Why 12 Step Programs Don't Work for Everyone

There’s a funny situation that regularly comes up in Alcoholics Anonymous (AA) communities. Someone will talk about a PTA meeting, church retreat, or company recruiting event where they accidentally introduced themselves as an alcoholic as everyone was going around the circle and saying their names. “My name is (so-and-so), and I’m an alcoholic” — for people in AA, the words become so natural that they come out automatically.

And yet these words are some of the hardest to say that first time. For many people, it’s the worst-case scenario: maybe they’re court-ordered to attend AA meetings after receiving a DUI, or maybe they’re introduced to the program at a detox facility or even in prison. And while a lot of people find relief, support, and recovery in 12-step programs, they don’t work for everyone — and that’s completely okay. So what is a 12-step program? And what are some alternatives to 12-step programs if you decide they’re not your thing? Let’s find out!

What Is a 12-Step Program?

First, let’s take a brief look at the story behind 12-step programs and their original founder, as well as the basic philosophy of recovery it’s based on.

Who Is Bill W.?

Back in the 1930s — in the heyday of Prohibition — salesman and military officer Bill Wilson found himself in trouble. Bill W., as he came to be known, couldn’t stop drinking. With doctors having given up on him, he was apparently headed for an imminent death, but he had a spiritual awakening, lost his desire to drink, and founded a peer-based nonprofit program called Alcoholics Anonymous (AA) together with his friend, physician Bob Smith. 

While Bill W.’s work has undoubtedly benefited many people — and was well-intended — it’s worth noting that Bill himself was a bit of a shady character. As a womanizer and serial 13th-stepper — an AA colloquial term for older male participants going after younger female members — he couldn’t prevent his views of women from seeping into the pages of the Big Book. Whether or not that discredits any of the information inside (and to what degree) is for everyone to decide for themselves.

What Are the 12 Steps?

The program itself was originally based on the Big Book of Alcoholics Anonymous written by Bill W. The book begins with Bill’s own story and outlines the core principles that he saw as central to his recovery as the “12 Steps.” Traditionally, members “work” the steps with a sponsor — an experienced group member who has completed the 12 Steps and has been sober for some time.

The 12 Steps themselves are a list of core principles that serve as a roadmap to recovery, AA-style. Here’s a brief rundown:

Admitting powerlessness. The first three steps introduce the idea of powerlessness over alcohol and introduce the concept of a “Higher Power” that can help “restore sanity” to what has become an “unmanageable” existence. While traditionally the “Higher Power” was synonymous with God, these days there’s a lot more flexibility — it can be anything from a different deity to the community of AA itself.

Listing character defects. Steps 4-7 deal with the so-called character defects — a broad term that encompasses resentments and any personal traits that might drive a person to drink. The idea is to make a “moral inventory” that lists these defects, then go over them with a sponsor and ask the Higher Power to remove them.

Making amends. This is perhaps the most publicized part of the 12 Steps: the so-called “amends” that call for members to tie up the many loose ends alcohol has created in their lives and personal relationships. Contrary to some popular misconceptions, amends are not “apologies” — they’re heart-to-heart conversations that often involve admitting our wrongs, but that are mostly meant to resolve anything that’s left unresolved. That said, when wrongs have been done, members are encouraged to do their best to correct them, whether that means apologizing or making financial restitution.

Continuing on the path of spiritual growth. The final steps call for a continued commitment to sobriety, fostered by prayer and meditation. They also mention the importance of admitting our wrongs as quickly as possible to avoid the emotional traps that contributed to our drinking patterns.

These days, AA has gone global, and the 12 steps have been applied to other forms of addiction, such as drugs (Narcotics Anonymous), eating disorders (Overeaters Anonymous), gambling (Gamblers Anonymous), and many others.

What Happens at Meetings?

Some meetings are open to the public, while others only admit those who identify as alcoholics. The format itself can also vary:

• Speaker meetings. In “speaker meetings,” a member will start off by telling their story with others sharing their thoughts afterwards.
• Discussion meetings. These are usually round-robin discussion meetings with members sharing thoughts about a particular topic — for example, “gratitude” or “resentments” — or just talking about whatever is important to them at the moment. It's a format that encourages interactive sharing and collective support.
• Step or tradition studies. These meetings focus on studying and discussing the specific steps or traditions of the program in detail, usually analyzing the step's meaning and its practical application in daily life.
• Big Book or literature meetings. As the name suggests, participants talk about specific literature or texts considered foundational in the program, such as the "Big Book" in AA. 
• Online or virtual meetings. A product of the digital age, online meetings became especially popular during COVID when in-person meetings were largely unavailable. 

Does AA Work?

What is the success rate of AA and other 12-step programs? The truth is, it’s really hard to tell. Some people stay sober for years while continuing to go to meetings — they tend to attribute their success to the program and believe that it can truly work for anyone (“It works if you work it,” as they say). There’s a bit of a chicken-and-egg dilemma here, though: would these 12-step advocates have gotten sober without AA? There’s just no way of knowing. Would they have stayed sober if they left the group and found another way to support their recovery? Perhaps.

There’s also a statistic that has been floating around, one that claims AA only works “5% of the time.” Its origins (and veracity) are a bit of a mystery, since it’s difficult to quantify “recovery rate” in the first place. With many different components and variables at play, it’s hard to come up with a single definition of what “recovery” even is — let alone figure out a way to measure it. 

In the end, it’s simple: recovery is personal, and what works for some of us might not work for others. 

When AA Works: The Helpful Aspects

• Success stories serve as “proof of the pudding.” Many people come to 12-step meetings at the most desperate point of their lives, having “hit bottom” (to use an AA term). Simply seeing dozens (or even hundreds at some meetings) of people who attest to being happily sober for an extended period of time offers a glimmer of hope and motivation to keep going in the hope that, one way or another, the same can happen for them, too. 
• The meetings offer a different way to see alcohol. Another preconception that many bring to their first meeting is that there’s no way to see alcohol as anything other than essential. And while there might be some problems and scientific inconsistencies with AA’s views (more on that later), this can be an important revelation for someone who has developed a dependency on alcohol.
• The community can provide crucial support, especially in the early days. One of the best aspects of 12-step programs is the community support they provide. While meeting cultures vary by state (and country, since they’ve gone international), there’s bound to be someone who will talk to a newcomer and offer their support (for example, by inviting them to talk over coffee after the meeting or exchanging phone numbers so the newcomer can call if they find themselves having an irresistible craving). This type of warmth and companionship can serve as a lifeline for many, whether or not they end up staying in the program.
• The structure and routine of the program can be helpful in the early days. At the beginning, staying sober for those who have been drinking heavily for a long time is usually a matter of figuring out what to do on a daily (or hourly) basis. Early recovery is disorienting, and AA’s clear, step-by-step process can be reassuring, offering a roadmap to follow. The routine meetings and regular check-ins help maintain focus and accountability, which can help.
• The self-reflection aspect introduces a component of mindfulness. The deep self-reflection encouraged by the program can lead to self-awareness and insights. This introspection — as well as the prayer and meditation emphasized in later steps — is a science-backed way many have found useful when trying to abstain from alcohol.
• The frequency and anonymity of the meetings make them accessible. The fact that 12-step meetings are open to anyone anywhere and that they are anonymous and provided at no cost makes them extremely accessible. This can be a lifeline for people in crisis, such as people experiencing a strong craving or difficult domestic or financial situation, since many other forms of treatment take some time to set up.

When AA Doesn’t Work So Well

• The all-or-nothing approach to sobriety can be too restrictive for some. While some meetings and communities offer more leeway than others, overall there’s not much wiggle room when it comes to options in exploring sobriety as a lifestyle choice. Someone inspired by the sober-curious movement rather than by a commitment or medical need to get sober might quickly feel alienated or be told (sometimes implicitly) that they are in “denial” of their “problem.” 
  
  Having to identify as an “alcoholic” and committing to a zero-alcohol lifestyle is bound to leave a large portion of people questioning their alcohol use. While many come to programs like AA after clearly reaching a point where alcohol poses a direct threat to their lives, many are not at that stage. Luckily, today, there are many other options available! (More on this in the following section.)
• The focus on what NOT to do can be limiting. For some people — especially at the beginning — the emphasis on not drinking “no matter what” can be helpful, refreshing, and even life-saving. However, it’s hard to build a fulfilling life based on something we’re trying to avoid. A meaningful life is a creative process, and building it requires enriching experiences, memories, conversations, and thoughts that cover a range of topics or interests. 
  
  For that reason, many find that while initially the single-minded focus of 12-step programs is relevant to them — because, let’s face it, for those whose alcohol use has crossed the line into addiction, the number one priority becomes getting sober — eventually they find themselves outgrowing it. And while this natural progression unfortunately can be met with criticism by some hardcore AA members, it’s perfectly okay!
• Varied preferences. Just as in all aspects of life, people have different preferences. Some may prefer group settings, while others might find success in more individualized treatments.

Options in Recovery: Alternatives to 12-Step Programs

Recovery is a personal journey. And there are many ways to get there! Let’s explore some alternatives to 12-step programs to get an idea of the spectrum of recovery options available today.

• Support groups beyond 12 steps. While 12-step programs might be the most widespread of the bunch, many other support groups are tailored to different philosophies and needs. For example, SMART recovery, which stands for Self-Management and Recovery Training, focuses on a more science-based, rational approach while still providing the sense of community of traditional 12-step programs.
• Mindfulness-based approaches. Mindfulness is all about engaging with the present moment and our experience with it, including observing our own thoughts and cravings. Holistic therapies include yoga, meditation, acupuncture, or art therapy. These approaches aim to align mind, body, and spirit, providing a serene foundation for recovery.
• Individual counseling. Meeting with a licensed therapist in one-on-one sessions tailored to our needs can be one of the safest, most effective ways to explore the role of alcohol (and addiction in general) in our lives. The conversations can take different forms, ranging from traditional talk therapy to motivational coaching, cognitive behavioral therapy (CBT), or dialectical behavioral therapy (DBT).
• Technology-based tools and programs. With the rise of digital health, we now have more options than ever, including apps such as Reframe, online therapy, and virtual support groups. These tools are at our fingertips (or in our pocket), ready to cheer us on and provide daily science-backed information and tools to help us on our journey with alcohol — whether we’re trying to cut back or leave it behind completely. Plus, there’s often a built-in community aspect that can provide the support many seek when initially trying out 12-step programs.

Crafting a Personalized Recovery Plan

These steps can help you find a recovery path that works for you.

• Start by defining your goals around alcohol. Think critically about how alcohol fits into your life and what you want to change.
• Build a support system. A strong network of friends, family, or professionals who understand and support your recovery goals can make a big difference.
• Explore different options and make a concrete plan. Clarity is important — even though you might change your plan later on, for now, decide which option you want to try and give it a chance. If it doesn’t work, you can always try something else.
• Reflect and adjust as you go. Keep track of what's working and what isn't. Recovery is an evolving process, and what worked at the beginning might not work later on — look at the need for adjustment as a sign of growth. You’re getting closer to your goal!

A Way Forward

In the end, your relationship with alcohol is yours to define, and the key is finding a solution that works for you. Whatever path you choose, know that the very fact that you’re on this journey means you’re making progress to a healthier, happier version of yourself. There’s no such thing as “going backwards” or “starting back at square one” — even if you have to change course. 

In Recovery: Freedom From Our Addictions, comedian Russell Brand writes, “The feeling you have that 'there's something else' is real. What happens when you don't follow the compulsion? What is on the other side of my need [...]? The only way to find out is to not do it, and that is a novel act of faith.” Exactly how we embark on the adventure of finding out what’s on the “other side” is up to us — so let’s approach it in the spirit of curiosity and excitement. There’s so much to gain from exploring a life with less alcohol and absolutely nothing to lose.