The 12 Step Programme
What is the 12-Step Programme?
The 12 step program was originally created for people struggling with alcoholism. Alcoholics Anonymous (AA) was the first incarnation of many groups that utilise the same format and fall under the title of a 12 step group. The founders discovered that the only way they were able to stay sober was to share their stories, pain, and successes with others who were also struggling.
The first 12 step program began in America with Alcoholics Anonymous in the 1930s. The first AA meeting was between two alcoholics who both set out to find if a new approach could be discovered to deal with alcoholism as various non-alcoholic fellowships had failed them. One of the men, a doctor, found help through meeting with another man, a New York stockbroker and fellow alcoholism sufferer.
The doctor then sought to help an alcoholic being treated in his hospital by using each other as support, which was of great success as this patient achieved complete sobriety. Though the name Alcoholics Anonymous had not yet been coined, these three men actually made up the nucleus of the first A.A. group.
By 1950, 100,000 recovered alcoholics utilising A.A. could be found worldwide. And by 1998, 2,000,000 members and 97,000 groups had been registered – 2,400 of these just in the UK.
The 12 Step approach has since grown to be the most widely used technique in dealing with not only alcoholism, but also drug abuse and various other addictive or dysfunctional behaviours. The 12 step programme has since been ported to other organisations such as Narcotics Anonymous and Overeaters Anonymous.
The 12 steps
- We admitted we were powerless over alcohol - that our lives had become unmanageable
- Came to believe that a Power greater than ourselves could restore us to sanity
- Made a decision to turn our will and our lives over to the care of God as we understood Him
- Made a searching and fearless moral inventory of ourselves
- Admitted to God, to ourselves and to another human being the exact nature of our wrongs
- Were entirely ready to have God remove all these defects of character
- Humbly asked Him to remove our shortcomings
- Made a list of all persons we had harmed, and became willing to make amends to them all
- Made direct amends to such people wherever possible, except when to do so would injure them or others
- Continued to take personal inventory and when we were wrong promptly admitted it
- Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out
- 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
How do the 12 steps work?
The 12 steps of AA begin with admitting you are powerless over alcohol and that your life has become unmanageable. Until you accept the reality of your problem, you cannot begin the process of recovery.
12 step progresses by taking a ‘moral inventory’, making a list of people that have been harmed by the individuals drinking, and making amends to them.
Later in the Alcoholics Anonymous programme, a person is asked to ‘seek to improve the relationship with God, as you understand Him’. AA has a strong spiritual component; however it is a non-denominational programme.
Finally, the 12 step programme says, ‘carry the message to others’. This is generally done through participation in the program and is also often done by serving as a sponsor, or mentor, to those newer to the program.
Everyone in the Alcoholics Anonymous programme is encouraged to get a sponsor. Newcomers can gain a sponsor by asking a member who has been in the programme longer than themselves. A sponsor should also be someone who has completed all 12 steps. The sponsor supports and encourages a person as you they work the steps.
Members are encouraged to continue attending after they have completed the steps. The ongoing support of the group is said to help prevent relapse, and the support of more established members is invaluable to newer members of the group.
Members are recognised for the amount of time they have been sober with coins commemorating landmarks such as one month, six months, and one year of sobriety.
The 12 step programme of AA is free to alcoholics. Donations are accepted to cover the cost of literature and other costs. Meetings are held in churches and other public service buildings that donate space for that purpose.
The 12 steps programme is run by alcoholics for alcoholics. It is not by professionals. It is called Alcoholics Anonymous because group members are to remain anonymous. They know each other by first name only and are under no obligation to share or give out personal information. Members are also not to share any information about group members outside of the group.
Is the programme successful?
Research into the effectiveness of the 12 step programme has generated a number of studies within the United States as well as within other countries. Several of these studies researched 12 Step Facilitation with alcoholic members.
Within Alcoholics Anonymous, a triennial survey is carried out to members asking various questions about the length of time spent in A.A. against their length of sobriety. The level of time that is mandatory for a member to carry out this survey is 90 days, as that is the length of time mandatory for newcomers in order to transmit empirical results. Also there is the risk that many members of A.A. are attending because of a court order or under the coercion of a treatment/recovery scheme.
The latest survey carried out in 2007 showed that of those in their fourth month of AA meeting attendance (i.e. have stayed beyond 90-days) 56% will still be attending AA at the end of that year. Also, the survey details the length of time members have stayed sober by attending A.A. meetings -
Length of sobriety in A.A. (UK survey. 2007)
- Sober more than 10 years -33%
- Sober between 5-10 years - 12%
- Sober between 1-5 years - 24%
- Sober less than 1 year - 31%
The average length of sobriety for each member is 8 years.
A study carried out by the Self-Help Alcoholism Research Project (SHARP) organisation, which put the 12 step programme up against 5 other forms of treatment including, AA meetings run by experienced non-professionals, RBT therapy administered by a non-professional, RBT therapy administered by degree professionals, Insight Therapy administered by professionals, and a control group which received no treatment.
After treatment was completed, a three month follow-up showed that AA group treatment was associated with five times more binge drinking than the control group and nine times the binge drinking of the nonprofessional RBT group.
Non-professional RBT was deemed the superior treatment in a comparison between the two. The study concluded that coerced AA attendance did not work well. A.A. was shown to have had the largest dropout rate of all methods.
Assessment of A.A. success or failure outcomes is complicated by the fact that there is no consistent record keeping within A.A. to conclusively verify or refute assertions of positive or negative results. A.A.’s autonomous and anonymous structure makes it a challenge just to obtain reasonable historical estimates of the number of A.A. groups and members, much less precise measurements of success or failure outcomes over the 75 years history of AA.
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