The Science of Step 11 AA: How Spirituality Can Help

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Alcoholics Anonymous (AA) is a 12-step program that consists of free, community-based groups that help support you in managing your alcohol use. However, some have questioned the effectiveness or science of Step 11 AA, which speaks to spiritual aspects of recovery and making contact with a higher power.

In this article:

What is Step 11 AA?
Why is a Higher Power Important in AA?
Is Spirituality Useful in Recovery?
How is Step 11 AA Used in Therapy?

What is Step 11 AA?

In AA, you will work through 12 steps as part of your recovery from alcohol use disorder (AUD). These steps include concepts such as admitting you are powerless to overcome your addiction on your own and making amends with people in your life whom your alcohol use has impacted. Several of the steps reference God or a higher power as part of the recovery process.

Step 11, as written on AA’s website, states, “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.”¹

Step 11 AA incorporates and evokes the concept of God or a higher power, which is meant to be based on your personal idea of spirituality. God can be a religious being, or the higher power could be defined as nature or even the group dynamic that you experience at an AA meeting.

Ways that you can work to complete Step 11 AA will vary depending on many factors, but may include:

Choosing your version of a higher power and spiritual practice that is most meaningful to you.
Reflecting on how spirituality can bring purpose and meaning to your life through prayer, meditation, mindfulness, or some other spiritual practice.
Finding ways to explore and carry out that purpose in your daily life.

Why is a Higher Power Important in AA?

AA views connecting to a higher power a significant part of the recovery process. You may feel powerless to your cravings for using alcohol, and AA will encourage you to admit that powerlessness and instead trust in a higher power to help you through. This may help alleviate feelings of shame that often accompany alcohol use disorder and relapses and lead you to a place of self-forgiveness and change.

Believing in a power greater than yourself can also help with feelings of isolation during your recovery process. You may feel like your family and friends do not fully understand what you are going through, but engaging with a higher power can help you feel you are not alone on your journey. This comfort can help prevent additional negative emotions during recovery.

Studies have shown that connecting with a greater purpose outside yourself can be a crucial factor in a successful recovery.² AA is founded on this belief and encourages you to involve mind, body, and spirit in the recovery process.

Is Spirituality Useful in Recovery?

Recent studies have examined how spiritual practices and beliefs impact the recovery process. Many of these studies look at the definition of spirituality as a connection to a higher power like God, nature, or the universe in which they can feel inspired, loved, hopeful, enlightened, and a sense of purpose through that connection.³

Some of the findings from such studies included:²

Spirituality is an integral part of prevention and recovery from AUD.
Those who attend spiritual programs such as AA have a lower risk of relapse.
82% of clients who integrated spiritual practices into their recovery process reported being completely abstinent at a one-year follow-up compared with 55% of clients who did not engage in spiritual practices.

When you have spiritual resources that you can use in your recovery, they are referred to as positive religious coping tools. These tools may include activities like prayer and meditation while including spiritual beliefs. Studies have also shown that if you effectively use positive religious coping tools, you have a better chance at positive, long-term recovery outcomes.²

Is Step 11 AA Effective?

While AA focuses on spirituality and the concept of a higher power, other recovery groups—such as SOS, LifeRing, and SMART Recovery—focus on personal empowerment. Because of AA’s spiritual aspects, some doubt the effectiveness of its approach in comparison to these other recovery groups. However, scientific research has recently tracked outcomes of AA compared to secular models and reported the following:^3,4

AA is 60% more effective than other alcohol intervention programs.
No studies have found AA to be less effective than other groups.
Rates of abstinence from substances are about twice as high among those who attend AA than members of other programs.

Thus, statistical comparisons can be used as a science of Step 11, proving it to be effective in helping people stay motivated to reach and maintain recovery from AUD.

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How is Step 11 AA Used in Therapy?

Evidence-based, therapeutic methodologies are a necessary aspect of your recovery from AUD, and a 12-step program like AA can complement or even integrate into therapy to increase the likelihood of success. A therapeutic intervention that uses a 12-step approach will center around these three ideas:⁵

Accepting your chronic condition of alcohol use disorder and that willpower alone is not enough to remain abstinent
Surrendering to a higher power and the support of the group
Attending regular 12-step group meetings

Cognitive-Behavioral Therapy

Cognitive-behavioral therapy (CBT) is the most commonly used therapeutic approach in recovery treatment. The theory behind this model is that your thoughts and beliefs determine your feelings and behaviors and change can be made to your behaviors by changing your perceptions or feelings. As such, the goal of CBT is to identify and change negative thought patterns.

Step 11 works alongside this approach in that it encourages you to look beyond your pre-established beliefs and focus that energy toward positive thoughts. Investing in belief of a higher power can change your perceptions and shift feelings of guilt and blame away from yourself. When you engage with a higher power, you often feel loved and valued, which is a belief that CBT aims to help you achieve.⁶

Furthermore, spirituality can be integrated into CBT methodology by changing the framing through which the client identifies and changes their negative thoughts. CBT combined with the religious or spiritual beliefs of a person, otherwise following the same guidelines and tools as CBT without this framing.⁶

Motivational Interviewing

Another therapeutic technique used to address alcohol use disorder is motivational interviewing. This is where the trained therapist will ask questions and, through discussion, help you find the motivation for change and identify obstacles that prevent you from reaching your goal. Step 11 complements this approach as well.

Spirituality allows you to find meaning and purpose through the lens of your beliefs. These beliefs can then serve as the groundwork of your motivation to change, which will be explored through motivational interviewing. Further, the science of Step 11 AA manifests in identifying ways to identify and engage with your purpose. This can be a profound motivator for remaining abstinent, and those purposeful activities can replace your drinking behaviors.

Research shows that any intervention is better than none when trying to stop using alcohol. If you or someone you know has alcohol use disorder, please call 800-948-8417 Who Answers? to speak to a specialist about treatment options that are right for you.

Resources

Alcoholics Anonymous. The Twelve Steps. Alcoholics Anonymous World Services, Inc.
Grim, B. J., & Grim, M. E. (2019). Belief, Behavior, and Belonging: How Faith is Indispensable in Preventing and Recovering from Substance Abuse. Journal of religion and health, 58(5), 1713–1750.
Kaskutas L. A. (2009). Alcoholics Anonymous Effectiveness: Faith Meets Science. Journal of Addictive Diseases, 28(2), 145–157.
Kelly JF, Humphreys K, Ferri M. (2020). Alcoholics Anonymous and other 12‐step programs for alcohol use disorder. Cochrane Database of Systematic Reviews, Issue 3.
National Institue on Drug Abuse. (2018). 12-Step Facilitation Therapy (Alcohol, Stimulants, Opiates). National Institutes of Health United States Department of Health and Human Services.
Pearce, M. J., Koenig, H. G., Robins, C. J., Nelson, B., Shaw, S. F., Cohen, H. J., & King, M. B. (2015). Religiously integrated cognitive behavioral therapy. Psychotherapy, 52(1), 56–66.