What Is 12-Step Facilitation?
Key points
- 12-step facilitation, originating from Alcoholics Anonymous (AA), has now been widely adapted to several programs and supportive aspects of the recovery process.
- Studies have demonstrated the overall effectiveness of ongoing participation and attendance at 12-step-related activities for active recovery.
- 12-step facilitation is often a key component of active treatment and post-treatment support.
- There are several avenues to accessing 12-step facilitation support within treatment and in the community.
The journey to overcome addiction can be varied, and as such, it often incorporates several supportive interventions to establish the recovery process, both therapy and non-therapy related. 12-step programs have long been a staple of addiction treatment, rooted in a philosophy that guides individuals to explore their issues with curiosity and care amongst a supportive group of their peers to gain new insights and develop new strategies to maintain sobriety.
What is 12-Step Facilitation?
At its core, 12-step facilitation involves engagement in a program of recovery that endeavors to provide members with a path to lasting sobriety and a substance-free lifestyle.[1] First developed by Alcoholics Anonymous (AA), 12-step programming has evolved to be applicable to several addictive behaviors, establishing a vital support network for those seeking to enter into the recovery process.
Typically, the core steps in 12-step facilitation revolve around:
- Honesty: Admitting one’s powerlessness over their addiction.
- Faith: Sometimes referred to as the ‘higher power,’ this step entails accepting the ability of something larger than oneself to heal them. It’s important to note that this does not have to be a belief in any religious entity, as several 12-step programs operate under a secular lens.[2]
- Surrender: Recognizing that you alone cannot recover but rather need to engage with others in order to succeed.
- Openness: Identifying one’s problems to get a clearer picture of how their behavior has affected themselves and their loved ones.
- Integrity: Clarifying and admitting one’s wrongdoing
- Acceptance: Accepting one’s inherent limitations and defects in order to make peace and let them go.
- Humility: Asking for help and acknowledging that one is unable to go it alone.
- Willingness: Taking an accounting of those you have harmed before your entry into the recovery process.
- Forgiveness: Making amends with those that were harmed.
- Maintenance: Continued engagement with the principles and activities that benefit ongoing sobriety.
- Discovery: Exploring a larger purpose for one’s life.
- Service: Assisting to carry the message of recovery to others and continuing to practice recovery principles.
12-step programming has been widely studied to be effective in helping people to create and maintain their recovery, along with providing an important sense of community and mutual support.[3]
12-Step Facilitation Interventions
12-step facilitation usually takes a structured approach, consisting of several sessions that tend to focus on one of the above-mentioned themes. The group facilitator will work to encourage sharing and processing from members of the group, in addition to sometimes providing exercises and self-reflective activities.
Many 12-step models have long been in use for addictions of all kinds, including substance-based, process, and behavioral, in addition to groups for eating disorders and several other conditions or afflictions. The 12-step philosophy emphasizes the importance of accepting a condition that is immutable yet able to be improved, providing hope and resources to those in their recovery journey.
Studies have shown that the median length of abstinence reported by AA and Narcotics Anonymous (NA) members is greater than five years, with participants attending between two to four meetings per week on average. [4]
The 12-Step Facilitation Model
Since there is no singular cause for addiction, it only makes sense that addiction treatment is itself varied and diverse, striving to meet the unique and holistic needs of the individual. As such, 12-step programs often function as both an adjunct to additional treatment modalities (such as therapy and medication) and as a varied, dynamic structure all its own.
Attendees at a 12-step meeting rely on one another to provide understanding and support as their issues are explored, although it should be noted that no one is required to speak at a meeting, and cross-talk and advice-giving are typically discouraged.
There can be great variety in how any given meeting is run, depending on the venue and subject, but most 12-step facilitation models encourage the development of personal responsibility and new insights around the behavior in question. 12-step programming is often included as both a feature of treatment for inpatient and outpatient-based centers, along with aftercare.
How (and Why) 12-Step Programming Works
At its core, 12-step programs assist those struggling with addiction and other challenges to access a mutually-supportive group of people with which to process through their struggles and identify new and healthier ways to cope with the temptations of addiction. A systematic review of 12-step-based interventions found that clinically-delivered twelve-step facilitation can be as effective as cognitive behavioral (CBT) or motivational enhancement therapy (MET) at reducing drinking intensity, promoting abstinence, and reducing alcohol-related consequences at 12 months.[5]
According to a study by the National Center for Biotechnology Information—a branch of the National Institute of Health (NIH)—beginning 12-step programming at the start of your treatment journey, particularly with groups held by the treatment facility, is associated with overall better outcomes. Additionally, consistent and frequent attendance is associated with better outcomes as well, particularly for substance use.[6]
What’s the Best Way to Find 12-Step Facilitation?
There are several avenues to identifying resources and locations for 12-step practices:
- Inquiring with your treatment center if 12-step programming will be included
- Participating in 12-step programming via aftercare
- Utilizing aa.org, SAMHSA’s National Helpline, 12step.com, and other online resources to find a 12-step meeting in your area
Find Twelve-Step Facilitation Therapy Near Me
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Cost of 12-Step Therapy
The costs associated with any 12-step programming within the bounds of structured addiction treatment will be included in the overall program. Treatment costs will vary based on your individualized treatment program that is designed to meet your unique needs. Feel free to ask any questions you may have about treatment costs prior to entering your first session.
On their own, outside the parameters of a treatment program, 12-step programming is provided free of charge in the community.
Frequently Asked Questions about 12-Step Facilitation
How can 12-step programs help me to stay sober?
12-step programming combines social support, inspiration, and accountability to assist attendees in developing fresh insights and new strategies to engage in the recovery process.
Are all 12-step programs faith-based?
No, there are several other options for potential attendees to engage with that do not utilize the traditionally faith-based model of AA, including SMART recovery.
Are 12-step programs always included in treatment?
Yes! This is an industry-standard expectation for any reliable treatment program. Treatment plans at Alpas Wellness incorporate several different types of 12-step programming into long-term care plans.
Will participating in 12-step programs be anonymous?
All treatment offered by a clinic or facility is HIPAA-protected, and most 12-step programs in the community adhere to strict guidelines for confidentiality.
Are there any requirements for attending 12-step programming?
The only requirement to attend a 12-step program is a desire to overcome your addiction or other issues.
Additional Treatment Resources
Donovan, D. M., Ingalsbe, M. H., Benbow, J., & Daley, D. C. (2013). 12-Step Interventions and mutual support programs for substance use disorders: an overview. Social Work in Public Health, 28(3-4), 313–332. https://doi.org/10.1080/19371918.2013.774663 on July 24th, 2023
Secular 12 Steps. (n.d.). Retrieved July 24, 2023, from https://aaagnostica.org/wp-content/uploads/2012/01/Secular-12-Steps.pdf on July 24th, 2023
Mendola, A., & Gibson, R. L. (2008). Addiction, 12-Step Programs, and Evidentiary Standards for Ethically and Clinically Sound Treatment Recommendations: What Should Clinicians Do? AMA Journal of Ethics, 18(6), 646–655. https://doi.org/10.1001/journalofethics.2016.18.6.sect1-1606 on July 24th, 2023
Donovan, D. M., Ingalsbe, M. H., Benbow, J., & Daley, D. C. (2013). 12-Step Interventions and mutual support programs for substance use disorders: an overview. Social Work in Public Health, 28(3-4), 313–332. https://doi.org/10.1080/19371918.2013.774663 on July 24th, 2023
Recommend Evidence-Based Treatment: Know the Options | National Institute on Alcohol Abuse and Alcoholism (NIAAA). (n.d.). Www.niaaa.nih.gov. https://www.niaaa.nih.gov/health-professionals-communities/core-resource-on-alcohol/recommend-evidence-based-treatment-know-options on July 24th, 2023
Kelly JF, Humphreys K, Ferri M. Alcoholics Anonymous and other 12‐step programs for alcohol use disorder. Cochrane Database Syst Rev. 2020;2020(3). doi:10.1002/14651858.CD012880.pub2 on July 24th, 2023