Twelve-step programs

AA was founded in 1935; NA followed in the 1950s. The twelve steps are a sequence of recovery actions — admitting powerlessness, taking a personal inventory, making amends, and ongoing maintenance — practiced individually and with a sponsor. Meetings are peer-led, free, and widely available; most cities have multiple meetings every day.

The research on twelve-step programs is stronger than many people assume. A major 2020 Cochrane review of AA found outcomes equal to or better than CBT for alcohol use disorder at twelve months and beyond, especially when combined with twelve-step facilitation therapy.

Luxury residential programs relate to twelve-step in different ways. Some are built around it; others offer it as one option among several; a few are deliberately secular and use SMART Recovery or refuge recovery instead. The right fit depends on the person. A program that forces one model regardless of the client's preference tends to produce worse results than one that meets them where they are.