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    The 12 Step Program: How does it work and is it still relevant?

    Recovery is a long journey of self-discovery and you walk it by taking one step at a time. One approach is to follow the 12-step Program that has strong spiritual roots and offers guiding principles to uncover deep-seated behavioural issues that drive addiction.

    There is much debate whether the world-acclaimed 12-steps Program is still relevant considering how neuroscience and addiction therapy have evolved in the 80 years since the Program was first introduced. It’s relevancy is constantly questioned, but at the end of the day if the Program resonates with you and you’ll benefit from it; then there’s no harm in including it in a holistic therapy plan.

    Although the 12-step Program is not central to White River Manor’s therapy philosophy, it can always be incorporated into your individual therapy plan.

    What is the 12 step recovery program?

    Since it was introduced in 1935, the renowned 12-step Program has dominated the primary approach to treating addiction. In fact, more than two-thirds of addiction treatment centres solely focus on the 12-step Program and they advocate recovering addicts attend AA-type meetings after they complete a stay at a rehabilitation centre.

    The purpose of the 12-step model is to aid recovery from compulsive, out-of-control behaviours that are ultimately linked to substance abuse. It’s one of the tools often used to understand what the root cause is of a person’s addiction; where participants attend self-help group meetings which serve as a safe place to admit past mistakes, surrender to a higher power and learn to stay sober.

    These AA-type meetings are readily available, easily accessible and most often free to join. Men and women from all walks of life attend who share experiences and gain strength and hope from one another.

    Who started the 12 step program?

    Alcohol Anonymous pioneered the 12-step Program which was established in the 1930s by Bill Wilson and Dr Robert Holbrook Smith, known to AA members as “Bill W” and “Dr Bob”. Together, they wrote about the positive effects people with alcoholism experienced when they shared their stories with one another and wrote down their own ideas for tackling addiction (to alcohol initially) in what came to be known as the Big Book.

    Wilson and Smith’s guide to shared recovery was deeply rooted in the Christian faith and still is today, although non-religious people tend to swop a higher “God” with a higher “spiritual being”.

    In addition to the Alcoholics Anonymous (AA) franchise, many other similar Programs sprung up as an offshoot of the original 12-step Program. This included Narcotics Anonymous (NA), Heroin Anonymous (HA) and Gamblers Anonymous (GA).

    For a long time, the 12-step Program dominated the world’s approach to treating substance abuse. However, over time, other therapy Programs have replaced the tradition 12-step Program and it’s no longer the preferred method for recovery.

    This is largely because many people struggle with the strong religious element of the Program, where the basic premise is healing cannot come about unless you surrender to a higher power. This doesn’t sit comfortably in a multi-denominational and multi-cultural world, particularly as the 12-step Program has a strong Christian foundation.

    How does the 12 step program work?

    The 12-step Program offers a set of guiding principles to help you on your journey to sobriety. More importantly, it provides continuity in the form of self-help group meetings once a person has left an addiction treatment centre and returned to daily life.

    The Program gives recovering addicts a simple process they can follow which allows them to understand and manage their addiction, find a supportive and non-judgemental group outside of the rehab centre and mend broken relationships and/or end destructive relationships with enablers.

    The focus of the 12-step Program is to enable cognitive restricting around substance abuse and similar behaviour. This entails understanding the root cause on the addiction and changing behavioural patterns.

    How do 12 step meetings work?

    The 12-step meeting is well-known. We’ve seen it in movies and television series where a group gathers and someone stands up and says, “Hello, I’m Mary and I am an alcoholic.”

    One member of the group leads the meeting; it opens with a prayer or meditation and people introduce themselves and at the same time, acknowledge their substance abuse.

    The rest of the meeting is spent either listening to an outside speaker or going over addiction literature, working through the 12 guiding principles and speaking out about experiences and challenges. You can choose to share or keep quiet and listen. It’s entirely up to you.

    The meeting ends off in prayer or another meditation.

    What are the 12 steps of the 12 step program?

    The 12-step approach to recovery from addiction follows a set of guidelines that act as steps in your journey of recovery. The idea is to visit these steps as often and whenever necessary.

    The 12-steps in the 12-step program are:

    1st principle: Surrender

    We admitted we were powerless over our addiction – that our lives had become unmanageable.

    2nd principle: Hope

    Came to believe that a Power greater than ourselves could restore us to sanity.

    3rd principle: Commitment

    Made a decision to turn our will and our lives over to the care of God as we understood Him.

    4th principle: Honesty

    Made a searching and fearless moral inventory of ourselves.

    5th principle: Truth

    Admitted to God, to ourselves and to another human being the exact nature of our wrongs.

    6th principle: Willingness

    Were entirely ready to have God remove all these defects of character.

    7th principle: Humility

    Humbly asked Him to remove our shortcomings.

    8th principle: Reflection

    Made a list of all persons we had harmed and became willing to make amends to them all.

    9th principle: Amendment

    Made direct amends to such people wherever possible, except when to do so would injure them or others.

    10th principle: Vigilance

    Continued to take personal inventory and when we were wrong promptly admitted it.

    11th principle: Atonement

    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.

    12th principle: Service

    Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics (addicts) and to practice these principles in all our affairs.

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    Does the 12-step recovery program work?

    As they say; “it works if it works for you”. Basically, the 12-step Program works if you are motivated to recover and maintain sobriety. It doesn’t work if you don’t buy into it, aren’t committed to getting “clean” or are forced into it by, for example, a court mandate or family intervention.

    The 12-step Program is not for everyone and if it’s the only approach offered by a rehabilitation centre, that would be limiting. Included in a holistic approach to addiction treatment, the 12-step Program has real value if it resonates with you.

    Non-religious addicts or addicts who practise a different religion are as likely to benefit from the Program; particularly, as part of an after-care Program where the 12-step Program can help to reinforce what they’ve discovered about themselves in rehab. Like them or hate them, AA-type meetings have been around for decades and have been life-saving for countless people.

    Is the 12-step program still relevant?

    One would think that after so many years, the 12-step Program or modified versions of it would have evolved. It hasn’t; in fact, the 12-steps haven’t been touched since 1939… in other words, since the beginning of World War II.

    In that time, 80 years to be exact; there have been incredible advances in the field of neuroscience, genetics and psychotherapy. This has led to the development of highly effective treatment approaches such as Cognitive Behavioural Therapy (CBT), Motivational Interviewing (MI), Mindful Meditation (MM) and Contingency Management.

    These therapy approaches have added to the arsenal that therapists have on hand to understand and treat the underlying causes of addiction. Used in isolation, the 12-step Program is limited when you consider how much more can be done to help a person seeking treatment for addiction.

    In short, many addiction specialists view the 12-step Program as being antiquated and no longer relevant. And there’s much debate in general over its credibility and just how successful it is. At the end of the day, it comes down to the person in recovery and how committed he or she is to the 12-step Program. If it doesn’t work, that may have more to do with the person than the Program.

    Why the 12-step program should not replace modern therapy approaches

    The AA-type meetings that form a big part of the 12-step Program are inclusive and provide comfort and support in a non-judgemental environment. However, critics of the spiritual-based model say that confession and prayer are not enough if addiction is to be treated as a medical condition. In many cases, substance abuse is linked to a mental disorder and simply handing something that serious over to a “higher power” can do more harm than good.

    When dealing with drug or alcohol addiction, we’ve come to understand how complex the condition can be. Any recovering addict knows that the recovery process is like peeling an onion layer by layer. Just when you think you’ve uncovered a deep emotional issue, something deeper surfaces; and the next layer begins to peel off and so the process continues.

    The modern approach to treating addiction involves a multi-disciplinary specialist team that designs a treatment plan for you that meets your individual needs, and always with your buy in. This may include the 12-step Program if the guiding principles resonate with you. An integrated, holistic approach that considers the whole being – mind, body and soul – is proving to be the most effective approach to treating addiction.


    White River Manor has had years of experience in dealing with alcohol and drug addiction and works closely with a dynamic team of specialists, therapists, highly experienced counsellors, medical practitioners, psychologists, and psychiatrists to create a holistic nurturing environment for clients.

    If you need expert advice and assistance, then White River Manor is the right place to go to make those changes in your life. You don’t need to struggle on your own.