Most 12-Step programs are modeled on the format of Alcoholics Anonymous, or AA, which is a fellowship of men and women who struggle with alcohol abuse and/or addiction and wish to remain sober. AA is nonprofessional, nondenominational group, and it is not affiliated with any political groups. It is free to join. Groups are self-sustaining and do not receive any outside funding.
Membership is open to anyone with alcohol abuse issues who wants to stay abstinent on a long-term basis. People do not have to do anything prior to attending a meeting; they can just show up. Attendance is kept confidential, and individuals are welcome to attend as many different group meetings as they desire. Meetings are typically an hour to 90 minutes in length.
As an international organization, AA holds meetings in over 180 countries and, in 2015, there were over 2 million estimated members and more than 115,000 AA groups meeting. Other 12-Step programs include Cocaine Anonymous (CA), Narcotics Anonymous (NA), and Marijuana Anonymous (MA) to name a few. There are specialty 12-Step groups for adolescents, the elderly population, LGBT individuals, men only, women only, or those suffering from co-occurring mental health disorders.
Finding a Meeting
With so many meetings around the world, individuals in recovery are likely to find meetings locally that are easy for them to attend. Substance abuse treatment providers may even provide transportation to and from meetings, and childcare may also be available. To find a local AA meeting, individuals can use the resources on the AA website. Mental health and substance abuse providers likely have current information on local groups, as do state or county behavioral health agencies.
Meetings for 12-Step groups are often held in public places like at churches. While groups do not affiliate themselves with any particular religion, they are inherently spiritual in nature, asking members to give themselves over to a higher power. The 12 Steps include admitting powerlessness over drugs or alcohol, requesting help from a spiritual being, taking a personal inventory, making amends, having a spiritual awakening, and sharing this information with others in recovery. As a peer support group, 12-Step groups are made up of individuals in recovery who help each other to remain abstinent and avoid relapse.
Typical 12-Step Meeting Format
Individual groups may differ slightly in the way they run meetings, but in general, a typical format for a 12-Step meeting is as follows:
- Welcome and opening
- Moment of silence and recitation of the Serenity Prayer
- Explanation of 12-Step values, expectation of confidentiality, and reiteration of openness to all and no cost for membership
- Reading from the Big Book, 12 Traditions, or 12 Steps
- Introductions around the room (first name only, though no one is required to speak)
- Introduction of the speaker or facilitator of the meeting
- Passing of the collection plate, donations are not required although this is how the group sustains itself
- Closing, most likely with a prayer
As 12-Step meetings are meant to be a fellowship, there is also often coffee and refreshments at some point either before, during, or after the meeting for networking and socializing. Members may choose to volunteer at 12-Step meetings as coffee servers, greeters, or collection plate passers, or they can get more involved volunteering as the group’s secretary, treasurer, chairperson, etc.
Those who have been in recovery for a long period of time may become a “sponsor” for newer members. The veteran member, or sponsor, can offer encouragement around the clock, helping to provide in-the-moment support when needed. Sponsors are available 24 hours a day, seven days a week, usually by phone, to help sponsees get through potentially difficult situations, temptations, or triggering events. Sponsors may meet or check-in with their sponsees regularly, and lifelong relationships may be formed.
Twelve-Step groups are safe environments free from drugs and alcohol where individuals are surrounded by others with the same goal of sustained recovery and abstinence. These meetings can provide individuals with a network of sober peers who can understand and empathize with each other in ways that others who are not in recovery may not be able to as easily.
Types of 12-Step Meetings
In general, there are two main types of meetings: open meetings and closed meetings. An open meeting is just that, open to anyone who wishes to attend, from family members to members of the community to treatment providers and more. Closed meetings are for individuals battling addiction or substance abuse only, as these meetings are meant to be a place for people to share personal experiences, circumstances, and hardships related to their substance abuse, which are expected to remain confidential within the group. Twelve-Step meetings provide moral support from other individuals who have been there and can therefore offer advice and support based on personal experience and knowledge.
Peers who have been sober for a long period of time may be excellent sources of hope and encouragement for individuals who are just starting out in recovery. The same is true in reverse, as it can be uplifting for individuals to feel that they are able to “give back” and help others in similar situations. The National Survey on Drug Use and Health (NSDUH) reports that in 2014, over 21 million people in the United States who were at least 12 years old, battled a substance use disorder. These peer support groups can help people to realize that they are not alone, thus dispelling the social withdrawal and isolation that often comes with addiction.
In addition to just open and closed meetings, 12-Step meetings may follow a couple of different formats, as explained by AA, such as:
- Discussion meetings: Likely the most common format, the chairperson or leader of the meeting will choose a topic, most likely from AA literature, to discuss during the meeting. These meetings may be open or closed.
- Beginner meetings: These meetings are led by a veteran member who has been sober for a long period of time and may follow the discussion format while focusing on the first three of the 12 Steps, or it may be more of a question-and-answer type format.
- Speaker meetings: Members who have been sober for a minimum period of time may be chosen beforehand to share their past experiences and how working through “The Program,” as AA’s 12 Steps and Traditons may be referred to, has helped them get to where they are today. These meetings are often open to the public.
- Big Book, 12-Step, or 12-Tradition meetings: A reading from one of these texts is shared and worked through during the meeting. These meetings are usually held in a rotation as the Steps or Traditions are worked through. Individuals may use workbooks and texts during the meeting or for homework assignments.
- Service meetings: These may be information meetings about service opportunities within the group or reports on service activities the group has performed.
- Group inventory meetings: Members work to determine if the group is fulfilling its purpose and functioning effectively.
- AA Grapevine meetings: Discussions are held based on topics from AA Grapevine, which is the international journal of AA.
- Business meetings: Generally, these meetings are for the members involved in the business aspects of the group. They may also include the group in electing officers or other group business needs.
Individuals can attend any type of meeting they wish and as many as they like. Individuals likely will find a home group and attend these meetings at least on a weekly basis throughout recovery. While it may be difficult to quantify the effectiveness of 12-step programs, studies published in the Journal of Addictive Disorders have indicated that individuals who attend AA meetings regularly for a long period of time are more likely to remain abstinent than those who don’t attend.