What to Know About 12-Step Rehabs

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Content Overview
What is 12-step rehab?

The 12-Step philosophy pioneered by Alcoholics Anonymous is used by about 74 percent of

treatment centers. The basic premise of this model is that people can help one another achieve
and maintain abstinence from substances of abuse, but that healing cannot come about unless
people with addictions surrender to a higher power. The 12-Step movement can be a force for
good for many people, but some struggle with the religious basis of the program. Most addiction
treatment programs offer alternatives to 12-Step methodology for those who are opposed to the
idea of a higher power.

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Table of Contents

The History of the 12-Step Program

The 12-Step Practice
 The 12 Steps
Variations on the 12 Steps
The 12 Steps with Other Treatments
Alternatives to the 12-Step Model
The Path to Recovery

One of the most well-known and commonly used types of recovery support is the12-Step
model. Just about everyone has heard of these meetings or of the organization that
originated the idea Alcoholics Anonymous.

Twelve-Step programs remain a commonly recommended and used treatment modality for
various types of addiction. According to the Substance Abuse and Mental Health Services
Administration (SAMSHA) in its National Survey of Substance Abuse Treatment Services from
2013, 12-Step models are used, at least occasionally, by approximately 74 percent of treatment
centers.

The History of the 12-Step Program

Alcoholics Anonymous (AA) originated the idea

for the 12-Step model in 1938, when founder Bill Wilson wrote out the ideas that had been
developing through his experience with and vision of alcoholism. He wrote about the positive
effects experienced when people struggling with alcoholism shared their stories with one
another.
Wilson wrote his program in what has become known as the Big Book. As explained in historical
information from the AA site itself, the steps were developed through synthesizing concepts
from a few other teachings he had encountered, including a six-step program espoused by an
organization called the Oxford Group. In their original form, the 12 Steps came from a
spiritual, Christian inspiration that sought help from a greater power as well as from peers
suffering from the same addiction struggles.
The Big Book was originally written as a guide for people who couldnt attend AA fellowship
meetings, but it soon became a model for the program in general. It has since been adopted as a
model for a wide range of addiction peer-support and self-help programs designed to help drive
behavioral change. In addition to the original Alcoholics Anonymous (AA) group, various
offshoots now exist, such as Narcotics Anonymous (NA), Heroin Anonymous (HA),
and Gamblers Anonymous (GA).

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The 12-Step Practice

The basic premise of the 12-Step model is

that people can help one another achieve and maintain abstinence from the substances or
behaviors to which they are addicted. They can do this through meetings in which they share
their experiences with one another and support each other in the ongoing effort of maintaining
abstinence.

In research, as seen in a recent article from the journal Addiction Research and Theory,
abstinence practices (as supported by 12-Step programs) can account for high levels of what
experts call flourishing, which is positive mental health and can contribute to longer-term
recovery. In the study, those who maintained abstinence were more likely to flourish in the long-
term, with 40.7 percent flourishing after three months (as compared to 9.3 percent languishing)
and nearly 40 percent flourishing after 12 months (compared to 12.4 percent languishing). Based
on this study, those who abstain altogether from substances as advised in the 12-Step model
have better mental health outcomes than those who dont abstain.

The 12-Step model gives people a framework from which to surrender their addiction, process
their experience, and move forward into new patterns. As described in an article on Psych
Central called Recovery Using the 12 Steps, following the model assists an individual by helping
build the following mental and emotional transformative practices and tools:

The ability to recognize and admit that one is experiencing an addiction problem
 A surrender to the fact that the addiction exists and a decision to seek control through an
outer guide
Self-observation and awareness of the behaviors that were part of and arose from the
addiction, as well as those that help promote self-restraint
A chance to practice that restraint and build self-esteem in ones positive capabilities
Achievement of self-acceptance and the ability to change behaviors
Compassion, both for those who have been affected by the addiction and for others who
similarly struggle with addiction
Tools that make the process a continual practice throughout the individuals life

By providing these experiences and tools, the 12-Step model can be a method for change in
many types of behavior. As a result, it can help individuals who wish to overcome addiction to
find a path to recovery.

The 12 Steps
Variations on the 12 Steps
The 12 Steps with Other Treatments
The 12 Steps, as outlined in the original Big Book and presented by AA are:

1. Admitting powerlessness over the addiction

2. Believing that a higher power (in whatever form) can help
3. Deciding to turn control over to the higher power
4. Taking a personal inventory
5. Admitting to the higher power, oneself, and another person the wrongs done
6. Being ready to have the higher power correct any shortcomings in ones character
7. Asking the higher power to remove those shortcomings
8. Making a list of wrongs done to others and being willing to make amends for those
wrongs
9. Contacting those who have been hurt, unless doing so would harm the person
10. Continuing to take personal inventory and admitting when one is wrong
11. Seeking enlightenment and connection with the higher power via prayer and meditation
12. Carrying the message of the 12 Steps to others in need

Alternatives to the 12-Step Model

Some people dont like or are not interested in the 12-Step model, even with the variations above
or through organizations that facilitate the 12-Step model. Some people dont like basing their
recovery on the idea that they cannot control their addiction, when there is evidence that there
are ways of practicing internal control over the recovery process.
Some of the programs based on this active control model include groups like SMART
Recovery and Moderation Management. These groups use a similar peer-sharing model, but they
dont rely on the idea of surrender. They instead promote the empowerment of the individual to
exercise control over the treatment of and recovery from addiction

The Path to Recovery

Most experts believe that a research-based,

residential treatment program that is customized to an individuals needs is the most effective
method to achieve and maintain recovery. Whether this program includes 12-Step aspects, is
based on the 12-Step concept, or is an alternative to this original model of addiction treatment,
its important that care is customized to the individual. Working with an addiction treatment
professional is a good way to find the treatment modality that is appropriate for each person,
leading to the best path to recovery.