Adapting 12-Step Programs For Teenagers

Twelve-step programs can be extremely helpful for teens who are struggling with addiction or who are on the road to becoming addicted, but they are more useful if they are adapted to the particular needs of adolescents, according to an expert on teenage addiction.

“These programs were developed for adults, and teenagers are not little adults—they are in a totally different developmental stage,” says Steven Jaffe, MD, Professor Emeritus of Psychiatry at Emory University, and Clinical Professor of Psychiatry at Morehouse School of Medicine, in Atlanta.

Dr. Jaffe, who has spent the past 25 years working to modify 12-step programs to make them developmentally meaningful for teenagers, spoke about his work at the recent American Society of Addiction Medicine conference. “These programs are free, they’re everywhere, they provide big brothers and sisters as sponsors, and they offer recovering friends,” he notes. “That’s really important, because if teens go back to their friends who use drugs or alcohol, they will start using again, too.”

Often, teens who are treated for substance use disorders are simply told to go to 12-step meetings. “You can’t just tell them to go, and leave it at that,” Dr. Jaffe says. “They have tremendous anxiety about going, so you need to link them with a sponsor who will take them to a meeting, or else they won’t go.”

Just getting them to the meetings may not be enough, however. Some of the basic concepts of 12-step programs may be troublesome for teenagers, according to Dr. Jaffe. The first step talks about being powerless over drugs and alcohol, but the word “powerless” can be a big turn-off for teens, he observes. “The goal of a teen is to have power, and they think, ‘Who wants to be part of a group that’s powerless?’”

Instead, Dr. Jaffe encourages them to think about getting clean and sober in order to enhance their power. “It’s the same step, but it’s rephrased and reemphasized to make it developmentally appropriate,” he says. “I tell them, flunking out of school, being thrown out of the house and being arrested as a result of drugs or alcohol is not powerful.”

Another concept in 12-step programs that teens can have trouble with is surrender. “Many teens, especially girls, have found themselves in very vulnerable situations when they are drunk or high, and the last thing they want to do is surrender. I tell them if they get clean and sober, they’ll be strong, and never have to put themselves in a position where bad things like that can happen.”

Dr. Jaffe developed two workbooks he uses with teenagers to make 12-step programs more meaningful to them. “So often, teens will tell me the negative consequences of using drugs and alcohol one day, and the next day they’ll deny it. So I have them write down the consequences in the workbook, so they can’t deny it the next day.” It takes one hour to complete the Adolescent Substance Abuse Intervention Workbook, which is then presented to a counselor individually or at a group. The Step Workbook for Adolescent Chemical Dependency structures the working of the first five steps.

Dr. Jaffe can be contacted about his work with teens and 12-step programs at

12 Responses

Leave your Response
    User Picture

    Donna Ray

    July 1, 2015 at 7:27 AM

    I wanted to say that I reframe powerless to even adult clients. I say that once the choice of putting a chemical into the body is made we are then powerless to the drug in our bodies. This makes us powerless to the effects of drugs in and outside of our bodies.

    To be empowered means to be able to see where we can make choices.

    User Picture


    April 15, 2013 at 12:49 PM

    I developed my addiction during my teen years and carried it into my young adult life. Looking back at it I dont think there would have been anyway I would have gotten sober in my teen years. I was simply to naive and arrogant. It took years of suffering to finally commit myself to 12 step recovery. Once I decided to I went to a san diego sober living called Normal Heights. The place changed my life. I would highly recommend visiting their site.

    User Picture


    July 5, 2012 at 1:51 PM

    Its interesting that the govt. should state 12 step programs are a religious organizations. When the twelve steps are the basis for any type of recovery, except 4 those sufferng from politicalism. I have been involed in recovery for twenty plus years and have seen various types of recovery groups. BUT they all seemed to have the 12 steps as basis, no matter type of groups that are out there.

    User Picture


    June 20, 2012 at 9:05 PM

    Why not introduce kids to other programs such as SMART Recovery? Given the well-documented sexual predation at 12-Step meetings (ever hear of the 13th step?) I would rather my kids get help from trained facilitators with professional oversight.

    User Picture

    Sonny Boy

    June 6, 2012 at 9:26 PM

    I contend this 12 step for kids is a dire mistake. Why tell kids they gotta attend meetings for the rest of life, or else die. Moreover, they will remain alcoholics and dope addicts for life, and will never fully recover. This is just a means of treacherous brainwashing for the young. A real sad state of affairs.

Leave a Comment

Please leave a comment below to contribute to the discussion. If you have a specific question, please contact a Parent Specialist, who will provide you with one-on-one help.

Your email address will not be published. Required fields are marked *