The Theoretical Underpinnings behind AA Practice

1. Introduction

The topic of this essay is “The Theoretical Underpinnings behind AA Practice”. This essay will explore the different models that have been proposed to explain addiction and recovery, with a focus on the Alcoholics Anonymous (AA) 12 step program and behavior therapy. It will identify the key similarities and differences between these approaches, and discuss the implications of each for clinical practice.

2. The Theoretical Underpinnings behind AA Practice

2.1 The 12 Step Program

The AA 12 step program is a set of guidelines for recovery from alcoholism that were first proposed by AA founders Bill Wilson and Bob Smith in the early 1900s (AA, n.d.). The program has since been adopted by numerous other 12-step programs for other addictive behaviours. The 12 steps are as follows:

1. We admitted we were powerless over alcohol- that our lives had become unmanageable.
2. We came to believe that a Power greater than ourselves could restore us to sanity.
3. We made a decision to turn our will and our lives over to the care of God as we understood Him.

4. We made a searching and fearless moral inventory of ourselves.

5. We admitted to God, to ourselves, and to another human being the exact nature of our wrongs.

6. We were entirely ready to have God remove all these defects of character.

7. Humbly we asked Him to remove our shortcomings.
8. We made a list of all persons we had harmed, and became willing to make amends to them all.
9. We made direct amends to such people wherever possible, except when to do so would injure them or others.
10. We continued to take personal inventory and when we were wrong promptly admitted it.
11. We sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out.
12 Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics, and to practice these principles in all our affairs’ (AA, n., d).

The AA program is based on several key concepts, including powerlessness, surrender, self-examination, confession, restitution, and spiritual awakening (AA, n., d). These concepts are based on the idea that alcoholism is a disease that can be overcome through admitting one’s powerlessness over it and surrendering to a higher power; learning from past mistakes through self-examination, confession and restitution; and having a spiritual awakening that leads to positive change in one’s life (AA, n., d). While the AA program has been criticized for its reliance on spirituality and its lack of scientific evidence, it remains one of the most popular models for addiction recovery in the world (Alcoholics Anonymous World Services Inc., 2012).

2.2 Behavior Therapy Behavior therapy is a type of psychological treatment that is based on the principle that problematic behaviours are learned through reinforcement or punishment (Wong & Rhatigan, 2009). In behavior therapy, problem behaviours are treated by modifying the reinforcing or punishing factors that maintain them (Wong & Rhatigan, 2009). For example, if a person is engaging in drinking behaviour in order to cope with negative emotions, then behaviour therapy would seek to teach that person alternative coping strategies that are more effective in managing their emotions.

Behaviour therapy has been shown to be an effective treatment for alcoholism and other addictions (Wong & Rhatigan, 2009). A key advantage of behaviour therapy is that it is based on a scientific understanding of learning and behaviour, which makes it easier to understand how and why problem behaviours develop and how they can be changed. Furthermore, behaviour therapy is relatively brief and focused on specific behaviours, which makes it more feasible for busy clinicians to implement in practice. However, one drawback of behaviour therapy is that it does not address the underlying psychological factors that may contribute to addiction, such as low self-esteem or trauma (Wong & Rhatigan, 2009).

3. What Unites and Divides These Approaches? There are several key similarities between the AA program and behavior therapy. Both approaches share the goal of helping people to recover from addiction and live healthier lives. Both approaches also emphasize the importance of changing one’s thoughts, emotions and behaviours in order to achieve this goal. However, there are also some key differences between the two approaches.

The AA program is based on the concept of powerlessness, which is the belief that addiction is a disease that cannot be controlled or cured (AA, n., d). In contrast, behavior therapy views addiction as a problem behaviour that can be changed through learning new skills and strategies (Wong & Rhatigan, 2009). Another key difference between the two approaches is that the AA program relies heavily on spirituality, while behavior therapy is secular in nature (AA, n., d; Wong & Rhatigan, 2009). Finally, the AA program is designed to be a lifelong process, while behavior therapy is typically shorter-term in nature (AA, n., d; Wong & Rhatigan, 2009).

4. Implications for Practice The different theoretical underpinnings of the AA program and behavior therapy have implications for clinical practice. For example, the AA program’s focus on powerlessness may lead clinicians to adopt a more passive approach to treatment, emphasizing support and encouragement rather than active intervention. In contrast, behavior therapy’s emphasis on changing problem behaviours may lead clinicians to take a more active role in treatment, working with clients to identify and change behaviours that are maintaining their addiction. It is important for clinicians to be aware of these differences when choosing an approach to treatment, as each has its own strengths and weaknesses.

5. Conclusion In conclusion, this essay has discussed the different models that have been proposed to explain addiction and recovery, with a focus on the Alcoholics Anonymous 12 step program and behavior therapy. It has identified the key similarities and differences between these approaches, and discussed the implications of each for clinical practice. While both approaches have their own strengths and weaknesses, they share the goal of helping people to recover from addiction and live healthier lives.


The main theoretical underpinnings of AA practice are the 12 steps and the 12 traditions.

These theories have evolved over time to become more inclusive and effective.

The evidence that supports the use of AA in addiction treatment is largely anecdotal, but there is some scientific research that supports its efficacy.

AA compares favorably to other approaches to addiction treatment, especially in terms of its low cost and high success rate.

The benefits of AA include its ability to help people overcome addiction, its supportive community, and its wide availability. The limitations of AA include its lack of scientific evidence and its reliance on a higher power.

People who are not already members of AA can get involved by attending meetings, finding a sponsor, and working the 12 steps.

AA has had a positive impact on society as a whole by helping to reduce the stigma surrounding addiction and by providing support for those struggling with addiction.