Adult Children of Alcoholics

1. Introduction

Version followed: Adult Children of Alcoholics/Dysfunctional Families (ACA), as published by ACA World Service Organization (ACA WSO): the Fellowship Text ("Big Red Book", BRB, 2006; contents from WSO's audio-edition index only), ACA Essentials, the Sample Meeting Format (©2006), the Sponsorship–Fellow Traveler pamphlet (drawn from BRB ch. 11), the Flip Side of the Laundry List (©2007), the Information for Health Professionals pamphlet (2025) and the Loving Parent Guidebook web page (2021). Material from local intergroups and workshops is marked as not conference-approved.

What it is. ACA is a peer-run Twelve Step mutual-aid fellowship. It is not a therapy, and a clinician does not deliver it. People who grew up in alcoholic or otherwise dysfunctional homes meet to share their experience, work an adapted set of Twelve Steps and practise "reparenting" themselves. The fellowship began in New York in 1978. Tony A. is usually named as its main founder, together with former Alateen members. The first groups were "Hope for Adult Children of Alcoholics" (Manhattan) and "Generations". The break from Al-Anon came around 1979–80, when Al-Anon asked the group to stop using Tony's Laundry List and the group refused. ACA adopted AA-adapted Steps in 1984. Some groups also read Tony A.'s own version of the Steps, which stresses a "blameless" inventory of the parents. Membership needs only a desire to recover from the effects of family dysfunction. ACA reports about 3,000 meeting locations worldwide, with in-person, phone and online meetings. [source: ACA And Its Beginnings; Information for Health Professionals; A New Hope Appendix A]

How change is understood. ACA's premise is that people are born whole and become fragmented by family dysfunction (addiction, abuse, neglect), which produces a "false self" and a set of survival traits. The Laundry List names 14 of these traits. These survival traits once protected the child but work badly in adult life. Recovery means identifying with the Problem (the Laundry List) and then living The Solution. The Solution means becoming one's own loving parent, reclaiming the inner child, gradually releasing grief in a safe group, releasing the parents from blame for present choices, and relying on a Higher Power, the Steps, meetings and phone contact. The members' own phrase for the arc is moving from "hurting to healing to helping". ACA describes itself to professionals as "supplementary to and not a replacement for professional counseling" and encourages "informed counseling" alongside Step work, meetings and sponsorship. [source: ACA Essentials; Information for Health Professionals; Therapy and Counselors page]

Your role as clinician. You assess fit, refer, prepare the client, help them use what they bring back from ACA, coordinate where Step work overlaps with trauma work, and handle problems. You do not run meetings, act as sponsor or lead Step work under ACA's name. ACA is "not allied with any form, discipline, or technique of therapy". [source: Therapy and Counselors page] Note that "adult children of alcoholics" is also a clinical literature (for example Woititz 1983; Black 1981, whose title BRB ch. 2 borrows). That literature is not drawn on here, and it should not be confused with the fellowship. [uncertain]

2. Framework

ACA does not use clinical phases or a fixed number of sessions. The fellowship literature describes a progression, set out in the table below. The BRB front matter has a "Stages of Recovery" section that is not drawn on, so this sequence is reconstructed from the other documents. [source: Sample Meeting Format; A New Hope Appendix A; BRB contents; Sponsorship pamphlet] [uncertain: stage names]

Clinician's framework (when ACA is used alongside therapy). [synthesis]

• Phase A: Assess and orient (1–2 sessions).
  • Screen the history.
  • Check fit, risk and readiness for group settings.
  • Explain what to expect.
  • Agree to six meetings.
  • Move on once the client has attended at least one meeting, or has made an informed decision not to go.
• Phase B: Integrate (ongoing).
  • Run a short meeting debrief in sessions.
  • Turn the Laundry List traits the client identifies with into therapy targets.
  • Track the client's support network.
• Phase C: Coordinate trauma-sensitive Step work.
  • Pace Step 4/5 and amends to parents against the client's stabilisation.
  • Agree role boundaries with the client, so the sponsor is not asked to act as therapist.
• Phase D: Consolidate and taper.
  • The fellowship continues after therapy ends.
  • Review the relapse plan (BRB ch. 12 covers relapse into old patterns).

3. Guiding principles

Fellowship principles, as ACA publishes them:

• Born whole; false self from dysfunction. Treat the Laundry List traits as survival adaptations, not defects of character. The BRB has a section distinguishing "character defects vs. Laundry List traits". [source: Health Professionals; BRB contents]
• Broad eligibility ("/Dysfunctional Families"). ACA welcomes people with no addiction in the family of origin: abuse, neglect, rigid or punitive homes, perfectionism, parental mental illness, gambling, debt, adoption, foster care and single-parent homes. Do not rule a client out because no parent drank. [source: A New Hope Appendix A; Sample Meeting Format]
• Confidentiality and no cross talk. Members do not interrupt, refer to or comment on another person's share, because adult children were often told their perceptions were wrong. For the client, meetings are a place where they are not corrected. [source: Sample Meeting Format]
• Responsibility, not advice. Shares use "I" statements and focus on one's own life. [source: Sample Meeting Format; A New Hope Appendix A]
• Fellow traveler equality. The sponsor relationship is a "two-way street" between equals. A sponsor is not a parent, authority figure, Higher Power or therapist. [source: Sponsorship pamphlet]
• Break the family rules. Sponsors encourage members to break the old family rules against talking, trusting, feeling and remembering. In practice, emotional expression is expected and supported. [source: Sponsorship pamphlet]
• Reparenting as the Solution. The member learns to treat themselves with gentleness, humour, love and respect. The therapy can reinforce the same internal stance. [source: ACA Essentials; Loving Parent Guidebook page]
• Parents released from blame for present choices. Grief and anger about the past are validated, but responsibility for today's choices rests with the member. [source: ACA Essentials]
• Spiritual, not religious. The member defines their own Higher Power (BRB ch. 5). Raise this with clients who have religious trauma or are atheist. [source: BRB contents; ACA Essentials]
• Gradual grief release in safety. Feelings are released "gradually", in a group that is safe. Pace matters. [source: ACA Essentials]
• Self-supporting and non-affiliated. Groups decline outside contributions (Seventh Tradition) and endorse no therapy. You cooperate with ACA but cannot direct it. [source: Sample Meeting Format; Therapy and Counselors page]
• Adjunct to professional care. ACA supplements counselling and does not replace it. ACA recommends an ACA-informed counsellor (BRB ch. 16, pp. 450–464). [source: Health Professionals; Therapy and Counselors page]

Clinician principles: [synthesis]

• Respect fellowship autonomy. Ask about meetings and the client's experience. Do not prescribe Step content.
• Keep roles separate. Therapy handles diagnosis, trauma processing and risk. The fellowship provides peer identification and continuity.
• Client choice. ACA is offered, never mandated. Its Higher Power language and group format do not suit everyone.

4. Intervention inventory

Part A covers ACA's own tools, as the fellowship publishes them. The client does these in ACA; you do not run them. For each tool, "Steps" says what the client will meet and what you do to support it. Part B covers clinician procedures for working alongside ACA, all marked [synthesis] unless a source is cited. Literature is paraphrased throughout: do not hand out or read aloud the Laundry List, Steps, Promises or prayers in session as if they were therapy materials. Direct the client to ACA's own free literature.

Part A: Fellowship tools

A1. The ACA meeting

• Purpose / when: Peer identification, breaking isolation and support between sessions. Suitable for any client from a dysfunctional family who can tolerate a group setting. [source: Sample Meeting Format; Health Professionals]
• Steps (what happens):
  1. The leader introduces themselves as an adult child and gives a confidentiality reminder. Phones go off.
  2. A moment of silence, then the Serenity Prayer. ACA uses its own version, which ends on changing oneself.
  3. Members read the Problem (or Laundry List), The Solution and the 12 Steps.
  4. Newcomers are invited to give their first name and are welcomed with applause. They are told they can relate even if nobody in the home was addicted, and are encouraged to attend six meetings in a row.
  5. The leader states the sharing guidelines: no cross talk, responsibility rather than advice, 5 minutes per share (3–4 in a large meeting).
  6. The meeting type is announced: Step Study, Open or Topic discussion, Tradition Study, Speaker or other. Sharing runs until about 15 minutes before the end.
  7. Seventh Tradition basket. Newcomers need not contribute at their first meeting.
  8. The Traditions are read, followed by business reports and announcements.
  9. The Promises are read, and the meeting closes with a prayer of the member's choice. The group stands in a circle holding hands.
  10. Total length about 1.5 h. In-person, phone and online formats exist. Beginner's meetings use a simpler script (Appendix A of A New Hope). Some meetings are themed on literature, such as Loving Parent Guidebook meetings.
• Example language (illustrative): "Most meetings run about 90 minutes. People read a few short pieces, then take turns talking for a few minutes, and nobody comments on what you say. You can just listen. Saying your first name is optional."
• Watch for:
  • Distress at hand-holding or prayer (offer: "you can stand back").
  • Dissociation during shares about abuse.
  • Over-identification followed by flooding.
  • Signs it is working: the client recognises themselves in others' shares, attends regularly, has a home group and builds a phone list.

A2. Sharing without cross talk

• Purpose / when: Practise speaking about feelings and perceptions without being corrected. Builds tolerance for exposure. [source: Sample Meeting Format; A New Hope Appendix A]
• Steps:
  1. The member raises a hand or speaks in turn around the room.
  2. They speak in "I" statements for 3–5 min about their own experience.
  3. No one interrupts, comments or advises.
  4. What is shared stays in the room.
• Example language (illustrative): "You could rehearse a two-minute share here first: what happened this week, and one feeling about it."
• Watch for:
  • Over-disclosure of trauma detail early on.
  • Shame afterwards (a "vulnerability hangover").
  • Feeling ignored when no one responds. Explain that the silence is deliberate.

A3. The Laundry List, The Problem and "Am I an Adult Child?"

• Purpose / when: Self-identification and psychoeducation. Useful early on, and as a shared vocabulary for case formulation. [source: ACA Essentials; ACA And Its Beginnings; BRB contents]
• Steps:
  1. The client meets the 14 traits, written by Tony A. in 1978, read at meetings. Jack E. later put them into narrative form as The Problem.
  2. In paraphrase, the trait themes are:
     • isolation and fear of people and authority
     • approval-seeking at the cost of identity
     • fear of anger and criticism
     • bonding with compulsive people
     • a victim stance
     • an over-developed sense of responsibility and focus on others
     • guilt when standing up for oneself
     • addiction to excitement
     • confusing love with pity
     • frozen feelings
     • harsh self-judgement
     • fear of abandonment
     • "para-alcoholic" traits
     • reacting rather than acting
  3. BRB ch. 1 reviews the traits one by one and includes an "Am I an Adult Child" self-check (p. 18). Its items are [uncertain].
• Example language (illustrative): "Which two or three of these feel most like you right now? Let's look at where each one shows up this week."
• Watch for:
  • Using the list as a fixed identity or label of damage. Pair it with the Flip Side (A4).
  • Self-blame ("I'm all 14").
  • It is working when the client can name a trait as it happens and choose differently.

A4. The "Other" Laundry List and the Flip Sides

• Purpose / when: The Other Laundry List (BRB ch. 1, p. 8) describes the opposite pole: adult children who act out the same dysfunction. The Flip Side lists describe healthy counterparts and serve as recovery goals. [source: BRB contents; Flip Side of the Laundry List; Complete List of ACA Books]
• Steps:
  1. The Flip Side of the Laundry List (©2007) turns each trait into a healthy statement. Paraphrased themes:
     • not isolated or afraid of authority
     • self-defined
     • not overwhelmed by angry people
     • not seeking abandonment or victim dynamics
     • no guilt when standing up for oneself
     • preferring calm to crisis
     • telling love from pity
     • feeling and expressing emotions
     • interdependence with healthy people
     • acting rather than reacting
  2. A Flip Side of the Other Laundry List also exists (SoCal ACA copy).
  3. The Laundry Lists Workbook expands the Other Laundry List with questions about shame, guilt and anger. Not drawn on here.
• Example language (illustrative): "If this trait were reversed in your life, what would you be doing differently on a Tuesday?"
• Watch for:
  • Treating the Flip Side as a standard the client is failing to meet. Present it as a direction, not a test.

A5. Sponsorship and fellow travelers

• Purpose / when: A one-to-one peer relationship for Step work and support. Ideally the first experience of an equal, respectful relationship. [source: Sponsorship pamphlet; BRB contents ch. 11]
• Steps:
  1. Types:
     • traditional (an experienced member guides the sponsee through the Steps)
     • co-sponsor (two peers of similar program time)
     • temporary (for members in treatment or institutions)
     • long-distance (by phone or online)
  2. Choosing:
     • Listen at meetings.
     • Look for someone who has worked the Steps, attends regularly and shows serenity and emotional sobriety.
     • A same-sex sponsor is typical, to avoid romantic confusion.
     • Talk with two or three people, discuss expectations, then ask.
  3. Sponsors do:
     • share their own experience, strength and hope
     • explain the traits and "emotional intoxication"
     • encourage Step work, meetings, journaling, meditation and a Higher Power
     • help the sponsee feel and name feelings and break the family rules
     • model their own recovery
     • support grief work and reparenting
  4. Sponsors do not:
     • act as parent, authority, Higher Power, therapist or counsellor
     • judge the sponsee's feelings
     • do for the sponsee what the sponsee can do
     • give or lend money
     • become romantically or sexually involved
     • rescue, or give advice instead of experience
     • sponsor while in active addiction
  5. Sponsee responsibilities: regular contact, honesty, abstinence from addictive behaviours, owning their own program.
  6. Ending: Ending a sponsorship is not abandonment. Whoever ends it should be honest and tactful.
• Example language (illustrative): "What would you want to know about someone before you asked them to be your sponsor? Let's write three questions you could ask."
• Watch for:
  • The sponsor relationship re-enacting the family: control, rescuing, sexualisation or demands.
  • Idealising the sponsor.
  • The client using the sponsor as a therapist for trauma processing.
  • Signs of health: equality, reliability and respected boundaries.

A6. Working the ACA Twelve Steps

• Purpose / when: The core program. It moves from admitting powerlessness over the effects of an alcoholic or dysfunctional upbringing, through inventory, sharing, amends and daily review, to carrying the message. [source: ACA Essentials; BRB contents; George AWC 2023 workshop handout; Sponsorship pamphlet]
• How the ACA Steps differ from AA's: They are adapted from AA. Step 1 names the effects of alcoholism or "family dysfunction", not alcohol itself. Some groups read Tony A.'s version instead, which has a blameless parental inventory and stresses self-love. [source: ACA Essentials; ACA And Its Beginnings]
• Steps (what the member does with a sponsor or step-study group):
  1. Step 1. The member reviews their family history (addiction, abuse, mental illness) and asks whether the traits have made life unmanageable and whether efforts to change have failed.
  2. Steps 2–3. The member comes to believe in a power greater than themselves and turns their will over to it, as they understand it.
  3. Step 4. The inventory is long: BRB pp. 150–188 include worksheets on pp. 160–187 (not drawn on). The member inventories the family environment, abuse and neglect, and their own traits. One workshop format (George, ACA World Convention 2023; conference-approval status not stated) builds Step 4 around a single trait chosen in Step 1. It asks how the trait shows up today, which memories connect to it, and what the member feels while working on it.
  4. Step 5. The member shares the inventory with God, themselves and another person. BRB Appendix B is guidance on "Hearing a Fifth Step" (not drawn on).
  5. Steps 6–7. Readiness to let go of survival traits and character defects. The BRB distinguishes the two.
  6. Steps 8–9. A list of people harmed and amends, including amends to oneself (workshop handout). The fellowship literature says sponsors and informed counsellors help, especially when the member is considering amends to an abusive parent.
  7. Step 10. Daily inventory of traits, prompt admission and self-forgiveness.
  8. Step 11. Prayer and meditation, listening to body and instincts, and reaching out to the support network.
  9. Step 12. Spiritual awakening, carrying the message and service.
• Materials:
  • BRB Part II.
  • The Twelve Steps of Adult Children Workbook (the "Yellow Workbook"), for individual or group use, with exercises and questionnaires.
  • Step-study meetings.
• Example language (illustrative): "When you start Step 4, let's agree how we'll pace it here. Which memories feel too big to write about without support?"
• Watch for:
  • Trauma flooding during Step 4 writing and the Step 5 telling.
  • Pressure to make amends to, or confront, an abusive parent. Agree with the client that safety comes first.
  • Self-blame when inventory turns survival traits into "defects".
  • It is working when the client makes self-compassionate links between past and present and feels relief after Step 5.

A7. Reparenting: becoming your own loving parent (The Solution)

• Purpose / when: ACA's central change process. The member develops an inner loving parent who meets the needs of the inner child and counters the inner critical parent. [source: ACA Essentials; BRB contents ch. 8; Loving Parent Guidebook page]
• Steps (as published):
  1. BRB ch. 8 (pp. 295–330) covers key terms, the inner child and the inner critical parent, then Loving Parent and Inner Child exercises (pp. 309–317). The exercises address sabotage, trust and self-esteem, and validating, negotiating with, celebrating and integrating the inner child (pp. 318–325). The chapter closes with what to expect, affirmations and a meditation. These pages are not drawn on; only their headings are known.
  2. The Loving Parent Guidebook (released for fellowship review in 2021) gives practical reparenting guidance. Its bonus resources include:
     • a reparenting check-in worksheet
     • guided check-in scripts of 2–3 minutes and of 15 minutes
     • a feelings, needs and physical sensations help sheet
     • an Inner Family Chart
     • a partner exercise
     • a toolkit
     • a study-group guide with sample agreements
  3. The client may join a Loving Parent Guidebook study group or meeting.
• Example language (illustrative): "When that critical voice says you've failed, what would a kind, steady parent say to the part of you that's scared?"
• Watch for:
  • Regression or overwhelm in inner-child work, especially with dissociative clients.
  • The "critical parent" turning on the work itself ("I'm doing reparenting wrong").
  • It is working when self-talk becomes gentler, needs are named, and the client keeps commitments to themselves.

A8. Non-conference-approved reparenting exercises circulating in ACA

• Purpose / when: Clients may bring intergroup workbooks from ACA meetings. One example is "Reparenting My Inner Child" (Central Coast ACA Intergroup, Oct 2020). It states that it is not conference-approved or affiliated with ACA WSO and draws on Bradshaw, Whitfield, Capacchione, transactional analysis, Lifespan Integration and EMDR. Know what these workbooks ask so you can pace the client. [source: CCIG Reparenting workbook]
• Exercises described in that workbook (paraphrased):
  • a 10-minute daily talk with the inner child, plus check-ins when strong feelings arise
  • loving-parent and inner-child role-play, including apologies and promises
  • a guided visualisation of meeting the child, with a partner debrief
  • dominant-hand and non-dominant-hand dialogue writing
  • mirror work and self-hug
  • talking to a childhood photo
  • play, art and a sensory log of associated memories
  • needs checklists
  • a "Tombstone" exercise
  • a life timeline
  • a belief-to-behaviour alignment grid
  • a boundary rule of ending a relationship after a third violation
  • a repeated reparenting affirmation
• Example language (illustrative): "Let's try the photo exercise here first, with a time limit and a plan for coming back to the present."
• Watch for:
  • Guided imagery and timelines can trigger trauma memories. Screen for dissociation and PTSD first.
  • The rigid "third violation" rule may not fit every relationship, such as with dependent children or an employer.
  • These exercises are not ACA WSO literature. Do not present them as ACA's program. [synthesis]

A9. Affirmations, the Promises and self-love practice

• Purpose / when: Counter internalised criticism. [source: ACA Essentials; BRB contents ch. 15]
• Steps:
  1. ACA Essentials includes affirmations giving permission to:
     • trust oneself
     • say no without guilt
     • rest
     • feel anger and cry
     • make mistakes and not know
     • ask for help
     • think differently from the family
     • detach with love
     • reparent oneself
  2. The Promises describe outcomes such as identity, self-esteem, less people-pleasing, intimacy, boundaries and the capacity to play. They are read at meetings.
  3. BRB ch. 15 has mirror exercises (p. 444).
• Example language (illustrative): "Pick one permission that feels almost believable, and notice when you act on it this week."
• Watch for:
  • Affirmations that feel false can increase shame. Choose ones the client finds plausible.

A10. Literature, journaling and meditation

• Purpose / when: Daily practice between meetings. [source: Complete List of ACA Books; Sponsorship pamphlet]
• Steps:
  • Strengthening My Recovery: 365 daily readings with BRB quotes.
  • A New Hope: the beginner's handbook.
  • Connections: a guide to support relationships, sponsors and boundaries.
  • Sponsors encourage journaling and meditation.
• Example language (illustrative): "What did this morning's reading stir up?"
• Watch for:
  • Rumination dressed up as journaling. Shift the client to brief, feelings-and-needs entries. [synthesis]

A11. Service and Tradition study

• Purpose / when: Moving from "healing to helping". Service as recovery: BRB ch. 10 covers recovery from pain, shutdown and survival through service. [source: BRB contents; A New Hope Appendix A; Sample Meeting Format]
• Steps:
  • Greeter or closer roles after about 3 months.
  • Passing the basket and handing out chips.
  • Group offices.
  • Sponsoring others.
  • Tradition study meetings. BRB ch. 19 pairs each Tradition with shares, insight, writing and meditation.
• Example language (illustrative): "Is taking on the greeter job something you want, or something you feel you should do?"
• Watch for:
  • Over-functioning or caretaking through service, which repeats the hero role.
  • Service used to avoid one's own work.

Part B: Clinician procedures

B1. Assessing fit for ACA

• Purpose / when: At intake, or whenever childhood family dysfunction appears central to the presenting problem. ACA's pamphlet for professionals targets anxiety, depression, PTSD and other effects of childhood trauma. [source: Health Professionals; rest synthesis]
• Steps: [synthesis]
  1. Take a family history. Ask about parental addiction, mental illness, abuse, neglect, rigidity or perfectionism, gambling or debt, foster care or adoption.
  2. Name two or three Laundry List themes you hear, in your own words, and ask whether they fit.
  3. Check the client's capacity for groups:
     • social anxiety level
     • dissociation
     • current crisis or suicide risk (do standard risk assessment first)
     • active addiction (ACA asks sponsors and sponsees to abstain; a primary addiction fellowship may come first or run alongside)
  4. Ask about attitudes to spirituality and Higher Power language, and any religious trauma.
  5. Check for practical or identity barriers: language, disability, wanting a meeting for a specific community. Online and phone meetings widen choice.
• Example language (illustrative): "There's a free peer group for people who grew up in homes like yours. You don't need a parent who drank. Would you like to hear what it's like?"
• Watch for:
  • Acute suicidality, psychosis or active domestic violence. Stabilise first. ACA is an adjunct, not a safety resource.

B2. Preparing for the first meeting

• Purpose / when: Once the client is interested. Reduces drop-out after one meeting. [source: Sample Meeting Format and Health Professionals for format and six-meeting advice; steps synthesis]
• Steps:
  1. Explain the format (see A1): readings, a prayer, optional first-name introduction, timed shares, no cross talk, a basket, a closing circle.
  2. Give the six-meeting suggestion and why: meetings vary, so try several.
  3. Help the client find a meeting through ACA's Find a Meeting tool. Choose a beginner's meeting if one is available.
  4. Plan opt-outs: "I'm just listening", stepping back from hand-holding, leaving early.
  5. Plan aftercare for the evening of the meeting: grounding, and a call to a safe person.
  6. ACA WSO offers health professionals a free copy of the Big Red Book on request. ACA meetings vary in whether non-members may attend; check locally. [uncertain]
• Example language (illustrative): "You can say 'I'll pass' when it's your turn. Let's decide now what you'll do afterwards if you feel stirred up."
• Watch for:
  • Avoidance framed as "it's not for me" before the client has attended. Explore it without pushing.

B3. Meeting and Step debrief in session

• Purpose / when: Each session, briefly (5–10 min). Links fellowship experience to therapy goals. [synthesis]
• Steps:
  1. Ask what stood out: a share, a reading or a feeling.
  2. Name the Laundry List trait or survival role involved.
  3. Explore the bodily and emotional response, and grounding if needed.
  4. Link it to the current treatment target.
  5. Note supports used: calls, sponsor, literature.
• Example language (illustrative): "When you heard her talk about her father, what happened in your body? Which old rule kicked in: don't talk, don't trust or don't feel?"
• Watch for:
  • Material from shares the client was told in confidence. Focus on the client's own reaction, not other people's stories.

B4. Using ACA language in case formulation

• Purpose / when: Turns ACA's vocabulary into clinical targets. [synthesis, drawing on terms from ACA Essentials, Sponsorship pamphlet and workshop handout]
• Steps:
  1. Map the Laundry List traits the client endorses onto your formulation. For example, approval-seeking maps to schemas or core beliefs, and the excitement trait to crisis-seeking.
  2. Use the Flip Side lists for goals.
  3. Use the "inner critical parent" as shared language for self-criticism work.
  4. Survival roles (hero or rescuer, lost child, scapegoat, mascot) appear in ACA workshop material. Use them only as descriptive aids, not as diagnoses. They come from the wider family-systems ACoA literature, which is not drawn on here. [uncertain]
• Example language (illustrative): "In ACA they'd call this people-pleasing. In here, let's track exactly when it starts and what it protects you from."
• Watch for:
  • Labels hardening into fixed identity.
  • Cultural differences in family obligations. Not every family duty is dysfunction.

B5. Pacing Step 4/5 and amends alongside trauma treatment

• Purpose / when: When the client starts a Step 4 inventory, prepares a Step 5, or considers amends to or contact with a parent. ACA refers members to informed counsellors at this point. [source: ACA And Its Beginnings for counsellor role; BRB ch. 16 headings on dissociation, PTSD and recovered memories; steps synthesis]
• Steps:
  1. Check stabilisation: emotion regulation skills, low dissociation, safe current relationships.
  2. Agree with the client on limits for writing: time-limited sessions, and a container for unfinished material.
  3. Bring the most intense memories to therapy rather than to solitary writing.
  4. Help the client tell their sponsor how much of the trauma detail they will share in Step 5.
  5. For amends or contact with an abusive parent, assess the risk of renewed harm, and remember that amends can be to oneself. No confrontation is required for recovery.
  6. If memories surface that were not previously known, keep a neutral stance. Do not confirm or interpret them. BRB ch. 16 has a section titled "recovering memories". [uncertain]
• Example language (illustrative): "Your Step 4 can go at the pace your nervous system can manage. What's one piece you can write this week, and what will you bring here instead?"
• Watch for:
  • Nightmares, rising self-harm urges, or dissociation after Step writing. Slow down and coordinate with the client.

B6. Supporting reparenting work in therapy

• Purpose / when: When the client is doing Loving Parent work in ACA. [synthesis]
• Steps:
  1. Ask what the inner loving parent and the inner child said in this week's check-in.
  2. Reinforce a compassionate voice and notice the critical parent.
  3. For exercises involving imagery, photos or timelines (A8), rehearse them in session with grounding first.
  4. If the client has a dissociative disorder, coordinate with phase-oriented trauma treatment before any inner-child dialogue.
• Example language (illustrative): "Let's do the check-in together now, for two minutes: feelings, needs, body."
• Watch for:
  • Switching, age regression or loss of time. Stop and ground the client.

B7. Role clarity: therapist, sponsor, fellowship

• Purpose / when: Throughout. Clinicians who are themselves ACA members need this most. [source: Sponsorship pamphlet for sponsor limits; Therapy and Counselors page notes that some therapists are ACA members; rest synthesis]
• Steps:
  1. Remind the client that the sponsor is not a therapist and that you are not a sponsor.
  2. If you are an ACA member yourself:
     • Avoid attending the same meetings as your clients, or agree a plan if you meet by chance.
     • Never sponsor a client.
     • Keep your own anonymity and the client's confidentiality separate.
  3. Get written consent before any contact with a sponsor. Such contact is rarely indicated.
• Example language (illustrative): "Your sponsor walks the Steps with you. My job is the trauma work and your safety plan. Both matter, and they're different."
• Watch for:
  • The client playing sponsor against therapist (splitting).
  • The sponsor giving clinical advice, such as about medication or diagnosis.

5. Handling problems

The ACA sources give almost no guidance on problems beyond sponsor boundaries and the six-meeting advice. Everything below is [synthesis] unless a source is cited.

• Client won't try a meeting.
  • Explore the specific fear: being seen, the prayer, groups in general, or being disloyal to the family.
  • Offer listen-only phone or online meetings as a first step.
  • Offer a single beginner's meeting rather than "joining".
  • Respect a no. ACA is optional.
• Drop-out after one or two meetings.
  • Remind the client of the six-meeting suggestion and that meetings differ in tone. [source: Sample Meeting Format]
  • Help pick a different meeting type, such as a speaker, Loving Parent Guidebook or beginner's meeting.
  • Debrief what went wrong at the meeting.
• Higher Power or prayer objections.
  • ACA describes itself as spiritual, not religious, and lets members define their own Higher Power (BRB ch. 5). [source: BRB contents]
  • Discuss non-theistic readings, such as the group or one's values.
  • Client may stay silent during prayers or step outside the circle.
  • Clients with religious trauma may need this processed in therapy first.
• Overwhelm or flooding from shares.
  • Teach grounding to use during meetings.
  • Client may sit near the door and leave if needed.
  • Fewer meetings while stabilising.
  • Plan aftercare for the day of each meeting.
  • Cut back if symptoms rise after meetings.
• Over-disclosure or trauma dumping in shares.
  • Rehearse "headline" shares that leave out detail.
  • Keep detailed processing for therapy.
• "I'm all 14 traits" (shame spiral).
  • Reframe the traits as survival adaptations. [source: Health Professionals — false self from dysfunction]
  • Pair each trait with its Flip Side.
  • Point to signs of resilience.
• Identity fixation or blame stuckness.
  • Client uses ACA language to explain everything, or stays in grievance.
  • Revisit The Solution's release of the parents from blame for present choices, and the client's agency now. [source: ACA Essentials]
  • Validate grief first.
• Problematic sponsor. The sponsor controls, shames, gives clinical advice, lends money, sexualises the relationship or rescues.
  • Use ACA's own list of things sponsors do not do as a benchmark. [source: Sponsorship pamphlet]
  • Coach the client to end the sponsorship: ending is not abandonment, and should be done honestly and tactfully.
  • Suggest a co-sponsor or a different sponsor.
  • If there is sexual exploitation or financial abuse, support the client in taking safety steps. ACA's published guidance does not cover reporting such abuse. [uncertain]
• The "Thirteenth Step" (romantic or sexual approaches to newcomers).
  • BRB ch. 9 lists the Thirteenth Step as a topic (not drawn on). [uncertain]
  • Warn newcomers who are vulnerable to people-pleasing.
  • Plan how they can say no and change meetings.
• Pressure to make amends to or confront an abuser. See B5.
  • Amends can be to oneself.
  • Safety comes before contact.
  • Recovery does not require reconciliation.
• Non-adherence to Step work.
  • Explore perfectionism: "I have to do Step 4 perfectly or not at all".
  • Break the work into small pieces.
  • Normalise variable pace. No timetable is published.
• Secondary addictions or relapse into old patterns.
  • ACA names secondary addictions (BRB ch. 4) and relapse (ch. 12). [source: BRB contents]
  • For substance use, refer to the relevant fellowship or treatment as well.
  • Name relapse into old behaviours as information, not failure.
• Rupture with the therapist. The client says "ACA understands me better than you" or "you sound like my critical parent".
  • Validate what the fellowship gives them.
  • Explore the rupture openly, as you would any repair.
  • Clarify your different role.
  • Avoid competing with the fellowship.
• Splitting between sponsor and therapist.
  • Name the pattern.
  • Restate the roles.
  • Do not criticise the sponsor. Keep the focus on the client's needs.
• Group process problems. Cliques, cross talk or a dominant member.
  • These belong to the group conscience under the Traditions, not to you.
  • Help the client choose another meeting or raise the issue at a business meeting.
• Dissociative or complex-trauma clients and inner-child work.
  • Postpone imagery, timeline and photo exercises (A8) until stabilisation.
  • Coordinate with phase-oriented treatment.
• Suicidal crisis.
  • ACA is not a crisis service.
  • Follow standard risk assessment and safety planning, including lethal-means counselling (safe storage and removal).
  • Add ACA contacts to the safety plan only as supplementary social support.

Sources

Sources:

• Sample Meeting Format (ACA WSO, ©2006)
• ACA And Its Beginnings (SoCal ACA copy of ACA history)
• ACA Essentials (ACA WSO)
• The Flip Side of The Laundry List (ACA WSO, ©2007)
• Complete List of ACA Books (ACA WSO)
• ACA Sponsorship – Fellow Traveler pamphlet (ACA WSO)
• Information For Health Professionals (ACA WSO, 2025)
• Therapy and Counselors (ACA WSO)
• A New Hope, Appendix A: beginner's meeting format (ACA WSO)
• Loving Parent Guidebook page (ACA WSO)
• Reparenting My Inner Child workbook (Central Coast ACA Intergroup, Oct 2020; not conference-approved)
• Audio Fellowship Text (A-BRB) contents index (ACA WSO)
• George, ACA World Convention 2023 Twelve Steps workshop handout

Further reading (not drawn on beyond the pages above):

• ACA WSO (2006). Adult Children of Alcoholics/Dysfunctional Families (Fellowship Text, "Big Red Book"). Torrance, CA: ACA WSO.
• ACA WSO. Twelve Steps of Adult Children Steps Workbook.
• ACA WSO (2021, fellowship review release). Loving Parent Guidebook.
• ACA WSO. Strengthening My Recovery; A New Hope: ACA Beginner's Handbook; Connections; The Laundry Lists Workbook.
• Tony A. (1991). The Laundry List: The ACoA Experience.
• Black, C. (1981). It Will Never Happen to Me. [uncertain]
• Woititz, J. G. (1983). Adult Children of Alcoholics. [uncertain]

Further reading (not drawn on): the ACA WSO Sponsorship–Fellow Traveler web page and the PTSD resources page. BRB chapter bodies, including ch. 8 exercises, ch. 16 on therapy and the Step 4 worksheets, are not drawn on; only their headings are used here. [uncertain]