Twelve-step facilitation therapy, first utilized by Alcoholics Anonymous (AA), is a model program intended to help people overcome compulsive drug or alcohol use.
The 12-step program is commonly offered within drug rehab programs at all levels of care, including inpatient, residential, and outpatient treatment for addiction.
Here you’ll find information on:
- what 12-step facilitation therapy is
- how the 12-step program works
- benefits of 12-step therapy
- where to find 12-step programs for substance abuse
What Is 12-Step Facilitation?
The 12-step recovery program is an abstinence-based program created in 1938 by the founders of Alcoholics Anonymous, Dr. Bob Smith and Bill Wilson.
While the model was originally developed to help people overcome alcohol abuse, today the model has been adapted to treat a range of conditions.
Some behavioral and drug addictions 12-step therapy can treat include:
- cocaine addiction
- opioid addiction
- compulsive eating behaviors
- shopping addiction
- gambling addiction
The main idea of 12-step treatment is that compulsive or addictive behaviors can be overcome by surrendering control to a higher power—and not through sheer willpower alone.
The program consists of 12-step work that participants can complete in their own time.
Each step serves to help people address their specific substance issue, and its effects on quality of life, relationships, and overall well-being.
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Understanding The 12 Steps
Twelve-step facilitation therapies provide structure and specific milestones that people who are overcoming addiction can pursue on their recovery journey.
The 12-step program, which traditionally emphasizes the role of God in recovery, does have strong spiritual elements.
However, some addiction treatment providers and community programs have adapted the 12 steps over the years to accommodate participants of diverse religious and spiritual backgrounds.
Using The 12 Steps In Addiction Recovery
All 12-step facilitation therapies consist of 12 steps.
While the exact language can vary in some programs, here are the 12 standard steps, as outlined by Alcoholics Anonymous (AA):
1. Admission: Admitting powerlessness over your addiction
2. Having faith: Believing that a higher power can help to restore a sense of well-being and normalcy
3. Submission: Deciding to turn control over to the chosen higher power
4. Understanding: Taking a personal inventory of oneself
5. Confession: Admitting to your higher power, yourself, and another person the exact nature of wrongs done
6. Preparation: Being ready to have the higher power correct and remove defects in your character
7. Humility: Humbly asking your higher power to remove such defects, or shortcomings
8. Amends: Making a list of those who you have wronged and being willing to make amends for those wrongs
9. Apology: Contacting the people who have been hurt to make direct amends, unless doing so would injure them or others
10. Integrity: Continuing to take personal inventory and promptly admitting when one is wrong
11. Meditation: Seeking spiritual enlightenment, knowledge, and a stronger connection with your higher power through prayer and meditation
12. Awakening: Carrying the message of the 12 Steps to others with addiction, and practicing these principles in everyday affairs
How Do 12-Step Programs Work?
Twelve-step therapies have been adapted over the years to meet the varying needs of those with substance use disorders, as well as to accommodate advancements in experts’ understanding of addiction.
The 12-step program can be linear in nature, or nonlinear. A person may go through each step in order, or skip past steps for the time being and return to them later in their recovery journey.
The 12-step model is commonly found through community support groups for addiction, including Alcoholics Anonymous, Narcotics Anonymous, and Cocaine Anonymous.
Twelve-step therapies may also be offered within rehab programs, alongside other addiction treatment services such as behavioral therapy and medication management.
What Are The Benefits Of 12-Step Programs?
Some studies researching the effects of 12-step facilitation therapies have shown some promise for helping people with substance use disorder achieve and maintain sobriety.
Benefits of 12-step facilitation include:
- can assist those in all stages of recovery by providing structured steps and goals
- can offer social and emotional support for participants
- cost-effectiveness compared to other conventional treatment models
- can help promote continued abstinence from drugs or alcohol
- can help you remain accountable for recovery-oriented behaviors
- can serve as a useful supplement to evidence-based treatment services
The benefits of 12-step groups are most often seen in people who have a high attendance rate at 12-step meetings, as well as those with the intrinsic motivation to stay sober.
Limitations Of 12-Step Therapy For Addiction
Twelve-step facilitation therapies are not a medical or comprehensive treatment for an alcohol or drug addiction on its own.
During rehab, 12-step therapies are offered as one component of a full treatment program for drug or alcohol abuse, alongside other treatment services.
A full drug rehab program may offer:
- detox services
- behavioral therapy
- group therapy (non-12-step)
- family therapy
- medication management
- relapse prevention planning
- aftercare support
The spiritual principles of 12-step fellowship meetings, its focus on abstinence, and its rigidity remain points of controversy among critics of 12-step facilitation.
While this form of therapy has shown helpful for some, alternatives to 12-step models for self-help have been developed in recent years to address the program’s shortcomings.
Where To Find 12-Step Programs For Substance Abuse
Many US treatment centers for substance abuse offer 12-step facilitation therapies as a treatment option for clients, alongside other treatments.
Where to find a 12-step program:
- inpatient treatment centers
- residential rehab facilities
- outpatient treatment centers
- community support groups (e.g. AA, Gamblers Anonymous)
- sober living communities
Not all rehab centers offer 12-step programming. Contact the rehab center you’re considering to see if they offer 12-step therapy at their facility.
FAQs For 12-Step Facilitation Therapies
Find answers here to some of the most frequently asked questions about 12-step therapy for substance abuse and addiction.
❓ What Is The Success Rate Of The 12 Steps?
✔️ Actual success rates of 12-step programs vary according to different studies, and sources of information. For instance, Alcoholics Anonymous claims its program is highly effective.
At the same time, critics of this approach point to research that demonstrates success rates ranging between five to 10 percent for AA/12-step participants.
❓ Is 12-Step Therapy Like CBT?
✔️ Cognitive behavioral therapy (CBT) is an evidence-based psychotherapy for substance abuse and various mental health disorders.
Unlike 12-step therapy, CBT can be offered individually through one-on-one therapy, does not have spiritual elements, and does not consist of specific steps.
❓ Why Do People Use 12-Step Programs?
✔️ Twelve-step programs are commonly sought by people who are seeking to overcome a drug or alcohol problem, or other compulsive behaviors.
The 12-step program can help build self-esteem, offer social support, accountability, and structure as one embarks on their lifelong journey towards addiction recovery.
Begin Your Addiction Recovery Journey Today
Millions of Americans struggle with drug or alcohol misuse. If this describes you or a loved one, you’re not alone. Help is available.
Call our helpline today to learn more about drug and alcohol treatment, or how to find a rehab center that offers 12-step meetings near you.
Addiction Resource aims to provide only the most current, accurate information in regards to addiction and addiction treatment, which means we only reference the most credible sources available.
These include peer-reviewed journals, government entities and academic institutions, and leaders in addiction healthcare and advocacy. Learn more about how we safeguard our content by viewing our editorial policy.
- Alcoholics Anonymous (AA)
- Alcoholics Anonymous (AA)
- NPR News
- Stanford Medicine
- U.S. National Institute on Drug Abuse (NIDA)
- U.S. National Library of Medicine: NCBI