The 12 Step Programme: What Are the 12 Steps?

Breaking the cycle of addiction is a very challenging process but it is achievable with the right treatment programme. Treatment programmes vary, but one method that has endured for over 80 years is the 12 Steps. So, what are the 12 Steps, and what are the benefits?

The 12 Steps are a set of guiding principles that are recommended to people recovering from addiction to enable them to live a fulfilling life, free of alcohol, drugs, and other addictions.

Within the 12 Step Model, addiction is seen as a chronic illness of body, mind and spirit, and addiction can be overcome and held in remission (rather than ‘cured’) through complete abstinence and ongoing mutual support meetings. The 12 Steps are structured to create a beginning-to-end transformation; from the early stages of acceptance of the addiction, to rebuilding your connections with loved ones, and focusing on altruism and spirituality to strengthen recovery.

 The 12 Steps have proven such a success worldwide that they are now used as the basis for recovery from addictions of all kinds such as gambling addiction, overeating, and internet addiction.

The History of the 12 Steps

The basic principles of the 12 Step model were originally developed by the founders of Alcoholics Anonymous (AA) and published in the ‘Big Book’ in 1939.1 The framework of the 12 Steps focuses on attitudinal and behavioural change through self-examination and personal responsibility and also incorporates elements of spirituality within the recovery process. 

The principles of AA have since evolved into a widely recognised and effective treatment framework for treating almost all substance and behavioural addictions. Emphasising honesty, openness, motivation for change, mutual support and spirituality, the programme guides people as they navigate 12 Steps of recovery, using a network of sponsors and self-help fellowship meetings.

What are the 12 Steps?

The 12 Steps begin by encouraging people to accept the reality of their problems and take personal responsibility for changing their lives. Once the huge obstacles of denial, victimhood and reluctance to ask for help are successfully addressed, the recovering person is led through a process of self-discovery and personal change where good, healthy habits are established and supported through the advice and example of others.

Based on the experiences of the first members of AA, the 12 Steps represent a therapeutic model designed to help people achieve a fulfilled life free from addiction. 

  1. We admitted we were powerless over 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 God as we understood Him.
  4. Made a searching and fearless moral inventory of ourselves.
  5. Admitted to God, to ourselves and to another human being the exact nature of our wrongs.
  6. Were entirely ready to have God remove all these defects of character.
  7. Humbly asked Him to remove our shortcomings.
  8. Made a list of all persons we had harmed, and became willing to make amends 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 God as we understood Him, 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 alcoholics and to practice these principles in all our affairs.

What Do The 12 Steps Mean?

Steps 1 to 3 involve accepting one’s powerlessness over addiction and asking for help from a power greater than oneself (the word God is used but no religious belief is required or specified throughout the programme).

Steps 4 to 7 focus on self-examination, acknowledging past mistakes and committing to change. 

Steps 8 to 9 involve reflection on past errors and making amends where possible. 

Steps 10 to 12 emphasise maintaining sobriety and recovery by continuing to practice the 12 Steps and carrying the message to others

The 12 Steps highlight spiritual growth, personal accountability, mutual support, and ongoing recovery as its core principles.

How Does the 12 Step Programme Work?

For most addicted people, the 12 Step Programme represents a whole new way of living that can only be successfully embraced where honesty, openness and willingness to change are fully present because the power of addiction allows no room for compromise. People able to demonstrate these three attributes in a determined and consistent manner generally do well.

The 12 Step recovery programme is designed to help addicted people harness their inner strength, in the firm belief that they are not bad, sick or stupid but merely suffering from the disease of addiction. The subsequent steps guide them toward empowerment, through honesty, compassion,  and altruism, thus contributing to their overall well-being and happiness. The basic premise of the 12 Step model is as a framework through which people can help one another achieve and maintain abstinence from substances.

The 12 Step philosophy emphasises certain fundamentals, including the importance of a higher power accepting responsibility for actions and choices in the past and understanding how they have contributed to a person’s struggle. The 12 Step programme doesn’t focus on absolute perfection and success in each step. It accepts that, as humans, we’re all capable of making mistakes and that success comes in a variety of ways. ‘Progress, not perfection’, is a commonly used phrase. It is generally believed that the 12 Step programme works by emphasising five key ideas which come from Alcoholics Anonymous:

  • Honesty – “Rigorous honesty” is often mentioned in AA literature.
  • Openness to new ideas is an important attitude to enable change.
  • Motivation to change.
  • Mutual support – the idea that “I can’t do this alone but together, we can” is fundamental.
  • Spirituality – the terrible power of alcoholism to destroy lives requires a more powerful response than a single person can provide. Spirituality means that the person suffering from alcoholism is no longer alone. Seeking help from a ‘power greater than ourselves’ and spiritual growth are the ‘X factor’ that makes the 12 Step Programme special.

Are The 12 Steps Religious?

‘God’ in the 12 Steps does not have to be a religious entity and the phrase ‘God of our understanding’ is commonly used in the 12 Step model. The purpose is to think of a higher power, which can be the God of religion, nature, the universe or human kindness.

Benefits of the 12 Steps

  • The 12 Steps provide a clear beginning-to-end approach for overcoming addiction and achieving long-term recovery.
  • The 12 Steps help you to replace addictive thoughts and behaviours with positive, productive, and achievable goals.
  • It provides a strong sober network that will be with you throughout your life.
  • It empowers you to accept responsibility for your actions and choices in the past and to understand how they have contributed to your struggle.
  • It is an easily accessible and widely-used approach worldwide. You can find AA meetings all over the world and online.
  • It is free! For those who don’t require residential rehab, AA meetings are free and open to anyone willing to give up drinking.

Disadvantages of the 12 Steps

  • The 12 Steps alone will not be suitable for those who require medical support for detoxification and other physical side-effects of their addiction.
  • The 12 Steps alone will not address other mental health issues and trauma that require psychotherapy.
  • Group dynamics vary and it may take a few tries to find the right group for you. 
  • The philosophy of the 12 Steps does not sit well with everyone, and sometimes other approaches will work better for the individual.
  • There is no guarantee of success through the 12 Steps (nor any other form of treatment). Recovery is unique to the individual and multiple factors lead to a successful recovery.

This is why a comprehensive treatment programme at a rehab is often recommended as the best way to get all the help you need under one roof.

Our Approach to 12 Step Treatment at Smarmore Castle

At Smarmore Castle, our holistic treatment programme combines a number of therapeutic interventions, including the 12 Steps. 

During 12 Step treatment at Smarmore Castle our experienced therapists will introduce you to the 12 Steps and equip you with the tools necessary to complete the first steps while you are in treatment. Everyone progresses through the 12 Steps at their own pace, and it’s important not to rush the process. Some people may take 4 weeks to reach Step 3, others may reach Step 5 in that time.  

You will advance through the steps, typically in a group therapy and one-to-one therapy setting. Group therapy encourages sharing progress, receiving feedback, and developing insight and awareness. Attending regular AA and other 12 Step fellowship meetings further enhances engagement, mutual support and recovery strategies.

Completing treatment marks a transition, not an end, to the 12 Step journey. The programme aims to instil a lifelong mindset shift, helping you maintain abstinence and eventually go on to support others in their recovery journey.

Research Studies on 12 Step Treatment 

Research, including the Project MATCH study and AA member surveys, consistently demonstrates the effectiveness of the 12 Step model in promoting sobriety and reducing relapse rates, often outperforming other treatments. Moreover, a 2020 Cochrane review confirms that AA and 12 Step programmes are as effective, if not more so, than other established treatments for alcoholism, with significant cost-saving benefits. This makes the 12 Step approach not only a viable option for individual recovery but also a valuable consideration for healthcare policymakers.

  • Project MATCH

    Project MATCH, initiated by Yale University in 1990, was an extensive eight-year clinical trial comparing the effectiveness of three treatment programmes for alcohol abuse and dependence: the 12 Step programme, cognitive behavioural therapy (CBT), and motivational enhancement treatment (MET). Contrary to initial expectations that the 12 Step method would be less effective, the results, published in 1997, showed that all three treatments were effective in reducing drinking and increasing abstinence over various intervals up to a year.

    Notably, the 12 Step model demonstrated a distinct advantage over both CBT and MET. One year after treatment, participants in the outpatient 12 Step programme maintained sobriety over 80% of the time, with those in aftercare remaining sober 90% of the time. The study revealed that the 12 Step model was equally effective for individuals with both alcohol abuse and chronic alcoholism, challenging the prior belief that relapse was inevitable for many suffering from addiction.

  • Cochrane Review 2020

    A 2020 review by Cochrane; an organisation known for its analysis of scientific research, has shown that addiction treatment based on the model of Alcoholics Anonymous works as well, if not better, than other scientifically proven treatments for alcoholism. The review looked at 27 studies involving nearly 11,000 participants.

    Cochrane Study Findings:

    • The evidence suggests that 42% of people participating in AA would remain completely abstinent one year later, compared to 35% of participants receiving other treatments including CBT. 
    • The review also found that AA-based programmes perform as well as other treatments in reducing drinking intensity and negative consequences.
    • Four out of five economic studies show significant cost savings with AA and 12 Step programmes, indicating potential for substantial healthcare cost reductions. This has potential interest for policy makers in government.
  • AA’s Member Surveys

    In the past 15 years, two surveys have been conducted (2007 and 2011) voluntarily by men and women currently attending AA meetings. 3

    • 72% of the group had been sober for more than a year
    • A third had been sober for more than 10 years
    • The more committed and “working”, the better the result.
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12 Step Programme at Smarmore Castle

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Getting Help with the 12 Step Programme at Smarmore Castle

Smarmore Castle provides a structured, supportive, and therapeutic environment where patients can focus on their recovery and support and motivate each other, ensuring a strong community spirit. The underlying principles of the 12 Steps underpin our treatment programme and we incorporate other therapies and clinical interventions on top of the basic 12 Step programme.

Patients work through the steps at their own pace, with guidance from experienced therapists and counsellors. The initial steps focus on acknowledging their addiction and surrendering to a higher power, while subsequent steps involve personal reflection, making amends, and ongoing self-improvement.

  • Individual Therapy Sessions

    Help patients explore the underlying issues of their addiction, develop coping mechanisms, and work through the steps in a more personalised manner.

  • Group Therapy

    Group sessions allow patients to share experiences, offer mutual support, and gain different perspectives. This communal approach is a cornerstone of the 12 Step philosophy.

  • Education and Workshops

    Patients attend educational sessions and workshops that cover various aspects of addiction, recovery, and the 12 Step Programme. These sessions help deepen their understanding of the programme and of recovery as a way of life.

  • Spiritual Growth

    The 12 Step Programme at Smarmore Castle emphasises spiritual growth, which can involve finding a higher power, meditation, and personal reflection. This spiritual component is tailored to fit each person’s beliefs and values.

  • Family Involvement

    Family therapy and involvement are encouraged to help repair relationships and create a supportive home environment for when the patient leaves the facility. 

  • Relapse Prevention

    Patients are taught relapse prevention strategies, including recognising triggers, developing coping skills, and creating a robust support network for life after treatment.

  • Aftercare Planning

    Before leaving Smarmore Castle, patients work with their therapists to develop a detailed aftercare plan. This includes continued participation in local 12 Step meetings, a sponsor, ongoing therapy, and other support systems to help maintain sobriety.

At Smarmore Castle, this evidence-based approach is integrated with psychotherapy, such as cognitive behavioural therapy (CBT), offering a comprehensive treatment approach. Overall, the 12 Step model fosters a lasting mindset shift, supporting lifelong abstinence and continuous personal growth, while also integrating with the broader recovery community.