Behavioural twelve-step fellowships

Domain V · Systemic, relational, group & community

What it is

What these are. Gamblers Anonymous (GA), Overeaters Anonymous (OA), Food Addicts in Recovery Anonymous (FA), Debtors Anonymous (DA), Underearners Anonymous (UA), Workaholics Anonymous (WA) and Clutterers Anonymous (CLA) are peer-run mutual-aid fellowships, not therapies. A clinician does not…

Format

• Newcomer stage. Attend many meetings; GA advises "as many meetings as possible". The UA format asks newcomers to try at least six meetings. Collect members' phone numbers, read the literature, and avoid triggers. GA names gambling venues, gambling friends, and online and mobile betting.
• Formats. Meetings run in person, by phone and on video. OA reports more than 6,400 meetings worldwide. FA holds meetings daily. CLA runs phone meetings and Phone Activity Sessions. Additional formats are Pressure Relief Groups (GA, Gam-Anon, DA), action meetings (UA), and buddy or bookending…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve fasting, a special diet or 'detox'? Have you discussed this with your doctor?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• How do you and the practitioner understand what is happening, in spiritual or cultural terms? Is that a source of comfort, worry, or both?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• minimising ("it's only money"). Note it and come back to it in A4.
• financial abuse, coercion or violence. Assess safety before any joint session about money.
• a client attending only because of therapy. Ask what they will keep doing once sessions end.
• inventory work that brings up trauma. Slow down and treat it clinically; it is not sponsor territory.
• journals reported only verbally, or vague answers. DA's Awareness Tool names "vagueness" as a thing to watch for.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.