Why 12-Steps Programs Don’t Work for Everyone: What are the Alternatives?

Break in Group Therapy Session

12-Steps programs have long been a popular go-to method for addiction recovery. In the last several decades, they’ve become globally renowned for their structured approach and supportive community. There’s little doubt that these programs have successfully guided many on their journey to sobriety. 

However, there is also a growing recognition that this path isn’t a universal solution. With diverse experiences shaping each person’s struggle with addiction, it’s clear that what works for one may not suit another. 

So why don’t 12-Steps programs work for everyone? Addressing this question is crucial in acknowledging the complex nature of addiction, and the importance of tailored individual-centric recovery strategies. 

In this article, we’ll explore the 12 Steps, and why they may not be right for you, as well as viable alternatives for successful, long-term recovery. 

What is the 12-Steps program? 

The 12-Steps program is a set of guiding principles designed to help people recover from addiction, compulsion, or other behavioural problems. Originally developed by Alcoholics Anonymous (AA) for alcoholism, it outlines a course of action for addressing these issues through personal and spiritual development. The steps include admitting powerlessness over the problem, recognising a higher power, examining past errors with the help of a sponsor, and making amends for these errors. 

What are the 12 Steps?

The 12 Steps, as outlined by Alcoholics Anonymous (AA), are:

  1. Admitting powerlessness over alcohol and acknowledging that one’s life has become unmanageable.
  2. Believing that a power greater than oneself can restore sanity.
  3. Deciding to turn one’s will and life over to the care of “God” as understood by the individual.
  4. Making a searching and fearless moral inventory of oneself.
  5. Admitting to God, oneself, and another human being the exact nature of one’s wrongs.
  6. Being entirely ready to have God remove all defects of character.
  7. Humbly asking God to remove shortcomings.
  8. Making a list of all persons harmed and becoming willing to make amends to them all.
  9. Making direct amends to such people wherever possible, except when doing so would injure them or others.
  10. Continuing to take personal inventory and promptly admitting when wrong.
  11. Seeking through prayer and meditation to improve conscious contact with God as understood by the individual, praying for knowledge of His will and the power to carry it out.
  12. Having had a spiritual awakening as a result of these steps, trying to carry the message to alcoholics and practicing these principles in all affairs.

History of the 12-Steps program

Alcoholics Anonymous (AA) was founded in 1935 in Akron, Ohio, by Bill W. (a New York stockbroker) and Dr. Bob S. (an Akron surgeon). Both men had struggled with alcoholism and were inspired by their involvement with a spiritual fellowship called the Oxford Group. Their collaboration marked the beginning of AA, which grew from meetings at Akron’s City Hospital to help alcoholics achieve sobriety​​.

In 1939, AA published “Alcoholics Anonymous: The Story of How Many Thousands of Men and Women Have Recovered from Alcoholism,” also known as The Big Book. Authored primarily by Bill Wilson, this book laid out the philosophy and methods of AA and has become a vital resource for many in recovery, selling millions of copies worldwide​​.

Since its relatively humble beginnings, the program has evolved into a component of addiction treatment across various centres. Its principles have been widely adopted and adapted​, resulting in global recognition. Indeed, AA now has over 2 million members worldwide, which seems like strong proof of its effectiveness for sustainable recovery. 

So does this mean the 12-Steps program is suitable for everyone? Far from it.

Why the 12-Step program may not be right for you

At Centres for Health & Healing, we’re driven by a passion to help people recover from addiction. So if the 12 Steps have helped you or a loved one achieve lasting sobriety, the last thing we would want to do is criticise your choices or dismiss this method outright. That being said, while transformative for many, the 12 Steps don’t cater to everybody’s recovery journey.

In an article published by the Guardian in 2021, Oscar Quine outlines his experience with the 12 Steps and how they ended up leaving him “feeling more broken”.

“Can anyone name any treatment methods for addiction, other than the 12 Steps?” asked a counsellor.

“Cognitive behavioural therapy?” offered a patient.

“These other methods come and go,” said the counsellor, with a wave of the hand. “But it’s only the 12 Steps that truly work.”

While this is an anecdotal account (and may not be indicative of every group within the program) it touches on a problematic aspect at its core: dogmatism. This is partly why the 12 Steps have developed a “cultish” reputation. In many cases, this is the result of exaggeration or misunderstanding. However, there is still an element of truth to it, not only due to the program’s religious underpinnings but also an inflexibility concerning other methods for addiction treatment. 

Man In Group Therapy Session

So while it is a viable addiction approach for many, the 12 Steps are not without limitations. Some of these include:

Concept of powerlessness

The idea of being powerless over addiction aims to alleviate shame and support recovery. However, it could be counterintuitive for those seeking to take back control of their lives. What’s more, this notion could be viewed as absolving responsibility, which might conflict with your understanding of addiction and recovery​​.

Spiritual or religious undertones

The program’s frequent references to a higher power might not resonate with you if you’re non-religious or hold different spiritual beliefs. Although these references are open to interpretation, their inherent spirituality might not align with your perspective​​.

Dependence on meetings

Regular meetings are a core element of the program, providing support and fellowship. While this is beneficial for many, you might perceive it as replacing one dependency with another. Furthermore, if you suffer from severe social anxiety and an addiction, you may not have the luxury of building up the coping skills to attend regular meetings. The group environment may not align with your personal preferences for more private, one-on-one support.

Lack of scientific evidence

A gap exists between scientific research on addiction and the principles of the 12-Steps program, leading to limited scientific evidence of its effectiveness. This is especially true when compared to the many evidence-based treatments used by mental health professionals and recovery centres. 

Rigid structure

A 12-Steps program might feel too rigid if you seek a more flexible or tailored approach to recovery. Moreover, the standardised nature of the steps might not address the unique aspects of your situation or specific recovery needs.

Judgment toward Medication-Assisted Treatment (MAT)

There is reported bias within 12-Steps programs against the use of medication-assisted treatments for addiction, such as methadone or buprenorphine. According to this paper, Narcotics Anonymous doesn’t consider people on medication to be “clean”. This type of inflexibility could hinder recovery, or even prove dangerous, especially for those dealing with opioid dependency

Alternative addiction treatments and approaches to the 12 Steps

A shrink is interviewing his client and writing down notes in a textbook during a session. A psychoanalyst is asking questions and writing down notes while a client is sitting on the therapist's couch

If the 12 Steps aren’t for you, don’t be dismayed. There are myriad alternatives available. While not an exhaustive list, the methods below are proven effective for treating addiction and improving chances of lasting recovery:

Cognitive Behavioural Therapy (CBT)

Considered the gold standard of addiction treatment, CBT focuses on identifying and changing harmful thought patterns and behaviours. It aims to help you develop coping strategies and problem-solving skills to address mental health and addiction struggles.

A study involving opioid users who received brief CBT sessions alongside methadone maintenance therapy showed improved psychiatric health, especially in reducing anxiety and sleep disorders​​.

Motivational Interviewing

Motivational Interviewing (MI) focuses on enhancing client engagement in addiction treatment. It supports behavioural change by helping you explore and resolve ambivalence and insecurities – and emphasises collaborative, person-centred guidance to elicit and strengthen the motivation and commitment needed for positive change.

Research indicates that MI interventions (which replace standard intake assessments with client-centred discussions) can improve treatment entry, attendance, completion, and overall client health and well-being​​​​​​​​.

Alternative group therapies

AA’s and NA’s forms of group therapy aren’t the right fit for everyone, and there are many other alternatives available. Broadly speaking, group therapy typically involves a small group of people who share similar issues or goals, guided by a trained therapist.

In these sessions, you not only receive support and insight from the therapist but also benefit from the collective experiences and advice of the group members. This collaborative environment fosters a sense of community and mutual understanding, which can be pivotal in recovery. 

According to this longitudinal study, participants in group therapy settings such as Women for Sobriety, LifeRing, and SMART Recovery showed abstinence outcomes equivalent to those in traditional 12-Steps groups. 

Holistic approaches

These address not just your symptoms, but your mind, body, and spirit, without the dogma often encountered in a 12-Steps program. Holistic approaches cover a broad spectrum, including meditation, mindfulness, yoga, acupuncture, nutrition, and art therapy. 

There is a growing body of evidence supporting all of these modalities, and they have been linked to relapse prevention, reduced cravings, improved physical health, and emotional healing​​​​​​.

Rational Recovery (RR)

In many ways on the opposite side of the spectrum to AA, RR offers a more cognitive approach to addiction treatment. As an alternative to the 12 Steps, RR is designed to help you overcome addiction by recognising and changing the irrational thoughts and beliefs that contribute to it. 

One study evaluating RR’s impact involved a national sample of 433 substance-abusing individuals attending 63 established RR groups. The results showed promising outcomes, with significant numbers of participants achieving abstinence after joining RR.

Centres for Health and Healing: A fully personalised alternative to the 12 Steps 

Loving family is smiling and embracing, enjoying quality time together in the countryside

At Centres for Health and Healing (CFHH), we shape your recovery journey around your personal needs and life experiences. Unlike the traditional 12-Steps program, we offer a more comprehensive approach and flexible framework:

Personalised treatment

Understanding that each client has a unique story, we design our holistic program specifically for you. Your treatment plan is tailored to your self, needs, and preferences, ensuring that your recovery path is as unique as you are​​.

Moving away from the 12-Steps method

CFHH diverges from the 12-Steps model, focusing instead on a Mindful Mental Health approach. This shift is due to the recognition that the 12-Steps method might not align with your core values. Our goal is to unearth the root causes of your lifestyle and challenges, offering a deeper, more introspective and transformative recovery path​​.

Mental health approach

Your treatment at CFHH is backed by research and includes one-on-one therapy, small group sessions, complementary therapies, and family-focused programs. This comprehensive approach ensures that you have the tools for long-term recovery, addressing not just your immediate needs but also preparing you for future challenges​​.

Family involvement

CFHH acknowledges the impact of stress, mental health, and addiction issues on both you and your family. The family program invites your loved ones to participate in the recovery process, helping them understand your journey and how they can support you effectively​​.

Our comprehensive approach places a firm emphasis on personalisation and holistic treatment, providing an evidence-based alternative to the traditional 12-Steps program. It fills in gaps that are often left by these methods, especially concerning mental health needs and family dynamics. Ultimately, we aim to provide a more all-encompassing recovery experience – one that leaves nobody’s needs unmet. 

If you’d like to find out more about our approach to treatment, or how we can help you or a loved one begin your recovery journey, please don’t hesitate to reach out to us.

Let us help you build a life free from addiction. 

Additional resources

  1. What Are the 12 Steps of Recovery? Verywell Mind, November 10, 2022
  2. Why the Hostility Toward the 12 Steps? Psychology Today, November 20, 2012
  3. Alternatives to 12-Step Addiction Recovery, Social Work Today, November/December 2013
Call now
Ready to get help?
Call for treatment options
Need financing?
Payment plans available