Mechanisms of behavior change in 12-step approaches to recovery in young adults


Kelly, J. F., Bergman, B. G., & Fallah-Sohy, N. (2018). Mechanisms of behavior change in 12-step approaches to recovery in young adults. Current Addiction Reports , 5 134.




Empirical evidence indicates that, in general, treatments which systematically engage adults with freely available twelve-step mutual-help organizations (TSMHOs), such as Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) often enhance treatment outcomes while reducing health care costs. Also evident is that TSMHOs facilitate recovery through mechanisms similar to those mobilized by professional interventions, such as increased abstinence self-efficacy and motivation, as well changing social networks. Much less is known, however, regarding the utility of these resources specifically for young adults and whether the TSMHO mechanisms are similar or different for young adults. This article provides a narrative review of the clinical and public health utility of TSMHOs for young adults, and summarizes theory and empirical research regarding how young adults benefit from TSMHOs.


Results indicate that, compared to older adults, young adults are less likely to attend TSMHOs and attend less frequently, but derive similar benefit. The mechanisms, however, by which TSMHOs help, differ in nature and magnitude. Also, young adults appear to derive greater benefit initially from meetings attended by similar aged peers, but this benefit diminishes over time.


Findings offer developmentally specific insights into TSMHO dynamics for young adults and inform knowledge of broader recovery needs and challenges.


12-step groups; Alcoholics Anonymous; Narcotics Anonymous; emerging adulthood; mechanism; mechanisms of behavior change; mediation; moderated mediation; moderators; mutual-aid; mutual-help organizations; recovery management; self-help; young adults

Publisher's Version

Last updated on 07/08/2019