What are the 12 Steps?

Discover the power of the 12 steps in addiction recovery, from origins to adaptations. Get the answers you need!

July 3, 2024

Understanding the 12 Steps

The 12 Steps are a set of guiding principles that have been widely adopted in various addiction recovery programs. These steps provide individuals with a framework to address their addictive behaviors and work towards a healthier, more fulfilling life. Let's explore the origin and purpose of the 12 Steps, as well as their role in addiction recovery.

Origin and Purpose

The 12 Steps were founded by Bill Wilson and Dr. Bob Smith in 1935, drawing inspiration from the Oxford Group. These steps were initially based on the six tenets of the Oxford Group, but Bill Wilson expanded them to twelve steps in a single night of writing. The Steps and the fellowship of Alcoholics Anonymous (AA) were designed around principles of moral inventory, honesty, purity, unselfishness, and love [2].

Bill Wilson started writing what would become the first edition of the Big Book in 1938, which included the 12 Steps. By the end of 1937, Bill and Dr. Bob realized they had discovered a way to help alcoholics get sober that actually worked, leading to the development of the 12 Steps. The book "Alcoholics Anonymous" was published in April 1939, containing these 12 steps.

Role in Addiction Recovery

The 12 Steps play a crucial role in addiction recovery. They are meant to help individuals recover from compulsive, out-of-control behaviors and restore manageability and order to their lives. By following the Steps, individuals are encouraged to practice honesty, humility, acceptance, courage, compassion, forgiveness, and self-discipline. This process promotes positive behavioral change, emotional well-being, and spiritual growth [2].

While the 12 Steps originated in the context of alcohol addiction, they have been adapted and applied to address other forms of addiction, such as drug addiction, as well as behavioral compulsions. The Steps provide individuals with a roadmap for personal reflection, acceptance of their powerlessness over addiction, making amends, and fostering a connection with a higher power or spiritual principles.

In addiction recovery programs, the 12 Steps are often recommended to be practiced daily and are considered the foundation of a 12-Step program. While Steps 1, 2, and 3 are fundamental, each step builds upon the previous one, guiding individuals towards self-awareness, personal growth, and a life free from the grips of addiction.

By embracing the principles and concepts outlined in the 12 Steps, individuals can embark on a transformative journey of self-discovery, healing, and recovery from addiction. These steps provide a path towards a more fulfilling and balanced life, while also offering support and a sense of community through the fellowship of others who have experienced similar struggles.

The 12 Steps Explained

The 12 Steps are a set of principles and guidelines used in various recovery programs, most notably Alcoholics Anonymous (AA). These steps are designed to help individuals identify and understand their own problems, accept responsibility, and work on self-improvement. Let's explore the different steps in detail.

Step 1 to Step 4

  1. Step 1: We admitted we were powerless over [substance/behavior]—that our lives had become unmanageable. This step involves acknowledging that there is a problem and that one's life has become unmanageable due to the substance or behavior in question. It requires honesty and self-reflection.
  2. Step 2: Came to believe that a Power greater than ourselves could restore us to sanity. Step 2 emphasizes the importance of having faith in a higher power or a source of strength beyond oneself. It involves recognizing that there is hope for recovery.
  3. Step 3: Made a decision to turn our will and our lives over to the care of God as we understood Him. Step 3 involves making a conscious decision to surrender control and trust in a higher power. It is about letting go of self-will and placing faith in a power greater than oneself.
  4. Step 4: Made a searching and fearless moral inventory of ourselves. Step 4 requires individuals to take a thorough and honest inventory of their thoughts, behaviors, and past actions. It involves examining both the positive and negative aspects of one's character.

Step 5 to Step 8

  1. Step 5: Admitted to God, to ourselves, and to another human being the exact nature of our wrongs. Step 5 involves sharing the inventory of Step 4 with a trusted individual or sponsor. It requires honesty, vulnerability, and a willingness to take responsibility for one's actions.
  2. Step 6: Were entirely ready to have God remove all these defects of character. Step 6 centers on being willing and open to change. It involves being ready to let go of negative traits and behaviors, and to work towards personal growth.
  3. Step 7: Humbly asked Him to remove our shortcomings. Step 7 is about seeking help from a higher power to remove character flaws and shortcomings. It involves humility and a willingness to let go of negative patterns.
  4. Step 8: Made a list of all persons we had harmed and became willing to make amends to them all. Step 8 requires individuals to compile a list of people they have harmed through their actions. It involves a willingness to make amends and seek forgiveness.

Step 9 to Step 12

  1. Step 9: Made direct amends to such people wherever possible, except when to do so would injure them or others. Step 9 involves taking action to make amends to those harmed in the past. It requires honesty, accountability, and a commitment to making things right.
  2. Step 10: Continued to take personal inventory and when we were wrong promptly admitted it. Step 10 emphasizes the importance of ongoing self-reflection and accountability. It involves regularly assessing one's thoughts, actions, and behaviors, and taking responsibility for any mistakes.
  3. Step 11: 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. Step 11 encourages individuals to deepen their spiritual connection through prayer and meditation. It involves seeking guidance, inner peace, and the strength to live a purposeful life.
  4. Step 12: Having had a spiritual awakening as the result of these steps, we tried to carry this message to [others struggling with addiction], and to practice these principles in all our affairs. Step 12 emphasizes the importance of giving back and helping others who are struggling with addiction. It involves sharing one's experiences, strength, and hope, while also striving to apply the principles of the 12 Steps in all areas of life.

The 12 Steps provide a roadmap for individuals seeking recovery from addiction and have been adapted for use in various other areas of personal growth and behavioral change. By following these steps, individuals can embark on a journey of self-discovery, healing, and transformation.

Adaptations and Applications

The Twelve Steps, originally designed to address alcoholism, have been adapted to meet the needs of individuals struggling with various mental and behavioral health conditions. These adaptations have expanded the scope of the Twelve Steps beyond alcoholism, allowing individuals to find support and recovery in different areas of their lives.

Beyond Alcoholism

While the Twelve Steps were initially created to address alcoholism, they have been successfully applied to other addictive behaviors and compulsions. Twelve-step programs have been adapted to support individuals dealing with gambling addictions, eating disorders, sex addiction, and co-dependency, among others. The principles and practices outlined in the Twelve Steps provide a framework for individuals to examine their behaviors, take responsibility, and work towards recovery and personal growth.

Mental Health and Behavioral Conditions

The Twelve Steps can also be applied to individuals experiencing mental health challenges and behavioral conditions. By engaging in the Twelve Steps, individuals can gain insight into their thoughts, emotions, and behaviors, and develop healthier coping mechanisms. These principles encourage honesty, humility, acceptance, courage, compassion, forgiveness, and self-discipline, fostering positive behavioral change, emotional well-being, and spiritual growth.

The adaptability of the Twelve Steps allows individuals to find a supportive network of peers who share similar struggles. By participating in Twelve-step programs, individuals can connect with others who understand their challenges, providing a sense of community and support throughout their recovery journey.

Adapting the Twelve Steps to address a wide range of issues has expanded the reach and effectiveness of this approach, offering hope and recovery to individuals struggling with various mental and behavioral conditions.

Success and Impact

When examining the success and impact of the 12 Steps, it is important to consider the statistics and studies surrounding their effectiveness. These findings shed light on the long-term recovery rates and provide insights into the outcomes of individuals who have engaged with the 12 Steps.

Statistics and Studies

Peer-reviewed studies suggest that the success rate of the 12 Steps programs, such as Alcoholics Anonymous (AA), is estimated to be between five and 10 percent. This means that approximately one in 15 people who enter these programs are able to become and stay sober [5].

An internal survey conducted by AA in 2007 showed that among its members, 33 percent reported being sober for more than a decade, 12 percent for five to 10 years, 24 percent for one to five years, and 31 percent for under a year. However, it is important to note that these figures do not account for the large number of individuals who do not complete the 12 Steps.

It is worth highlighting that engagement and active participation in 12-Step group activities are significant factors in achieving positive outcomes. Reviews of literature have shown that individuals who engage in activities such as service at meetings, reading 12-Step literature, getting a sponsor, or calling other group members have a greater likelihood of abstinence for prolonged periods, improved psychosocial functioning, and increased levels of self-efficacy.

Long-Term Recovery Rates

While the 12 Steps have helped many individuals achieve and maintain sobriety, it is important to acknowledge that attendance and engagement can be challenging for some. On average, 81 percent of newcomers to AA stop attending meetings within the first month, with only 10 percent remaining after 90 days, and that figure is halved after a full year.

Despite these challenges, there is evidence to suggest that the 12 Steps, particularly Twelve-Step Facilitation Therapy (TSF), can be effective in reducing drinking and promoting abstinence. Project MATCH, a large multisite trial, compared TSF to other therapeutic approaches and found that patients treated with TSF attended more 12-Step meetings, had reductions in drinking comparable to other treatments, and had higher levels of overall abstinence. TSF focuses on acceptance of a chronic illness, complete abstinence as the necessary goal, and hope for recovery through faith in a Higher Power and acknowledgment of the role of 12-Step fellowship in recovery.

While the success rates and long-term recovery rates vary, the 12 Steps have proven to be a valuable tool for many individuals seeking to overcome addiction. It is important to remember that individual experiences may differ, and what works for one person may not work for another. The 12 Steps provide a framework of support, guidance, and community that has helped countless individuals on their journey to recovery.

Criticisms and Challenges

While the 12 Steps have been widely embraced as a method for addiction recovery, there are criticisms and challenges associated with their implementation. Two significant areas of concern are attendance and engagement, as well as the effectiveness of the 12 Steps and the availability of alternatives.

Attendance and Engagement

One criticism of the 12 Steps is the issue of attendance and engagement. According to a study cited by The Atlantic, on average, 81 percent of newcomers to Alcoholics Anonymous (AA) stop attending meetings within the first month. Only 10 percent remain after 90 days, and this figure is halved after a full year. These statistics highlight the challenges individuals face in maintaining consistent engagement with the 12 Steps.

Effectiveness and Alternatives

The effectiveness of the 12 Steps has been a subject of debate. Peer-reviewed studies suggest that the success rate of AA is between five and 10 percent, with approximately one in 15 people who enter these programs able to become and stay sober, as reported by The Atlantic. While these numbers may be discouraging for some, it's important to remember that the 12 Steps may not be suitable for everyone and that success rates can vary depending on various factors.

Additionally, individuals seeking alternatives or complementary approaches to the 12 Steps have options available to them. Various recovery programs exist that offer different methodologies and philosophies. These alternatives may include cognitive-behavioral therapy, motivational interviewing, mindfulness-based approaches, and medication-assisted treatment. It's crucial for individuals to explore different options and find a recovery path that aligns with their beliefs and needs.

Understanding the criticisms and challenges surrounding the 12 Steps is essential for individuals seeking addiction recovery. While the 12 Steps have helped many people achieve long-term sobriety, they may not be a one-size-fits-all solution. Exploring alternative approaches and finding a supportive community can contribute to a more comprehensive recovery journey.

References

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