12-Step Facilitation of Treatment

12-Step Facilitation of Treatment

As explored in the previous chapter, groups are a highly effective modality for the treatment of addictions, and have a long and successful history in the field of chemical dependency. Twelve-step groups may be more appropriately titled “self-help groups” (because not all self-help groups have exactly 12 steps). The terms will be used interchangeably throughout the chapter.

The primary focus of self-help groups is to provide emotional and practical support and an exchange of information. Such groups use participatory processes to allow people to share knowledge, common experiences, and problems. Through their participation, members help themselves and others by gaining knowledge and information, and by obtaining and providing emotional and practical support. Traditionally, self-help groups have been in-person meetings, but more recently, Internet self-help groups have become popular.

One of the most widely recognized groups for the treatment of addictions is Alcoholics Anonymous (AA). Miller and McCrady (1993) note that Alcoholics Anonymous is the “most frequently consulted source of help for drinking problems” (p. 3). In fact, approximately 1 in every 10 adults in the United States has attended an Alcoholics Anonymous meeting at least once (Doweiko, 1999; Miller & McCrady, 1993; Zweben, 1995). Concurrently, affiliation with 12-step groups has been consistently linked to the achievement of abstinence among persons experiencing alcohol and other drug problems (Laudet & White, 2005). It is highly recommended that counselors, even if they do not regularly incorporate these groups into their counseling practice, should at least be familiar with them. The goal of this chapter, then, is to help counselors meet the following objectives:

1. To have a basic understanding of the foundation, history, and development of the 12-step model of treatment for addictions;

2. To gain a basic knowledge of the advantages and disadvantages of these groups, and how to use this knowledge to make appropriate referrals; and

3. To understand how to incorporate 12-step groups into culturally sensitive and client-appropriate addiction treatment for the most effective outcome.

History: Development of 12-Step Groups

Alcoholics Anonymous

As will be discussed later, Alcoholics Anonymous (AA) is one of the most widely recognized 12-step groups, and has been an instrumental force in the establishment of other groups using its model. Alcoholics Anonymous was founded on June 10, 1935, when Dr. Robert Holbrook Smith, an alcoholic physician, had his last drink (Doweiko, 1999). His cofounder, Bill Wilson, a failed Wall Street stockbroker, had previously been affiliated with the New York Oxford Group, a nondenominational group of Christians committed to overcoming a common drinking problem. The two men met coincidentally in Ohio while Wilson was seeking support to stay sober during a business trip (Miller, 2005). The plan for the group was devised by the two men, with a shared aim to spread the supportive message of sobriety to other alcoholics.