Family twelve-step fellowships

Domain V · Systemic, relational, group & community

What it is

What these are. Al-Anon/Alateen, Nar-Anon, Gam-Anon, Co-Anon, COSLAA and Families Anonymous (FA) are mutual-aid fellowships for relatives and friends of people with alcohol, drug, gambling, cocaine, or sex-and-love-addiction problems. They are not therapies and a clinician does not run them.…

Format

• These fellowships have no clinical phases or session counts. Membership is open-ended and attendance is voluntary. Below, (a) is the member path as the fellowships describe it; (b) is a clinician's frame for using them, which is.
• First contact. No appointment, advance notice or written referral is needed. Most groups have a contact person who can give directions. Where there is no local meeting, there are electronic, phone and online meetings. Newcomers may come early or stay late to ask questions.

Who practises it, and how they are trained or regulated

• Alateen – teenagers (some groups also accept pre-teens); online Alateen chat meetings for ages 13–18; groups need certified adult Al-Anon sponsors.

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?
• 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?
• Does it use a device, heat, cold, water or a physical procedure? Has a medical professional checked that it is safe for you?
• 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

• child-protection concerns disclosed in therapy. Act on them per local law.
• service used to avoid one's own issues, or a caretaking pattern re-enacted.
• fear of being seen locally. Offer online meetings or meetings in another area.
• passages used to suppress justified anger or safety-seeking. Discuss them in session.
• the client experiencing therapy and fellowship as contradictory. Name the difference openly.

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.