The teenage years are a critical time for brain development and the development of addiction. Important areas of the brain involved in decision-making and judgment are still being formed. Meanwhile, peer influences are considered to be the ultimate authority. As a result, teens are highly susceptible to substance abuse and substance use disorders.
The need for appropriate teen addiction treatment cannot be overstated. Most individuals with a substance use disorder begin abusing alcohol or illicit drugs by age 18 and become addicted by age 20. Fortunately, substance use disorder is one of the most preventable causes of disease among teens.
Nearly half of teen addiction treatment programs include a 12 step program, and 85% connect teens with 12 step groups for continuing care. However, the 12 step program was originally designed to treat adults with addiction. This fact begs the question, can the 12 steps be applied to treat teens with addiction, and if so, are they effective?
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What is the 12 Step Program?
The 12 step program was designed by the founders of Alcoholics Anonymous in 1939. It consists of a set of guiding principles that are now used to treat all kinds of addiction. The 12 steps are centered on accepting help from a higher power to overcome addiction and make amends. Individuals who are a part of a 12 step program support each other in working through the steps and staying sober.
The 12 steps are used in professional addiction treatment programs and community groups across the world.
- Examples of 12 step community groups include:
- Alcoholics Anonymous (AA)
- Marijuana Anonymous (MA)
- Crystal Meth (and other amphetamines) Anonymous (CMA)
- Narcotics Anonymous (NA)
- Cocaine Anonymous (CA)
Support groups for family members and friends of people with addiction may also practice the 12 steps.
Why Some Teens Are Wary of the Program
Evidence-based research has shown consistent participation in 12 step programs to be an effective treatment for addiction for adults and adolescents. However, despite these benefits, teens have a low likelihood of attending 12 step groups for more than a year outside of a monitored program.
- Some reasons for why teens are wary of the 12 step program include:
- Feeling bored or like they do not belong in a group dominated by adults
- Inability to grasp the lifelong nature of addiction and addiction treatment
- Difficulty accepting abstinence as the only treatment option
- Trouble relating to adult problems caused by addiction (e.g. marital strife, divorce, child custody disputes, employment problems, etc.)
- Trouble relating to adult severity of disease (e.g. severity of withdrawal symptoms and medical complications)
- Difficulty with the religious elements of the 12 steps (e.g. being “powerless” over alcohol and drugs and needing to “surrender” to a higher power)
- Misunderstanding relapse as a reason for exclusion from 12 step programs
Supportive factors for teen engagement in 12 step programs include older age of participation, prior treatment for addiction or other mental health conditions, parental experience with 12 step groups, religious service attendance and support for recovery by family and friends.
Tailoring the Program to Teens
For teens to participate in a 12 step program, it is crucial that the program reflects their experiences and needs. Current evidence suggests that 12 step programs are more effective in engaging teens when:
- They include more teens
- They emphasize identification with the experiences of others
- They give teens empowering opportunities for active, verbal participation
- They emphasize how the program helps to feel less lonely and more connected to others
- They provide friends, encouragement and support for recovery
- They give teens more frequent contact with a 12 step sponsor outside of meetings
- They provide hope for a better future
- They provide continuing care intervention to encourage 12 step participation over the long term
The Pros & Cons of Using the 12 Step Program for Teens
The 12 step program can be an effective treatment for addiction for teens. Here are the pros and cons of the program:
- Community 12 step programs can serve as a free and widely available resource for teen addiction treatment.
- The program helps teens feel more connected to others and less lonely.
- Program sponsors provide the flexibility and mentorship desired by teens.
- Community programs require no paperwork or disclosure of personal information.
- The program gives teens tools such as greater self-awareness and a sense of empowerment to avoid relapse.
- The program provides friends, encouragement and support for recovery.
- The program provides hope for a better future.
- Teens may feel bored or like they do not belong if the program is dominated by adults.
- Teens may be turned off by the 12 steps if they are not rewritten to reflect their stage of development.
- Teens may be turned off by the religious elements of the 12 steps.
- Teens may forego treatment altogether if they become discouraged by adult experiences with addiction that they cannot relate to.
Chi, FW; Campbell, CI; Sterling, S; Weisner, C. “Twelve-Step attendance trajectories over 7 years among adolescents entering substance use treatment in an integrated health plan.” Addiction, May 2012. Accessed September 23, 2019.
Chi, FW; Kaskutas, LA; Sterling, S; Campbell, CI; et al. “Twelve-Step affiliation and 3-year substance use outcomes among adolescents: social support and religious service attendance as potential mediators.” Addiction, June 2009. Accessed September 23, 2019.
Kelly, JF; Kaminer, Y; Kahler, CW; Hoeppner, B; et al. “A pilot randomized clinical trial testing integrated 12-step facilitation (iTSF) treatment for adolescent substance use disorder.” Addiction, December 2017. Accessed September 23, 2019.
Kelly, JF; Myers, MG; Rodolico, J. “What do adolescents exposed to Alcoholics Anonymous think about 12-step groups?” Substance Abuse, 2008. Accessed September 23, 2019.
Kelly, JF; Urbanoski, K. “Youth recovery contexts: the incremental effects of 12-step attendance and involvement on adolescent outpatient outcomes.” Alcoholism: Clinical and Experimental Research, July 2012. Accessed September 23, 2019.
National Institute on Drug Abuse. “Principles of Adolescent Substance Use Disorder Treatment: A Research-Based Guide.” January 2014. Accessed September 23, 2019.