Primary and secondary care via the 12 Steps

This article and the accompanying infographic developed by Broadway Lodge explains the “Primary Care” and “Secondary Care” aspects of the well-known 12 Step programme. (25.10.17)

The 12 Steps approach has helped people treat addiction problems for over 80 years. Since its inception in America in the 1930s, and originally as part of Alcoholics Anonymous, the guiding principles of the 12 Steps have been adapted worldwide to help people address many types of addiction, compulsion and other behavioural problems. 

The approach has achieved popularity due to frequent Press reports of celebrities having entered the programme. However, there are millions of ordinary people around the world who have more quietly benefited from its success in treating a range of addictions such alcohol, illicit drugs, gambling, etc.

The 12 Step programme is an abstinence-based approach grounded in self-examination, resolve and compassion. The therapy is based within a group support structure rather than other types of intervention. Crucially, the 12 steps take a holistic approach to addiction so that the treatment addresses both the mind and the spirit.

At its heart is an admission by the individual that they have a problem that is unmanageable and that they need help - that’s Step 1, ‘Honesty’. Together with the next 4 steps, the Primary Care stage takes the person dependent on alcohol and/or other drugs through developing various aspects of personal growth such ‘Hope’, ‘Faith’, ‘Courage’ and ‘Integrity’. The original religious-tinged framing of the steps has evolved alongside society so that the model easily accommodates people of all faiths - and none.

The Secondary Care Steps 6 to 12 encourage those taking part to develop new codes of behaviour for their life (‘Humility’, ‘Discipline and Action’, ‘Acceptance’ etc.) with the final step (‘Service and Gratitude’) being reaching out to support others undergoing recovery.



The 12 Step programme aims to break the cycle of addictive behaviour, treating the specific substance or behaviour as, in many ways, immaterial. It takes courage to confront an addiction and seek treatment and there will be huge and significant changes in the individual’s life. The 12 step programme can help people to equip themselves with the cognitive tools they need for sustained recovery.

Individuals needing help can choose to attend 12 step meetings or opt to stay at a residential rehab centre for a more focused period of concentrating on getting better. Treatment can be followed up with outpatient care where necessary. The programme is useful as support for people who are receiving treatment that include clinical interventions. It meets people where they are, with the ethos to “Change what I can”.

The 12 step programme offers an additional option for those struggling with addiction, as well as support for their families.

Broadway Lodge

Download infographic as PDF