[1] Since that time dozens of other organizations have been derived from AA's approach to address problems as varied as drug addiction, compulsive gambling, sex, and overeating.
[2] As summarized by the American Psychological Association (APA), the process involves the following:[1] Twelve-step methods have been adapted to address a wide range of alcoholism, substance abuse, and dependency problems.
Over 200 mutual aid organizations—often known as fellowships—with a worldwide membership of millions have adopted and adapted AA’s 12 Steps and 12 Traditions for recovery.
In 1946 they formally established the twelve traditions to help deal with the issues of how various groups could relate and function as membership grew.
[5][6] The practice of remaining anonymous (using only one's first names) when interacting with the general public was published in the first edition of the AA Big Book.
Variations in the languaging of the third step (which once spoke of making "a decision to turn our will and our lives over to the care of God as we understand Him"[12]) sometimes occur[13][14][15][16] to avoid gender-specific pronouns[citation needed] or to accommodate non-theistic beliefs.
[19] Alcoholics Anonymous' Twelve Traditions are:[7] In the twelve-step program, the human structure is symbolically represented in three dimensions: physical, mental, and spiritual.
[20][21] The process of working the steps is intended to replace self-centeredness with a growing moral consciousness and a willingness for self-sacrifice and unselfish constructive action.
[28] Publications from twelve-step fellowships emphasize that sponsorship is a "one on one" nonhierarchical relationship of shared experiences focused on working the Twelve Steps.
[35] Michel Foucault, a French philosopher, noted such practices produce intrinsic modifications in the person—exonerating, redeeming and purifying them; relieves them of their burden of wrong, liberating them and promising salvation.
[35][36] The personal nature of the behavioral issues that lead to seeking help in twelve-step fellowships results in a strong relationship between sponsee and sponsor.
[45] Some medical professionals have criticized twelve-step programs as "a cult that relies on God as the mechanism of action" and as lacking any experimental evidence in favor of its efficacy.
[46][47][48] Ethical and operational issues had prevented robust randomized controlled trials from being conducted comparing twelve-step programs directly to other approaches.
[47] More recent studies employing non-randomized and quasi-experimental studies have shown twelve-step programs provide similar benefit compared to motivational enhancement therapy (MET) and cognitive behavioral therapy (CBT), and were more effective in producing continuous abstinence and remission compared to these approaches.
[52] Statutes on group therapy do not encompass those associations that lack a professional therapist or clergyman to whom confidentiality and privilege might apply.