12-Step Facilitation Therapy
About 12-Step Facilitation Therapy
12-Step Facilitation Therapy is an addiction treatment method designed to increase the likelihood that a person managing addiction becomes affiliated with and actively involved in 12-step self-help groups based both AA and NA. This method promotes acceptance, which includes the realization that drug addiction is a chronic, progressive disease over which one has no control, and that life has become unmanageable because of drugs. Generally, willpower alone is not enough maintain abstinence. This method also promotes surrender, which involves giving oneself over to a higher power, accepting the fellowship and support structure of other recovering addicted individuals. Lastly it promotes active involvement in 12-step meetings and related activities.
The 12 Steps
To understand our 12-Step Therapy Program, you should be familiar with the 12 Steps of Alcoholic Anonymous as well as the 12 Steps of Narcotics Anonymous.
The 12 Steps of Alcoholics Anonymous:
- We admitted we were powerless over alcohol–that our lives had become unmanageable.
- Came to believe that a Power greater than ourselves could restore us to sanity.
- Made a decision to turn our will and our lives over to the care of God as we understood Him.
- Made a searching and fearless moral inventory of ourselves.
- Admitted to God, to ourselves and to another human being the exact nature of our wrongs.
- Were entirely ready to have God remove all these defects of character
- Humbly asked Him to remove our shortcomings
- Made a list of persons we had harmed, and became willing to make amends to them all.
- Made direct amends to such people wherever possible, except when to do so would injure them or others.
- Continued to take personal inventory and when we were wrong promptly admitted it.
- Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out.
- Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics and to practice these principles in all our affairs.
The 12 Steps of Narcotics Anonymous:
- We admitted that we were powerless over our addiction, that our lives had become unmanageable.
- We came to believe that a Power greater than ourselves could restore us to sanity.
- We made a decision to turn our will and our lives over to the care of God as we understood Him.
- We made a searching and fearless moral inventory of ourselves.
- We admitted to God, to ourselves, and to another human being the exact nature of our wrongs.
- We were entirely ready to have God remove all these defects of character.
- We humbly asked Him to remove our shortcomings.
- We made a list of all persons we had harmed, and became willing to make amends to them all.
- We made direct amends to such people wherever possible, except when to do so would injure them or others.
- We continued to take personal inventory and when we were wrong promptly admitted it.
- We sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out.
- Having had a spiritual awakening as a result of these steps, we tried to carry this message to addicts, and to practice these principles in all our affairs.
Working the First Three Steps
Step 1. “We admitted we were powerless over our addiction, that our lives had become unmanageable.”
The client’s work on this step involves journaling about their drug use, with emphasis on the negative consequences, the progression of their symptoms, and failed attempts to control their drug use. This includes all of the associated problems that addiction has caused in their life. This exercise gives the clients insight into the severity of their problem, and the areas of their life it has affected. Through journaling, they begin to address and understand the need for abstinence in their life. They start to understand the benefits of a life free from chemical dependence.
Clients present their work within individual and group counseling settings, telling their stories and receiving feedback from their peers and therapists. In a group setting, they can listen to other clients present their work ahead of them, enabling them to be confident and able to achieve the necessary level of self-disclosure to share freely. This “common ground” provides a normalizing environment in which clients can truly benefit from the clinical experience. Group members provide support and acceptance to each other in this process, which proves helpful for clients who are struggling with the guilt, shame, and self-judgement associated with substance abuse behavior. Through this whole process, clients begin to feel empowered through the acceptance of their powerlessness over addiction.
Step 2. “We came to believe that a power greater than ourselves could restore us to sanity.”
Worksheets and treatment activities related to Step 2 guide the client through examining the role of mental defenses and judgement errors in their beliefs and behavior. The client is them in a position to clarify their values. Many clients are faced with clarifying religious beliefs to understand their personal concepts of spirituality. Some clients choose to suspend decisions about traditional religious beliefs and use the 12-steps fellowship itself as a “higher power” for purposes of their recovery. This step work is completed in group and individual therapy sessions.
Step 3. “We made a decision to turn our will and our lives over to the care of God as we understood Him.”
Work within a treatment program on Step 3 helps clients look at their commitment to recovery and puts into action a plan to permanently change their behavior. This step directly addresses the client’s ability to set aside egocentric self-will and accept a spiritual or ethical foundation for their lives.
Our 12 Step Therapy program is based on the steps and principals of Alcoholics Anonymous and Narcotics Anonymous. Below is a general outline of how we use the steps to confront the client with the negative aspects of their addiction, work to instill acceptance towards the process of addiction recovery, and work towards their commitment to recovery. For someone to receive help for addiction, the person must first want to break their addiction on some level. A person completely resistant to the process will commonly avoid any work related to this type of program. However, if the person has some desire to become clean and sober, working the steps may cause their desire to live a sober lifestyle grow and become higher in importance.
Treatment Goals and Objectives
12-Step Facilitation Therapy Goals
A 12-step facilitation therapy program has two major goals, which relate directly to the first three Steps of Alcoholics Anonymous.
- Acceptance by clients that they suffer from the chronic and progressive illness of addiction.
- Acceptance by clients that they have lost the ability to control their drinking or drug abuse.
- Acceptance by clients that, since there is no effective cure for addiction, the only viable alternative is complete abstinence from the use of drugs and alcohol.
- Acknowledgment on the part of the client that there is hope for recovery and sustained sobriety through accepting the reality of loss of control and by having faith that a Higher Power can help them.
- Acknowledgment by the client that the fellowship of AA/NA has helped millions of addicts sustain their sobriety and that the client’s best chances for success are to follow the AA/NA path.
12-Step Facilitation Therapy Objectives
The two major treatment goals are reflected in a series of specific objectives that are congruent with the AA or NA view of alcoholism and drug dependence.
- Clients need to understand some of the ways in which their thinking has been affected by drug abuse or alcoholism.
- Clients need to understand how their thinking may reflect denial which will contribute to continued drinking or drug abuse and resistance to acceptance.
- Clients need to see the connection between their drug or alcohol abuse and the negative consequences that resulted from it. These consequences may be physical, social, legal, psychological, financial, or spiritual.
- Clients need to understand the AA/NA view of emotions and how certain emotional states (e.g., anger, loneliness) can lead to drinking and drug abuse.
- Clients need to be informed regarding some of the practical ways AA/NA suggests for dealing with emotions so as to minimize the risks of drinking and drug abuse.
- Clients need to understand how the powerful and cunning illness of alcoholism has affected their whole lives and how many of their existing or old habits have supported their continued drinking.
- Clients need to turn to the fellowship of AA/NA and to make use of its resources and practical wisdom in order to change their behavior.
- Clients need to “get active” in AA/NA as a means of sustaining their sobriety.
- Clients need to attend and participate regularly in AA/NA meetings of various kinds, including AA/NA-sponsored social activities.
- Clients need to obtain and develop a relationship with an AA/NA sponsor.
- Clients need to access AA/NA whenever they experience the urge to drink, use drugs, or suffer a relapse.
- Clients need to reevaluate their relationships with “enablers” and fellow addicts.
- Clients need to experience hope that they can arrest their addiction.
- Clients need to develop a belief and trust in a power greater than their own willpower.
- Clients need to acknowledge character defects, including specific immoral or unethical acts, and harm done to others as a result of their addiction.
This facilitation program is very structured, with each session having a specific agenda and following a prescribed pattern. Clients are asked to keep a personal journal. Each session includes specific “recovery tasks”. These are suggestions made to patients for reading, and action to be taken between sessions. Therapists will suggest reading material drawn from AA/NA Conference-approved texts. Central to this approach is strong encouragement of the client to attend several AA/NA meetings per week of different kinds and to read the “Big Book” (“Alcoholics Anonymous”) as well as other AA publications throughout the course of treatment.