The very first twelve-step program was Alcoholics Anonymous. It started in the early 20th century by Dr. Robert Smith and Bill Wilson. “Dr. Bob and Bill” created twelve steps to govern their group and to help rid their members of their alcoholism. Other twelve step groups would organize to deal with their respective pathologies and adopt AA’s twelve steps. This article looks at the history, the use, the effectiveness and the criticisms of twelve-step programs.
The first twelve-step program originated in Akron, Ohio. This twelve-step program remains to be the most popular twelve-step program today: Alcoholics Anonymous. It is argued whether it was founded on August 11, 1938 when Bob Smith and Bill Wilson created the 12 steps or on June 10, 1935, when Bob Smith had his last drink. AA would grow in popularity throughout the 40s and 50s. In 1953 Alcoholics Anonymous would give permission to Narcotics Anonymous to use its twelve steps, making it the second official twelve-step program.
Twelve-step programs use twelve steps, developed by Alcoholics Anonymous, to treat the pathologies they specialize in. These twelve steps are also used to help govern the groups. They are also used to help solve conflicts in finances, religion and publicity within the group and among its members. Most twelve-step programs are based on the disease model. This is an old model that originated in the medical sector. In it the patient has an illness that needs to be treated. In regards to the twelve-step programs the pathology is treated as an illness that needs to be cured. The twelve-step program aims to rid you of your old life and replace it with a new life based in faith.
As opposed to other treatment programs, twelve-step programs are free of cost. This is because they are volunteer-run programs. This may not necessarily mean they are more effective, but being free of cost does help to open the door to more potential members. Having said that, twelve-step programs generally polarize their potential members by splitting them into believers and non-believers as they are spiritual/religious-based in their approach. Another reason that makes it difficult to judge their effectiveness is that members are not just random members of society. They are either individuals who are motivated to stop abusing whichever substance it is they are abusing and join the twelve-step program or they have such heavy addiction problems that they have been court-ordered to take the program.
One of the largest criticisms around the twelve-step programs is their belief in a higher power. This is makes it difficult for the program to have any sort of universal appeal. Another criticism is about the efficacy of the programs. Some seem to work well whiles others do not seem to have high success rates. For instance, Alcoholics Anonymous’s members have a 40% success rate after the first year. Of this 40%, there is an 80% after the second year. And in 5 years time there is a 90% success rate of those 80%.