Why the 12-step program doesn't work
This paper by Cathleen A. Mann examines the shortcomings of the 12 steps program.
In summary, AA operates in a cult-like fashion, and does not consider the individual differences of the person entering the AA program. Additionally, AA has been atheoretical, anti-medical, and anti-research since its inception in 1935.
Mann, Herman & Heinz (2000) state that pharmacological treatment of addiction in general have had the most success.
Relapse is viewed as "neuroadaption, sensitization, and monoaminergic dysfunction," all occurring physically within the brain and having nothing to do with acceptance or, or lack thereof, a spiritual awakening.
Criticisms of the AA:
Highly male dominated in administration.
Makes no provision for non-religious or atheists.
Antipsychotherapy and anti-medication (Ketcham, Asbury, Schulstad & Ciaramicoli, 2000).
It has not adapted in the light of new research over the last 65 years.
Despite evidence to the contrary, the AA believes that alchoholism has a moral cure.
According to Trimpey (1998), AA is cult-like in its approach.
From article: Therapeutic groups versus 12-step groups: An analysis of the AA prototype, by Cathleen A. Mann
The 12-step programme only appears to help a small percentage of the population. Drop out rates are over 90%.
According to psychologist Marc Kern, the AA's treatment has not kept up with current research. According to Dr. Alan Marlatt, the idea of abstinence keeps most alcoholics out of treatment. Richard Banton, who followed the AA program for six years, felt like a social outcast while in treatment. Although sober, he was uncomfortable with the methodology. "[With AA], you are terrorized to fall into line... Anytime you say anything that conflicts with their model, then you're in denial."
A study by RAND Corp. found that for some categories of alcoholic abstainers were at greater risk of relapse than moderate drinkers. This was backed up by research from Mark and Linda Sobell in the early seventies.
12 step programs may be contra-indicated for women with Post-Traumatic Stress Disorder. AA meeting may be too confrontational for some cases.
According to a report by Robert Westermeyer, PhD, the 12 step program advocates abstinence whereas research shows that for non-severe problem drinkers, moderation is an attainable goal. (Sanchez-Craig, et al.,1984; Miller et.al., 1980. 1981; Marlatt, 1989).
According to psychiatrist Lance Dodes, 12-step programs fail because they don't address the underlying problem behind addictive behaviour.
American medical association - bio-chemical addiction.
The spiritual based system of AA means that atheists object to the program. In 1990, Robert Warner was by court to attend AA. He sued the probation service saying that it was unconstitutional for him to be sentenced to attend the 12-step program, which relied on God and a "higher power" as its method of addressing alcoholism, and at which prayer was a regular feature. This article also discusses how AA is no more effective than other treatments.
According to Jack Trimpey - AA dropouts were afflicted with persistent self doubt and 'relapse anxiety, ' specifically related to their recovery group experience. Others also acquired a variety of emotional problems during their participation in AA.
According to Mitch Bailey 'AA is trapped in a sexist and classist time-warp.'
What works and what doesn't. Research has shown that other methods work better than AA.
Marc Kern had great difficulty with the religious flavor of the programme and the embarrassing public pronouncements.
The Stanton Peele Addiction Web site has a number of testimonials including "AA was helping me to continue to feel that I was a failure and unable to manage my own life, therefore I was unable to look at myself in a positive light."
AA member - coercive and manipulative.
Further testimonials can be found at
According to a review for this book, the 12-step program was written by and for a group of individuals of a specific gender and socio-economic group - WASPy men of the 1930's.
Many Roads One Journey: Moving Beyond the 12 Steps by Charlotte S. Kasl
Books about the failure of the 12-step plan.
The Real AA: Behind the Myth of 12-Step recovery.
"12 step" "reasons for failure" alcoholics
"12 step" antimedical
"12 step program" fail
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