12-Step Facilitation Therapy

In the process of treating an addiction, therapeutic methods are crucial. Therapy can help the individual to identify and evaluate the underlying beliefs, characteristics, and damaging experiences that contribute to the development of an addiction, with the goal of eventually overcoming them. Twelve step therapy (TSF) is one approach to assisting addicts in doing so.

12 Step SmallTwelve Step Programs

A number of public and private substance treatment centers use twelve step philosophy to combat addiction. Often, this program is introduced following detoxification and is implemented as a support system for recovering alcoholics and addicts. Since its humble beginnings in 1935, Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) have grown to consist of more than 73,000 groups around the world. Twelve step therapy is an extension of these types of programs.

Elements of TSF

TSF can be applied to alcohol abuse, alcoholism, drug abuse, and other addiction-based problems. It is brief and highly structured, involving between twelve and fifteen sessions that may take place with an individual client or in a group therapy setting. TSF is based on the principles of twelve step programs, which address the cognitive, spiritual, and behavioral aspects of the individual and how they are tied to addiction. In addition, twelve step philosophy posits that willpower alone is not enough to sustain sobriety over time. Long-term recovery must consist of reaching out to others and undergoing spiritual renewal.


In TSF, clients are given two main goals. The first goal is accepting the need to abstain from alcohol and/or drugs. This involves making the realization that drug addiction cannot be controlled; it is a progressive, chronic disorder that cannot be stopped by willpower alone. The second goal is surrendering or making oneself willing to participate in a twelve step program in order to maintain sobriety in the long-term. This goal also involves accepting the support of other individuals in twelve step programs as a way of facilitating recovery.

Process12 Step Large

A TSF-trained counselor completes an initial assessment of the clients drug and alcohol use. He or she then acts as an advocate for abstinence and describes the basic pillars of twelve step philosophy to the client. The therapist helps to facilitate the clients integration and participation in an AA or NA group. The therapist may also offer pertinent resources to the client as issues arise.


There is currently a lack of research evaluating twelve step programs, in spite of the fact that they have been a prevalent form of therapy for quite a few decades. This is in part due to the aspect of anonymity that is emphasized in AA and NA groups. What little research exists has indicated that AA is a successful way for recovering alcoholics and drug abusers to find a supportive community. AA and NA programs have to date helped millions of people around the world to cope with substance abuse. It would stand to reason then, that twelve step facilitation therapy is a promising way to extend this type of treatment to those who are in need.