the craving and unease one experiences. The spiritual aspect is the self-centeredness in the person. The program aims to uplift all these areas. Spiritual enlightenment is aimed at and achieved by recognising wrong behaviour and encouraging unselfish acts.

During the journey through these 12 steps, people are encouraged to choose a sponsor. A sponsor is someone who has taken the 12 steps and is more experienced. The sponsor encourages the sponsee in their recovery journey. They do not act as a therapist but simply share their experiences in their journey with the sponsee. This kind of bond increases the chances of remaining abstinent. 

How did they start?

It was started by the founders of Alcoholics Anonymous in the 1930s. This was first published in the book “Alcoholics Anonymous: The story of how more than 100 men have recovered from alcoholism.” As it gained popularity, many other fellowships emerged that modified the 12 steps to their specific addictions. For Example, Cocaine Anonymous, Gamblers Anonymous, Workaholics Anonymous etc. Now, there are many different programs and groups all around the world. 

How effective is it?

The 12 steps model has many unique features which make treatment accessible and comfortable for people suffering from addiction. This method is one of the most popular for addiction treatment globally. There are many success stories. However, due to its anonymous nature, research in this area is limited. Some studies have shown that 12-step programs work better than some other treatment modalities in maintaining abstinence. 

From the nature of the program and the many success stories, it can be said that the program does work. It provides consistent support throughout the journey. This kind of social support and acceptance is otherwise hard to find from other people who haven’t experienced addiction.

The effectiveness of the program may depend on the kind of fellowship, the kind of group, the nature of the problem, the involvement of the user, and their outlook on the approach. 

Who is 12 step model most suited for?

You can seek 12-step treatment for any kind of addiction or compulsion. These are available for various types of substance addictions:

1. Alcoholics Anonymous
2. Narcotics Anonymous
3. Cocaine Anonymous
4. Crystal Meth Anonymous
5. Heroin Anonymous
6. Marijuana Anonymous
7. Pills Anonymous

There are also groups for behavioural addictions:

1. Gamblers Anonymous
2. Food Addicts in Recovery Anonymous
3. Workaholics Anonymous
4. Sex Addicts Anonymous
5. Love Addicts Anonymous

There are other 12-step groups that are for friends and family members of the person with addiction:

1. Families Anonymous
2. Al-Anon
3. Nar-Anon
4. Gam-Anon
5. CoSex and Love Addicts Anonymous 

Although the program has spiritual elements, it is not specific to a religion. The word “God” in the steps can have different meanings for different people. This helps people of different religions and beliefs benefit from the program. For agnostics and atheists, the higher power can just be the group itself, the universe, or any other idea that they believe in. For people who might still find it challenging to adapt the concept of “higher power” in these, there are also alternative 12-step programs created explicitly for non-believers. 

These programs work better for people who do not have other comorbidities. In this case, a personalised program would be better which caters to your specific needs. The 12 steps meeting can a part of that treatment plan. Since the Covid-19 Pandemic, a lot of the 12-step groups and meetings connect online. Most people are encouraged to take part in one meeting every day for 90 days. However, the timing may differ for each individual. 

You could try attending a few meetings to see how it helps you. If not this, there are many other treatment approaches available, like holistic treatments, psychotherapy, pharmacotherapy, outpatient or inpatient treatment or a mixed approach. If you are unclear about whether 12 steps is the right treatment option for you, discuss with a mental health expert or rehab centre to get more details. You can see our curated list of rehab centres that use 12 steps approach here. 

Sources:

Crape, B. L., Latkin, C. A., Laris, A. S., & Knowlton, A. R. (2002, February). The effects of sponsorship in 12-step treatment of injection drug users. Drug and Alcohol Dependence, 65(3), 291–301. https://doi.org/10.1016/s0376-8716(01)00175-2

Kelly, J. F., Humphreys, K., & Ferri, M. (2020, March 11). Alcoholics Anonymous and other 12-step programs for alcohol use disorder. Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.cd012880.pub2

Laudet, A. B., Magura, S., Cleland, C. M., Vogel, H. S., Knight, E. L., & Rosenblum, A. (2004, June). The Effect of 12-Step-Based Fellowship Participation on Abstinence Among Dually Diagnosed Persons: A Two-Year Longitudinal Study. Journal of Psychoactive Drugs, 36(2), 207–216. https://doi.org/10.1080/02791072.2004.10399731 

Wikipedia contributors. (2022, March 4). List of twelve-step groups. Wikipedia. https://en.wikipedia.org/wiki/List_of_twelve-step_groups