The 12 steps of Alcoholics Anonymous

Step 1 We admitted that we were powerless over alcohol—that our lives had become unmanageable. Step 2 Came to believe that a Power greater than ourselves could restore us to sanity Step 3 Made a decision to turn our will and our lives over to the care of God as we understood Him Step 4 Made a searching and fearless moral inventory of ourselves

Step 5 Admitted to God, to ourselves, and to another human being the exact nature of our wrongs Step 6 Were entirely ready to have God remove all these defects of character Step 7 Humbly asked him to remove our shortcomings

Step 8 Made a list of all persons we had harmed, and became willing to make amends to them all Step 9 Made direct amends to such people wherever possible, except when to do so would injure them or others Step Continued to take personal inventory and when we were wrong promptly to admit it 10

Step Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for

11 knowledge of His will for us and the power to carry that out

Step Having had a spiritual awakening as a result of these steps, we tried to carry this message to alcoholics and to practice

12 these principles in our affairs.

Only two randomized controlled studies of 12-step programmes have been conducted. One compared inpatient treatment (with fewer hours of psychotherapy than many such programmes) with a 12-step inpatient programme (with slightly more hours of therapy). There was a non-significant trend towards a greater total abstinence programme and less relapse in the 12-step programme. (35 In Project MATCH, patients were randomly allocated to cognitive-behavioural therapy, motivational enhancement therapy, or '12-step facilitation', which instructed patients in the tenets of AA, and assisted and encouraged them to attend AA meetings. The three treatments resulted in similar outcomes after 1 and 3 years. However, for those who had been relatively free of psychiatric problems at entry to the study, 12-step facilitation was associated with slightly better outcomes after 1 year. After 3 years the 12-step facilitation led to better outcome for patients who, at entry to the study, had family, social, or work environments bringing them into frequent contact with drinking.(36)

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