Twelve step programs

This article examines the history of Alcoholics Anonymous (AA), the goals of the 12 steps, research on AA, and common issues reported by clients about this approach and offers suggestions for addressing these issues.

AA was developed by two severe alcoholics in the 1930s in an effort to provide holistic treatment of addictive disorders.

Twelve-step programs and the related disease concept of addiction have heavily influenced inpatient and outpatient treatment.

The 12-step approach emphasizes a comprehensive approach for the disease of addiction, addressing mental, physical, and spiritual components, and participation in each other’s treatment is critical to sustained sobriety.

With intensive work in the program, the 12-step approach offers management of the addictive behavior as well as improvement in handling "life on life’s terms."

Twelve-step treatments have significant positives such as wide availability for little to no cost and promising success through a holistic treatment strategy.

However, the 12-step approach has been criticized for being overly religious, inflexible, and controlling, and has also been accused of fostering a substitute dependency. Despite anecdotal reports of positive outcomes, rigorous examination of treatment efficacy has produced varying results.

However, more recent and detailed studies have generated optimistic findings. The benefits of enhanced knowledge about this treatment modality are apparent when serving chronically addicted clients in an increasingly managed-care environment.

Research; Lile, B. Twelve step programs: An update. Addictive Disorders and Their Treatment, 2(1):19-24, 2003