What are twelve-step programs for family and friends?

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Al-Anon family groups (including Alateen) and similar programs, including Nar-Anon, Co-Dependents Anonymous, and Adult Children of Alcoholics, use the meeting and twelve-step format developed by Alcoholics Anonymous to provide support and recovery for relatives and friends of alcoholics and addicts. The programs emphasize repairing the psychological damage caused to the relative or partner, not implementing the addict’s recovery.
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Addictions of all descriptions exact a grievous emotional and physical toll on family members and close associates of the addict. People who live in close association with an addict for any considerable time develop patterns of behavior and ways of looking at the world that are decidedly maladaptive. Spouses, partners, parents, and children become socially isolated, frustrated, and discouraged at futile efforts to bring about reform in the loved one and they have difficulty identifying their own needs and desires and in taking reasonable steps to see that their needs are met. Depression and physical illnesses with a strong psychological component are common in this demographic.

There is a definite hereditary component to addiction that appears to be a combination of anomalies in brain chemistry that influence pleasure-seeking behavior and, in the case of alcoholism, differences in metabolism that reduce adverse consequences of excessive use in the early stages of the disease. Children and siblings of addicts are at high risk of becoming addicts themselves and can benefit from any program that reduces their chances of involvement. Growing up in an addicted environment also increases the likelihood that a person will select an addicted partner and remain in a destructive relationship, perpetuating the unhappy family cycle.

The term addict conjures an image of a person addicted to illegal street drugs, particularly heroin. However, in terms of impact on families, alcohol is the most common and most damaging substance of abuse; thus efforts to repair the damage caused by addiction, whether through twelve-step programs or through psychiatric intervention, concentrate on alcoholism. This focus on alcoholism occurs because the use of hard drugs typically destroys relationships and breaks up families before a chronic pattern of dysfunction is established.


Al-Anon was founded after Alcoholics Anonymous (AA), which itself was founded in 1935. Within a few years AA had established a small network of groups meeting regularly to share stories and achieve sobriety through working a series of twelve steps. Briefly, these steps involve admission of powerlessness, reliance on a higher power, identification of and admission of shortcomings, making restitution (when possible) to persons harmed, continuing to lead a sober and spiritual life, and carrying the message to current alcoholics.

The original AA membership was overwhelmingly male. At many meetings the wives would get together informally to discuss how to be supportive of their husbands’ recovery and also to share experiences about the challenges they were facing in their own lives. Lois Wilson, wife of AA cofounder Bill Wilson, was active from the start in facilitating a New York group for wives and in corresponding with similar groups in other parts of the country. The first (1939) edition of Alcoholics Anonymous contains the chapters “to Wives” and “the Family Afterwards,” incorporating some of Lois Wilson’s experience and wisdom. These chapters, however, were written by Bill Wilson and emphasize how families can reinforce and support the man’s sobriety rather than how to help with the emotional recovery of the wives of alcoholics.

As these groups evolved it became apparent that the twelve-step format also could be used to benefit the spouses of alcoholics, substituting “powerless over the alcoholic” for “powerless over alcohol.” A woman working the twelve steps of what later became Al-Anon was encouraged to detach from her husband’s addiction, abandon efforts to reform him, and concentrate on strengthening her own connection to a higher power, on identifying and trying to eliminate undesirable patterns of thought and behavior in her own life, and on making amends to people who had been harmed by her own actions.

In 1941, Lois Wilson began collaborating with Ann B., wife of an AA member who was unable to stay sober. Over the next ten years family groups developed under the guidance of the two women. Al-Anon became a formal organization in 1951. It has its own corporate structure, parallel to AA but entirely separate from it. In 1957, Bob, a California teenager with an alcoholic father, established the first group for young people, and in 1959 the Alateen Committee was formed within Al-Anon to coordinate groups for minor children of alcoholic parents. Alateen groups have an adult Al-Anon sponsor and usually meet at the same time and location as an established Al-Anon group.

As of 2012, Al-Anon/Alateen had r25,418 groups worldwide. According to its 2015 member survey, the average Al-Anon member has been in the program for thirteen years. More than three-quarters of Al-Anon members have had a relationship with an alcoholic spouse or partner, and more than 40 percent by an alcoholic father or stepfather. In about one-quarter of cases the spouse or partner is in recovery in AA.

How Al-Anon Works

Like AA, Al-Anon is open to anyone with a desire to recover from the adverse effects of living with an alcoholic. There are no dues or fees for membership; the organization is supported through voluntary contributions and through the sale of literature. The first step for an individual is usually to locate and attend a meeting. There are online, telephone, and correspondence resources for people in small communities without Al-Anon meetings.

It is recommended that an individual get a sponsor, a person who has some experience with the program, to guide them through the twelve steps. Unlike AA, Al-Anon publishes a twelve-step workbook and a number of pamphlets with specific guidance and advice on psychological matters.

The membership is slowly changing, but Al-Anon remains a mostly female fellowship of partners and former partners of alcoholics.

There is a common misconception that Al-Anon exists to help a spouse, sibling, or parent get an alcoholic loved one sober, and that Al-Anon will provide some “magic formula” or will help to organize an intervention. This is not the case. Al-Anon provides hope for leading a stable and happy life despite damage done by the alcoholic; it is up to the alcoholic to seek his or her own recovery.

Other Programs

There exists a plethora of twelve-step programs for addressing myriad addictions, compulsive behaviors, and miscellaneous life problems. None is as widespread or successful as AA. At one time or another most of these programs have probably spawned a few coordinating family groups of their own, but the only groups with staying power are Nar-Anon, Co-Dependents Anonymous (CODA), and Adult Children of Alcoholics (ACA). Addictive behaviors such as gambling and pornography often have alcohol abuse as a comorbidity, in which case Al-Anon is a useful resource.

Nar-Anon, for family members of hard-drug addicts, filed articles of incorporation in 1971 and established a world service office in 1976. Meetings are held mainly in urban areas in the United States. Members are more likely to be parents and siblings of addicts than spouses of addicts, and the problems addressed can include extensive legal involvement.

The goal of ACOA membership is emotional sobriety. The organization, founded in New York City in 1976, publishes a variety of literature, including a “big book,” collections of personal stories, and a step workbook.

CODA is a twelve-step format fellowship of people whose problems in relationships stem from being raised in dysfunctional families. Its common purpose is to develop healthy relationships; members gather to support and share with each other in a journey of self-discovery and self-love. To the extent that the dysfunction of the family stemmed from addictive behavior, CODA can help a person from an addictive background.

Although they still follow the twelve-step format, ACA and CODA deemphasize the need for personal reform that characterizes AA and Al-Anon. Recovery tends to be an elusive concept, at least when compared with AA and Narcotics Anonymous. Although it may be questionable how much improvement the twelve-step approach produces in emotional health, many people find it sufficiently helpful to continue participating, and a twelve-step program has the advantage of being accessible to all at little to no cost.


ACA World Services. Adult Children: Alcoholic/Dysfunctional Families. Torrance: ACA World Services, 2006.Print.

Al-Anon Family Groups. How Al-Anon Works for Families and Friends of Alcoholics. Virginia Beach: Al-Anon Family Groups, 2008. Print.

Borchert, William G. The Lois Wilson Story: When Love Is Not Enough. Center City: Hazelden, 2005. Print.

Rivinus, Timothy M., ed. Children of Chemically Dependent Parents: Multiperspectives from the Cutting Edge. New York: Brunner, 1991. Print.

Zajdow, Grazna. Al-Anon Narratives: Women, Self-Stories, and Mutual Aid. Westport: Greenwood, 2002. Print.