Contact: Julienne Giard, LCSW, 860-418-6946, firstname.lastname@example.org
Twelve-step facilitation is an active engagement strategy designed to increase the likelihood of an individual becoming affiliated with and actively involved in 12-step self-help groups. While the efficacy of 12-step programs (and 12-step facilitation) in treating alcohol dependence has been established, the research on other areas is more preliminary but promising for helping individuals sustain recovery. The National Institute of Drug Abuse (NIDA) has recognized the need for more research in this area. DMHAS recognizes 12-step facilitation as an evidence based practice (EBP) and this practice is embedded in the Department of Mental Health and Addiction Services (DMHAS) Assertive Community Treatment Program (ACT), Community Support Program (CSP)/Recovery Pathways Program (RP), Integrated Dual Disorder Treatment (IDDT) and the Dual Diagnosis Capability in Addiction Treatment (DDCAT).
*Adapted from the National Institute on Drug Abuse (NIDA) on Evidence-Based Approaches to Drug Addiction Treatment
History of the 12 Steps
Alcoholics Anonymous and the 12-steps began in June of 1935, during the great depression. Bill Wilson founded the organization after discovering his Higher Power while detoxing in a
The Alcoholics Anonymous book, also known as “The Big Book”, has since become the foundation of addiction treatment throughout the
Alcoholics Anonymous is the largest of the different twelve-step programs. The next largest group is Narcotics Anonymous (NA). The largest numbers of twelve-step members are in recovery for addiction to drugs or alcohol; however, the majority of twelve-step programs deal with other issues. An example of this is Al-Anon, the third largest twelve-step program which assists family members of individuals with an addiction. Roughly twenty percent of twelve-step programs help those struggling with addiction. The other eighty percent deal with a variety of issues from mental health to debt.
These are the Twelve Steps as published by Alcoholics Anonymous (AA):
1. We admitted our powerlessness over our illness, or drugs and alcohol—that our lives had become unmanageable.
2. Came to believe that a Power greater than ourselves could restore us to sanity.
3. Made a decision to turn our will and our lives over to the care of our Higher Power.
4. Made a searching and fearless moral inventory of ourselves.
5. Admitted to our Higher Power, to ourselves, and to another human being the exact nature of our wrongs.
6. Were entirely ready to have our Higher Power remove all these defects of character.
7. Humbly asked our Higher Power to remove our shortcomings.
8. Made a list of all persons we had harmed, and became willing to make to them all.
9. Made direct amends to such people wherever possible, except when to do so would injure them or others.
10. Continued to take personal inventory and when we were wrong promptly admitted it.
11. Sought through prayer and meditation to improve our conscious contact with our Higher Power, praying only for knowledge of His will for us and the power to carry that out.
12. Having had a spiritual awakening as the result of these steps, we tried to carry this message to drug and alcohol addicts, and to practice these principles in all our affairs.
Power of the Group
Individual therapy is effective, but according to psychologists, one of the best ways to change human behavior is to treat individuals with similar problems in groups. In 1905 Joseph Pratt, a physician in
According to Project Match, a multisite clinical trial of alcohol treatment at the University of Connecticut Health Center, “no single treatment is effective for all persons with alcohol (drug) problems. A more promising strategy involves assigning patients to alternative treatments based on specific needs and characteristics of patients”.
Project Match was conducted between 1989 and 1997 wherein more than 1,700 individuals suffering from alcohol dependence were assigned to one of the three successful drug treatment therapies used by professional drug rehab programs. The therapy used was called 12-step facilitation, wherein a licensed therapist assists clients through Bill Wilson’s 12-step method. The second was cognitive behavioral therapy (CBT) which teaches individuals with a substance use issue to recognize the triggers and situations that have lead to relapse. By specifically identifying people, places and situations that have lead to relapse, individuals can learn to avoid these compromising situations in the future. Finally, motivational enhancement therapy (MET) was incorporated. MET is an individual-therapy-interview process that strengthens a person’s reasons for maintaining recovery.
The final conclusion of Project Match was that all three of these therapies were about equally successful at reducing alcohol (drug) intake among participants. 12 step facilitation was substantially more effective at achieving total abstinence as compared to just limiting alcohol (drug) consumption.
* adapted from 12-step program,
12 Step Groups:
Linked below is a representative list of twelve-step groups based on the set of guiding principles for recovery that was originally developed by Alcoholics Anonymous (AA). The twelve-step method has been adapted widely by fellowships of people recovering from various addictions, compulsive behaviors, and mental health issues. Additionally, some programs have adapted the twelve-step approach in part.
12-Step Facilitation Resources