The effectiveness of 12 step groups varies widely, and is dependent on so many factors that it is difficult to study 12 step groups scientifically and accurately. Obviously, these groups work for some people, or they would not be so popular, but they also fail for large numbers of others, for a variety of reasons. Ultimately, joining a 12 step group should be considered only one aspect of treatment, to encourage people to use as many resources as possible when they attempt to cope with a problem like drug addiction, codependency, alcoholism, or gambling addiction.
Alcoholics Anonymous (AA) was the first 12 step group, and in 1939, the original Twelve Steps were published, leading people to adapt them to other forms of addiction as well. Since 1939, huge numbers of people have “worked the 12 steps,” moving through the process with a supportive group. Membership in a 12 step group requires regular attendance at meetings, the selection of a personal sponsor to assist with the process, and a belief in the spiritual principles of the 12 steps.
In studies of 12 step groups, researchers are faced with several problems in evaluating effectiveness. The first is that study subjects are self-selected, rather than random, and many of them obviously join such groups because they recognize a problem and want to work on it. A control group is also not possible with a 12 step group, making it hard to create a basis for comparison, and researchers also recognize that a number of factors can influence someone's recovery from addiction, ranging from genetic predisposition to social pressure.
In long-term studies on 12 step groups, researchers have found that around 95% percent of participants drop out in the first year. After the first year, commitment among the remaining five percent tends to be much stronger, and the attrition rate drops sharply. For those among this five percent, obviously 12 step groups really do work. However, the success rate is comparable to other methods of addiction treatment, so it has been suggested that 12 step groups are no more or less effective than other recovery programs.
Ultimately, 12 step groups are as effective as their participants want them to be. For some people, the approach of a 12 step group simply does not work, and participation in such programs will be of limited benefit, although other treatment programs could be very effective. For others, the spiritual approach and focus on group support is ideally suited, and they may do very well in 12 step.