The 12 Steps

An Overview of the 12-Steps

12-step recovery programs are a time-tested path to healing that has helped millions of people find freedom from addiction.  See below for "Efficacy of 12 Step programs" for alist of studies that document the positive impact of 12-step programs on sustained recovery.   The 12-steps guide individuals through a process of personal and spiritual transformation.  Beginning with an admission of powerlessness and progressing toward making amends and helping others, each step builds upon the last. The process is not about perfection, rather a focus on progress - learning to live one day at a time, with humility, honesty, and faith. In a 12-step community, people discover they are not alone, and they find the strength to rebuild their lives with the support of others who understand their struggle.  See the "Support Systems" page for resources on specific 12-step communities that support recovery.  

Free Online Recovery Resources

• AA Big Book 12 Steps and 12 Traditions Voices of Recovery Answers in the Heart 

• Your Brain on Porn Road to Freedom

•  Sex Addicts Anonymous – Green Book:  The foundational text of Sex Addicts Anonymous (SAA), this comprehensive guide outlines the Twelve Steps and includes personal stories from members. It's available to read online for free.

See the Reading Room page for more resources

YouTube Videos - Understanding the 12 Steps

• What are the 12 Steps of the 12-Step Recovery Programs -  Dr. KJ Foster provides an overview of each of the 12 steps, explaining their purpose and how they aid in recovery.    Watch on YouTube

• The 12 Steps of AA Explained! -  A personal interpretation of the 12 steps, offering insights into their practical application in daily life.   Watch on YouTube

• 12-Step Recovery Playlist -  A comprehensive playlist covering each step in detail, providing a deeper understanding of the 12-step process.   View Playlist

• Houston SAA 12 Steps workbook - Great Resource

• Lee's 12 Steps  - Great Resource

Each 12-step group defines their 12 step promises slightly differently.  While there are nuances between organizations, the intent remains the same.  Here is one example of the steps:  

The 12 Steps of SAA are:

1. We admitted we were powerless over addictive sexual behavior—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 God.

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 God 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 doing 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 God, praying only for knowledge of God’s 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 other sex addicts and to practice these principles in our lives.

Evidence of 12-Step Efficacy

Here are a few data driven research papers that quantify the effectiveness and relapse prevention rates associated with Twelve-Step approaches to addiction treatment:

1. "Participation in Treatment and Alcoholics Anonymous: A 16-Year Follow-Up of Initially Untreated Individuals" by Rudolf H. Moos and Bernice S. Moos (2006)
   Findings: This longitudinal study followed individuals over 16 years and found that 67% of those who engaged extensively with Alcoholics Anonymous (AA) remained abstinent, compared to lower abstinence rates among those with less or no AA involvement. en.wikipedia.org
   
   

2. "After Drug Treatment: Are 12-Step Programs Effective in Maintaining Abstinence?" by Robert Fiorentine (1999)
   
   Findings: In this 24-month longitudinal study, approximately 75% of participants who attended 12-step meetings at least once a week reported abstinence from drugs and alcohol. Specifically, 77.7% of regular attendees self-reported being drug-free, and 74.8% reported being completely sober from alcohol. In contrast, among those who did not attend meetings regularly, 56% reported abstinence from drugs, and 40% reported sobriety from alcohol. en.wikipedia.org
   
   

3. "Alcoholics Anonymous and Other 12-Step Programs for Alcohol Use Disorder" by John F. Kelly, Keith Humphreys, and Marica Ferri (2020)
   Findings: This Cochrane review concluded that AA participation leads to higher abstinence rates than other interventions like cognitive-behavioral therapy (CBT) and motivational enhancement therapy (MET). en.wikipedia.org
   
   

4. "Estimating the Efficacy of Alcoholics Anonymous Without Self-Selection Bias: An Instrumental Variables Re-Analysis of Randomized Clinical Trials" by Keith Humphreys et al. (2014)
   Findings: Using advanced statistical methods to control for self-selection bias, this study found that AA attendance significantly increased the likelihood of abstinence compared to other interventions. en.wikipedia.org
   
   

5. "Alcoholics Anonymous Effectiveness: Faith Meets Science" by Lee Ann Kaskutas (2009)
   Findings: This study linked increased AA attendance with higher spirituality and reduced alcohol consumption, suggesting a positive correlation between AA participation and recovery outcomes. en.wikipedia.org
   
   

6. "Alcoholics Anonymous and 12-Step Facilitation Treatments for Alcohol Use Disorder: A Distillation of a 2020 Cochrane Review for Clinicians and Policy Makers" by John F. Kelly et al. (2020)
   Findings: This distillation of the Cochrane review highlighted that AA and Twelve-Step Facilitation (TSF) treatments are more effective in achieving continuous abstinence compared to other established treatments. en.wikipedia.org
   
   

7. "Alcoholics Anonymous and Other 12-Step Programs for Alcohol Dependence" by Marica Ferri, Laura Amato, and Marina Davoli (2006)
   Findings: This Cochrane review found that AA and other 12-step programs are as effective as other psychosocial interventions in reducing alcohol dependence, with some studies indicating higher rates of continuous abstinence. en.wikipedia.org
   
   

8. "Narcotics Anonymous Participation and Changes in Substance Use and Social Support" by John W. Toumbourou et al. (2002)
   Findings: This study found that higher participation in Narcotics Anonymous (NA) was associated with a four-fold reduction in levels of hazardous drug and alcohol use, less illicit income, and higher emotional support at re-interview after 12 months. en.wikipedia.org
   
   

9. "Psychosocial Treatments for Cocaine Dependence: National Institute on Drug Abuse Collaborative Cocaine Treatment Study" by Paul Crits-Christoph et al. (1999)
   Findings: This study found that individual drug counseling based on the 12-step philosophy, combined with group drug counseling, was more effective than other treatments in reducing cocaine use. en.wikipedia.org
   
   

10. "A Unique Model for Adolescent Addiction Treatment: A Description of the Alberta Adolescent Recovery Centre" by Amelia M. Arria et al. (2017)
    Findings: This study found that the Alberta Adolescent Recovery Centre, which uses a 12-step approach, had a high rate of treatment completion (80.5%). en.wikipedia.org
    
    

These studies collectively provide data driven evidence that Twelve-Step programs are effective components in the treatment of addictions, particularly in promoting long-term abstinence.