Maintaining recovery from substance use-disorder, alcoholism and addictions can be difficult regardless of age. Whilst there are many studies showing 12 step fellowships to be beneficial to adults in recovery, the data around the same subject, for young adults and teenagers, is limited. However, Dr. John F Kelly has recently conducted a study which shows that a recovery treatment plan using aspects of the 12 step approach, engaging adolescents in step work, sponsorship and active attendance at meetings, can have a positive impact and help to sustain long term abstinence.(1)
Many residential rehabilitation facilities and outpatient treatment programs will incorporate attendance at 12 step fellowship meetings where possible and sometimes even include some 12 step work in their clients treatment plan. Long seen as an essential working element of recovery by many professionals within the field of addiction, 12 step fellowships and meetings are readily accessible worldwide with millions of members maintaining sobriety.
Conceived in 1939, the 12 Steps of Alcohol Anonymous are now widely used to successfully address the many forms of addiction that present in today’s society. Alcohol Anonymous was started by two alcoholics, who realised that no one can support an alcoholic better than another alcoholic. This ethos helped to design a program to enrich the lives of those suffering with alcoholism and has enabled AA to grow into what it is today. Currently AA has an estimated two million members worldwide with 118,000 active groups, not to mention the many offshoots of AA like NA, CA, CoDA, and many, many others. All fellowship groups that follow similar traditions and the original, adapted for the addiction they are addressing, 12 steps of AA.
Barriers to the Participation of Youth in the 12 Step Fellowship
Some people may have an idea of what a 12 Step fellowship meeting may look like. Television and films portray dimly lit church halls with melancholic old alcoholics, however this is not an accurate depiction of fellowship meetings, nor does it show the far reaching positive influences being part of a recovering community can have. This misrepresentation however can be enough to seep into the social psyche and add to the stigma often attached to recovery circles. This depicted age demographic could definitely be seen as a barrier when considering why attendance by adolescents is low at 12 Step Fellowship meetings. Narcotics Anonymous has only 2% of attendees under the age of 20 and Alcohol Anonymous, according to a 2011 membership study, have only 2% under 21 years old.(2)
There have been efforts to address this problem in recent years, many meetings are now age specific for young people, aimed at providing a safe supportive space where those attending can get some form of relevant identification, an important aspect of any 12 Step fellowship meeting. Studies have indicated that when adolescents attend meetings with others of a similar age, rather than adult only meetings, the likelihood of engagement and sustained attendance is greatly increased.(3)
The Benefits of 12 Step Meeting Attendance for Youth
The benefits of attending a 12 Step fellowship are plentiful. Addiction is an isolating condition. Many users will withdraw from immediate family, social circles and positive peer groups. For adolescents, a substance use-disorder in their formative years can create developmental barriers that can be difficult to overcome. Fellowships offer a sober social structure, where people who have endured and conquered addiction issues provide support, guidance and advice. Social events for sober people are often held outside of meetings too. Working through the steps with a sponsor can really help with connection, regular contact is encouraged, as is meeting attendance. It helps to foster a togetherness and a common goal with others who attend meetings. Becoming involved with a fellowship meeting by way of service is considered another pillar of the 12 Step philosophy, being able to give back to a meeting can give a young person a sense of purpose that will likely have been taken away during addiction. Newcomers to meetings often help to put the chairs out or away, clean up or make coffee or tea. What seems on the outside a menial task can help a newcomer to feel part of something, integrating them into the protective social circle of the meeting.
A study undertaken in 2008, aimed to see what adolescents actually thought about 12 Step fellowship groups, found that young people responded positively to the social dynamic within these established groups, finding support and encouragement to stay sober, as well as identification through the experience of other members.(4) It is this group setting that can help reduce feelings such as depression, shame and alienation. All benefits to group therapy depicted in Yalom’s book, The Theory and Practice of Group Psychotherapy.(5)
How We Can Help Young People Engage
Although engaging adolescents in 12 Step fellowships has historically been a problem, we have already discussed how some of the barriers can be overcome. Many of the 12 Step organizations in existence now produce literature targeted towards young people in order to combat the lack of engagement within this demographic. They have compiled age appropriate recovery testimonies, designed with the hope that the young reader can identify and relate, and that he or she may then want to attend a 12 Step meeting thereafter. The famous AA big book has been rewritten and is now available in most bookstores and online. It’s called The Big Book Unplugged: A Young Person’s Guide to Alcoholics Anonymous. Meetings that now require the attendees to be under a certain age can be found in many towns and cities worldwide. It has been shown that for adolescents, sustained attendance and engagement, and therefore maintenance of sobriety, is more likely when they are among peer groups of their own age.(6)
As a professional working with a young client, researching information about 12 Step Fellowships in the patients surrounding area is an important part of the process. Knowing which fellowships are available, where they meet and the number of young people that attend is important before advising attendance. Understanding what happens inside a fellowship meeting will help you to explain the format and manage expectations. You may also be able to find someone who already attends and would be happy to accompany your client and help make them feel more comfortable.
The first 90 days of a person’s recovery are crucial. Whether or not they’ve been to treatment, encourage them to go to meetings and engage as much as possible. If you personally have not been to a fellowship meeting before, and would like to learn more firsthand, it is possible to visit as a professional. Meetings will be listed online as open or closed. An open meeting means non addicts/alcoholics, whether family members, professionals or simply interested members of the public, are welcome to attend.
The final point to mention in this article, is the importance of the family unit in the recovery journey of a young person. This includes the part they can play in helping an adolescent engage in the 12 step fellowship. They can help overcome barriers such as difficulty getting to and from meetings by offering rides and even attending some meetings with their young person. There are also 12 step support groups for families affected by the addiction of a loved one such as Families Anonymous, Al-Anon or Nar-Anon. These fellowships use the 12 step format, and as well as offering much needed time, space and identification for a family supporting someone with addiction issues. They also enable parents and families to learn more about the 12 steps and the untold benefits they, and the meetings, can have for their child’s recovery.
1) John F. Kelly et al, A Pilot Randomized Clinical Trial Testing Integrated Twelve-Step Facilitation (Itsf) Treatment for Adolescent Substance Use Disorder, Addiction (2017). DOI: 10.1111/add.13920
2) Labbe, Allison K et al. “The importance of age composition of 12-step meetings as a moderating factor in the relation between young adults’ 12-step participation and abstinence.” Drug and alcohol dependence vol. 133,2 (2013): 541-7. doi:10.1016/j.drugalcdep.2013.07.021
3) Leonard, J. (2013). Adolescents and the Twelve Steps. Hazelden Betty Ford Foundation. www.hazelden.org/web/public/adolescents-and-the-twelvesteps.page (accessed 22/11/2019)
4) Kelly JF, Myers MG, Rodolico J. What do adolescents exposed to Alcoholics Anonymous think about 12-step groups? Subst Abus. 2008;29(2):53-62. doi: 10.1080/08897070802093122. Epub 2008 Aug 17. PubMed PMID: 19042324; PubMed Central PMCID: PMC3811164.
5) Yalom, I. D., & Leszcz, M. (Collaborator). (2005). The theory and practice of group psychotherapy (5th ed.). New York, NY, US: Basic Books.
6) Leonard, J. (2013). Adolescents and the Twelve Steps. Hazelden Betty Ford Foundation. www.hazelden.org/web/public/adolescents-and-the-twelvesteps.page (accessed 22/11/2019)