Twelve step meetings aren’t group therapy.

The Differences Between Group Therapy and 12-step Meetings

 Before I actually went to some open 12-step meetings, I thought they would be like group therapy meetings. However, 12-step meetings have basic differences from group therapy meetings.

 Twelve-step meetings are free. Most group therapy costs some amount of money.

 Members don’t give advice to each other. Or at least, experienced members of Narcotics Anonymous and Alcoholics Anonymous don’t tend to give advice to each other. Instead, members share their own experiences. They tell about what worked for them, and what didn’t work.  The topic is often about how to get through situations without using drugs or alcohol, but may also be about how to live with difficult life situations, and still retain one’s serenity.

 In group therapy, members are encouraged to give advice, or feedback, to other members. Some treatment centers believe that alcoholics and addicts must be confronted, so that denial can be broken through. Twelve-step meetings don’t take this stance. Instead, members offer their own experience, freely and without expectations. It’s a subtle difference, but important. Other 12-step members don’t assume they know what another person should do about life decisions; they simply offer their own experiences.

 In 12-step meetings, there’s no therapist or counselor in charge of the meeting. Instead, there’s a chairperson, a member of the 12-step program who opens and closes the meeting. This person is in charge only in the sense that she guides, rather than controls, the meeting. Some chairpersons guide more than others. For example, some chairpersons will interrupt a member who’s sharing something that can be harmful to the group. This could mean interrupting a “drunkalog” (long pointless sharing that glamorizes drinking or using drugs). Other chairpersons let the meeting run its course, believing that a Higher Power is always in control. The chairperson is responsible for starting and ending the meeting on time.

 No record of attendance is kept at 12-step meetings. A person is considered to be a member of Narcotics Anonymous when that person says they are a member. The only requirement for membership is a desire to stop using drugs.

 Twelve step meetings are held in slightly different ways in different areas of the country. In some places, meetings range from fifty minutes to an hour and a half.  At “speaker” meetings, one person tells their story of addiction and recovery for the whole hour, traditionally telling “what it was like, what happened, and what it’s like now.” At other types of meetings, all persons present are offered a chance to share or pass to the next person. In some meetings, members who wish to share raise their hands and are called on by the meeting chairperson. In group therapy, all members are usually expected to say something during the session, but at NA or AA, no one is coerced to speak.

 I tell my patients about these differences, because many people who really need the guidance and support that 12-step meetings don’t go, because of their mistaken opinions about meetings.

 They think they will be made to speak at an NA or AA meeting, and don’t want to go for that reason. Other patients say if they hear people talking about drugs it will make them want to use drugs. Other people say they “don’t want to hear everybody else’s problems.”

 Problems are shared at meetings, but the emphasis is on solutions. Most good meetings don’t allow the meeting to become a dumping ground for negative experience.  I explain that in most meetings, sharing about specific drugs is discouraged. NA members are encouraged to share about what they are feeling, and what kind of help they need to remain abstinent from all drugs.

 Overall, the mood of 12-step meetings is one of humbleness, where one recovering addict shares what worked for her with the rest of the group, without expectations and with humility. By contrast, in group therapy, feedback or advice is usually given by other group members. But an addict’s tendency with such an approach is to ask, “Who are you to be telling me what to do?” Narcotics Anonymous meetings recognize that advice and feedback often grates on addicts, and their meetings are constructed differently. Other member’s experiences are offered as learning opportunities.

 Twelve step members aren’t perfect, to say the least. Many members are wrestling with serious mental and emotional problems. Sometimes members do lapse into advice-giving and preaching, but nearly always lose this tendency to try to control others as they progress in their own recovery.

 There’s a reason 12-step recovery has been around for seventy-five years. Many other recovery methods have attained a brief popularity, only to fade away within ten or twenty years. Twelve step recovery has helped millions of people worldwide, continues to grow, and will be with us for a long time to come.

6 responses to this post.

  1. Now I know that 12 Step Programs have been fictionalized in the media, I did view it as being like a group therapy meeting.

    Sounds like the 12 Step programs are meant to be non-judgmental. Is this the reason why they are conducted the way they are?

    I’m going to call a few programs in my city (Boston) to see if they’d let me sit in and observe. I’m a student & researcher interested in opioid addiction. I’d really like see first hand what the patients go through when trying to handle withdrawal symptoms. I want to see what type of support community they form with one another.

    Thanks for the insight about what really goes on in these meetings.

    – Jennifer


    • Thanks for writing, Jennifer. Anyone – family, friends, interested professionals – can attend an “open” meeting of either NA or AA. But if it’s listed as a “closed” meeting, only members or prospective members can attend. If you don’t have a schedule that tells you, you can ask members when you get to the meeting if it’s open or closed.

      Yes, meetings are meant to be non-judgmental, though as I said, newer members may occasionally give advice. Even then, usually the more experienced members let this pass, believing newer people will learn with time and example.

      Don’t be surprised if you can’t tell what drugs an addict used. Most of the time, members don’t share about specific drugs. But if you talk to people before and after the meetings, you will likely be given a wealth of information that can help you understand opioid addiction better.

      Most meetings are very welcoming to students, researchers, and counselors. I expect you’ll enjoy the experience.


  2. Just to clarify about not giving feedback in 12-step meetings (from someone who’s in recovery.) It actually has nothing to do with being “grating.” Giving feedback, which is termed “crosstalk” in 12-step meetings, is generally restricted as a way to make the meetings a safe place to share one’s experiences. The idea is that people seeking recovery from addictions often have the experience of others stepping in to tell them what to do–or more often, berate them–when they talk about the problems their addictive behavior causes in their lives. Since recovery work centers on each person finding their own answers in their own time (with the help of their Higher Power), barring crosstalk lets people share without anyone else trying to control what is being shared–and gives everyone else in the room the benefit of hearing everyone’s shares uninterrupted, too.


  3. Thank you!
    Well said.


  4. Hey, I’ve run Addiction Treatment Centers in the UK and South Africa and you’ve summed up some key differences.

    Thanks for sharing!

    Big love from Cape Town.



  5. Posted by Joe on March 21, 2013 at 12:01 am

    I am in Gambers Anonymous (GA) and really appreciate the difference in the therapies. Definitely makes sense and I intend on practicing the ‘non-advice’ aspect and focus more on the ‘share experience’ aspect.


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