The Big Book debuted AA's suggested—but not required—twelve steps as a continuing sobriety program of prayer, reflection, admission, better conduct and atonement, all to produce a "spiritual awakening" followed by taking others—usually sponsees—through the steps. Integral to the steps is divining and following the will of an undefined God—"as we understood Him" or a “ higher power"—but differing practices and beliefs, including those of atheists, are accommodated.[8]
To keep sobriety as its primary purpose, and to remain what Wilson called a “benign anarchy”, AA instituted its twelve traditions in 1950 to ensure membership to all wishing to stop drinking with no dues or fees required. Members are advised not to use AA for material gain or to increase public prestige. All memberships are to be kept anonymous, especially in public media, but for broken anonymity, no consequences are prescribed. The traditions have AA steering clear of hierarchies, dogma, public controversies, while other outside entanglements or acquisition of property are to be avoided. To stay independent and self-supporting, the traditions would have AA groups accepting outside contributions from no one.[14][15]
For all demographics, a 2020 scientific review found clinical treatments increasing AA participation via AA twelve step facilitation (AA/TSF) had sustained remission rates 20-60% above well-established treatments. Additionally, 4 of the 5 economic studies in the review found that AA/TSF lowered healthcare costs considerably.[a][17][18][19] Regarding the disease model of alcoholism, despite scattered allusions in AA literature an otherwise receptive AA has not endorsed it. Its association with AA, as well as a good deal of its broader acceptance, stems from many members propogating it.[20]
With AA’s permission other recovery fellowships such as Narcotics Anonymous and Al-Anon have adopted and adapted the twelve steps and traditions.[21]
^ abAA Grapevine (15 May 2013), A.A. Preamble(PDF), AA General Service Office, archived(PDF) from the original on 9 October 2022, retrieved 13 May 2017
^Chappel, JN; Dupont, RL (1999). "Twelve-Step and Mutual-Help Programs for Addictive Disorders". Psychiatric Clinics of North America. 22 (2): 425–46. doi:10.1016/S0193-953X(05)70085-X. PMID10385942.
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