Family twelve-step fellowships

1. Introduction

Version followed: each fellowship's own current public materials as opened in October 2026 (Al-Anon WSO professionals FAQ and blog; Al-Anon UK & Eire UKG7 suggested meeting format; Nar-Anon WSO newcomer leaflet plus one local US Nar-Anon meeting format of 11/2020; Gam-Anon International "Tools of Gam-Anon"; Families Anonymous suggested meeting format 5003 dated 18 June 2025, Letter to the Newcomer 6001 and sponsorship guideline WSOF-26). Co-Anon and COSLAA are covered only from directory listings because their own sites are not drawn on [uncertain].

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. Meetings are led by members, there are no professionals in the chair, no fees, and no outside funding [source: Al-Anon professionals FAQ; Nar-Anon newcomer leaflet; FA format 5003]. Nar-Anon states plainly that it "is not group therapy" [source: Nar-Anon newcomer leaflet]. This guide is written for a clinician who refers family members to these groups, works alongside them, or uses their principles in individual or family work.

Core idea of how change happens (as the fellowships describe it). The family member cannot cause, control or cure the other person's addiction; recovery is for the family member and does not depend on whether the drinker or user stops [source: Al-Anon professionals FAQ; Al-Anon domestic-violence blog member account]. Change comes from peer identification ("We learn by listening and heal by sharing" [source: Nar-Anon newcomer leaflet]), keeping the focus on oneself rather than the addicted person, working the Twelve Steps (often with a sponsor), daily use of literature and slogans, and service. Working on oneself is described as the most useful thing a member can do for the loved one [source: FA basic readings, format 5003].

Who each fellowship serves [sources as tagged]:

• Al-Anon – adults affected by someone else's drinking; people who are unsure whether drinking is harming them are welcome; people concerned about drug use may attend, knowing the programme focuses on alcoholism. In Al-Anon's 2015 member survey 40% first came because of a relative's or friend's drug problem [source: Al-Anon professionals FAQ].
• Alateen – teenagers (some groups also accept pre-teens); online Alateen chat meetings for ages 13–18; groups need certified adult Al-Anon sponsors [source: Al-Anon professionals FAQ].
• Nar-Anon – families and friends of people with addiction (drug focus) [source: Nar-Anon newcomer leaflet].
• Gam-Anon – anyone affected by a loved one's gambling: spouses, partners, parents, children, siblings, friends, employers; usually meets the same night as Gamblers Anonymous in a separate room [source: Gam-Anon tools page; GA Toronto Gam-Anon page]. A teen branch (Gam-A-Teen) exists but its details are [uncertain].
• Co-Anon – men and women affected by someone else's cocaine (and, per wider usage, other mind-altering substance) use; runs an international e-meeting and sells its own literature [source: Faces & Voices of Recovery directory listing, secondary; scope beyond cocaine uncertain].
• COSLAA (Co-Dependents of Sex and Love Addicts Anonymous) – listed by an SLAA intergroup as a Twelve Step/Twelve Tradition group for family and friends of sex or love addicts; SLAA itself runs no meetings for family members. No description of COSLAA's format could be opened [uncertain]. Alternatives with published descriptions: S-Anon (anyone affected by another's sex addiction; in-person, phone and online meetings; S-Ateen for ages 12–19) and COSA (peer-led, free; for people affected by another's compulsive sexual behaviour) [source: SLAA FWS family page; Sacramento SLAA links page].
• Families Anonymous – relatives and friends concerned about someone's use of mind-altering substances or related behavioural problems; a suspicion of a problem is enough to attend [source: FA format 5003].

2. Framework

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 [synthesis].

(a) Member path (published)

1. 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 [source: Al-Anon professionals FAQ]. Newcomers may come early or stay late to ask questions [source: Nar-Anon newcomer leaflet].
2. Trial period. Attend at least six meetings before deciding whether the programme fits (Nar-Anon; FA format), or about six weeks of meetings (FA Letter to the Newcomer). Listen for similarities, not differences [source: Nar-Anon newcomer leaflet; FA 5003; FA 6001]. Early anger, confusion and hopelessness are expected. Deciding can take several weeks [source: FA 6001].
3. Regular attendance and between-meeting contact. Take the group phone or email list and use it, especially in a crisis or before hard decisions. Read the fellowship's literature and daily reader. Try other local meetings [source: FA 6001; Gam-Anon tools; Nar-Anon leaflet].
4. Sponsorship and Step work. Later, ask an experienced member to sponsor you through the Twelve Steps [source: FA 6001; FA WSOF-26; Gam-Anon tools; Nar-Anon leaflet].
5. Service. Help at group or wider level. This is framed as the Twelfth-Step principle of giving back [source: Gam-Anon tools; Nar-Anon leaflet].

A typical meeting lasts about an hour to an hour and a half. Share length is commonly 3–5 minutes (FA), with a leader share of up to 10 minutes (one Nar-Anon format) [source: FA 5003; Nar-Anon local format]. Exact meeting length is not stated in the sources [uncertain].

(b) Clinician frame for using a family fellowship [synthesis]

3. Guiding principles

Fellowship principles (as published), each with what it means for the clinician:

• Keep the focus on yourself [source: Nar-Anon leaflet; Nar-Anon format; FA readings]. Meaning: the client's own reactions, not the addicted person's behaviour, are the work. Don't frame attendance as a way to fix the user.
• Recovery does not depend on the loved one stopping [source: Al-Anon professionals FAQ]. Meaning: measure progress by the client's wellbeing, not by the drinker's or user's sobriety.
• Addiction is an illness, not a moral failing; family cannot stop another's use but can avoid blocking recovery [source: FA "About Substance Use Disorder"; Nar-Anon "About Addiction" reading]. Meaning: use the illness frame to reduce blame and guilt, and pair it with the client's own responsibility for their reactions.
• Peer support, not advice or direction [source: Al-Anon FAQ; Nar-Anon leaflet; FA crosstalk rule]. Meaning: prepare clients that nobody will tell them what to do. Decisions (separation, money, ultimatums) stay with the client and with you in therapy.
• Not group therapy; no professional leadership [source: Nar-Anon leaflet; Al-Anon FAQ]. Meaning: you may help start a group, but members run it. Never chair or steer it.
• Spiritual, not religious; Higher Power self-defined [source: Al-Anon FAQ; FA "no religion" note]. Meaning: explore the client's beliefs. Secular and atheist clients can define the concept their own way.
• Anonymity and confidentiality – first names only; what is heard stays in the room; phone numbers are never passed on without permission; anonymity protects the addicted person too [source: UKG7; Nar-Anon leaflet; FA 5003; Gam-Anon tools]. Meaning: don't ask the client to report on other members. Agree how the client will talk about meetings in therapy.
• Take what you like and leave the rest; programme is suggestion-based [source: Nar-Anon local format; FA 5003 closing]. Meaning: the client may use parts of the programme. Partial uptake is legitimate.
• Neither for nor against interventions; no discussion of treatment centres, drugs or religion in meetings [source: Nar-Anon leaflet]. Meaning: treatment-engagement strategies (for example CRAFT-style work) belong in therapy, not in the meeting [synthesis].
• Avoid group-harming behaviours: religion talk, gossip, dominating or advising, dwelling on the past (FA's "Four Destructive Forces") [source: FA 5003]. Meaning: these are the norms the client will meet, and they can be used as a self-check.
• Self-supporting, no outside affiliation; voluntary contributions [source: Al-Anon FAQ; FA 5003; Nar-Anon leaflet]. Meaning: there is no cost barrier. Some meetings ask newcomers not to contribute.
• Safety first – Al-Anon states its programme does not provide counselling or immediate domestic-violence resources; in danger, call emergency services [source: Al-Anon DV blog]. Meaning: the clinician, not the fellowship, owns risk assessment and safety planning.
• Clinician stance [synthesis]: be curious and non-directive about attendance; respect the fellowship's autonomy; keep clinical decisions clinical; don't use fellowship slogans to override safety concerns or the client's legitimate anger.

4. Intervention inventory

The inventory has three parts. 4A covers the tools all six fellowships share, as they describe them. These are things the member does; the clinician explains them and helps the client use them. 4B covers what is specific to each fellowship. 4C covers clinician procedures for referring to and working alongside the fellowships; these are mostly [synthesis], because the fellowships publish little guidance for therapists beyond how to refer.

4A. Shared fellowship tools (as published)

A1. The meeting

• Purpose / when: this is the core tool. Peer identification breaks isolation ("realize they aren't alone" [source: GA Toronto Gam-Anon page]). Use from first referral onwards.
• Steps (typical sequence, paraphrased from published formats):
  1. Opening: welcome, often a moment of silence, the group's purpose and a confidentiality reminder.
  2. Readings: the fellowship's preamble or welcome, the Twelve Steps and Twelve Traditions, plus the fellowship's own basic readings. In Nar-Anon this includes "About Addiction" and optional readings on Detachment and Enabling. In FA it is six basic readings, including "Four Destructive Forces" and "Helping".
  3. Introductions by first name only.
  4. Announcements and business.
  5. A topic, Step or speaker. In Al-Anon this might be a topic such as acceptance, fear, change or a slogan.
  6. Members share in turn.
  7. Newcomers are gently invited to speak.
  8. Voluntary collection (the Seventh Tradition).
  9. Closing reminders: take what you like and leave the rest; respect anonymity.
  10. The Serenity Prayer, then informal fellowship time.
  [source: UKG7; Nar-Anon local format; FA 5003; Al-Anon FAQ]. Formats vary by group and country [uncertain about any single "standard"].
• Example language (illustrative): "It's run by members, not professionals. You'll hear readings, then people take turns talking about their own experience. You can just say your first name and 'I'll listen today.'"
• Watch for: the client leaving with relief ("others live this too"), or alienation (religious language, people with very different stories). Debrief after each meeting (C4).

A2. Sharing etiquette: no crosstalk, no advice, focus on self

• Purpose / when: these norms make the room safe and are central to the method. Prepare clients for them before their first meeting.
• Steps:
  • Raise a hand and wait to be recognised.
  • Speak for about 3–5 minutes.
  • Don't comment on, question or counsel another member's share. That is crosstalk.
  • Avoid gossip, criticism, religion and dwelling on the past.
  • Talk about yourself rather than the addicted person. One UK format discourages talk about the alcoholic, and Nar-Anon discourages discussing the user's drug types or treatment.
  [source: FA 5003; Nar-Anon leaflet; UKG7].
• Example language (illustrative): "Nobody will answer you directly or give you advice. That can feel cold at first, but it's deliberate. It's so everyone can speak without being fixed."
• Watch for: clients who feel unheard because nobody responds to them. Use therapy to process the content they shared.

A3. The Twelve Steps

• Purpose / when: a personal-change sequence, adapted from AA for family members. It runs from admitting powerlessness (over the other person's addiction) and unmanageability, through a self-defined Higher Power, a moral inventory and amends, to prayer or meditation and carrying the message to others [source: FA 5003 summary; Al-Anon FAQ on self-defined Higher Power]. Usually worked with a sponsor after the trial period.
• Steps: worked in order with fellowship literature and a sponsor. The clinician does not teach the Steps (the texts are copyrighted and fellowship-owned). The clinician can help the client process material that Step work raises, such as inventory, resentment and amends [synthesis].
• Example language (illustrative): "What came up for you writing about the resentments? Is there anything there you'd like to look at here, too?"
• Watch for: inventory or amends work turning into self-blame for the other person's addiction or for abuse. See section 5.

A4. Traditions, anonymity and confidentiality

• Purpose: the Traditions protect group unity: leaders serve and don't govern, groups are autonomous, groups have one purpose and no outside affiliation, groups are self-supporting, and anonymity is their foundation. Members may be as anonymous as they choose [source: FA 5003; Gam-Anon tools].
• Steps for the clinician: reassure the client that first names are enough and that phone numbers are not passed on without consent [source: UKG7]. In virtual FA meetings, members join from a private space, use first name and last initial, and do not record [source: FA 5003].
• Watch for: fear of being seen locally. Offer online meetings or meetings in another area [synthesis].

A5. Sponsorship

• Purpose / when: individual, structured support from an experienced member who has worked the Steps. It goes deeper into the Steps than meetings alone [source: FA WSOF-26]. A Gam-Anon sponsor listens objectively rather than supplying all the answers and keeps in regular contact between meetings [source: Gam-Anon tools].
• Steps (as described):
  1. Call several members between meetings.
  2. Gravitate to one of them.
  3. Ask that person to sponsor you.
  Some groups list long-time members who are willing to sponsor [source: FA WSOF-26]. FA's detailed roles are in its booklet #1020 [uncertain].
• Example language (illustrative): "Is there anyone whose sharing you related to? You could ask them for coffee or a call before deciding anything about sponsorship."
• Watch for: sponsors giving clinical, legal or medication advice, or a sponsor relationship that reproduces control or dependency [synthesis]. See section 5.

A6. Telephone and email list

• Purpose / when: daily contact between meetings, especially in a crisis or before hard decisions. Experienced members also reach out to newcomers [source: Gam-Anon tools; FA 6001; Nar-Anon leaflet].
• Steps: take the list, make one low-stakes "practice" call early, and call before reacting in a crisis.
• Example language (illustrative): "Before the next payday argument, could you call one person on the list, even just to say you're anxious?"
• Watch for: the client never calling. Shame and fear of burdening others are common barriers, and therapy can address them [synthesis]. Solicitation using the list is prohibited [source: Nar-Anon local format].

A7. Literature and daily readers

• Purpose: members read the same materials worldwide and carry small pamphlets for support during stressful moments [source: Gam-Anon tools].
• Examples named in sources: Nar-Anon Conference Approved Literature, the Blue Booklet and the SESH daily reader [source: Nar-Anon leaflet]; FA's Today A Better Way daily reader and its tools handbook (#5001) [source: FA 5003; FA product page via search]; Al-Anon's Courage to Change [source: Al-Anon personal-safety blog].
• Example language (illustrative): "Would one reading a morning be manageable? Notice which ones you argue with as well as which ones help."
• Watch for: passages used to suppress justified anger or safety-seeking. Discuss them in session.

A8. Slogans

• Purpose: short reminders for moments of high emotion. Examples given in sources are "One Day at a Time" and "Easy Does It" [source: Al-Anon FAQ; Nar-Anon format closing]. A related phrase from a member account: "I didn't cause the alcoholism, I can't control the alcoholism, and I can't cure it" [source: Al-Anon DV blog].
• Use: help the client choose one slogan as a coping cue for a specific trigger [synthesis].
• Watch for: slogans used to dismiss real problems. One Day at a Time does not mean ignoring a safety plan.

A9. Writing

• Purpose: writing helps members understand themselves, firm up resolutions, and pause before speaking hastily [source: Gam-Anon tools].
• Steps: write before difficult conversations, and after meetings to note what resonated [synthesis on specific uses]. The writing can be brought to therapy.

A10. Service

• Purpose: giving back to the programme, framed by the Twelfth Step [source: Gam-Anon tools; Nar-Anon leaflet]. Ranges from setting out chairs to group and world-service roles.
• Watch for: service used to avoid one's own issues, or a caretaking pattern re-enacted [synthesis].

A11. Electronic, phone and online meetings

• Purpose / when: for clients with no local meeting, with mobility, childcare or privacy barriers, or who are teens. Examples: Alateen chat for ages 13–18 [source: Al-Anon FAQ]; FA virtual and hybrid meetings with camera-on, mute, private-space and no-recording norms [source: FA 5003]; Co-Anon's international e-meeting [source: Faces & Voices listing].
• Watch for: a client joining from a home where the addicted person can overhear. See the safety procedures (C2).

4B. Fellowship-specific features

B1. Al-Anon and Alateen

• Purpose / when: for family and friends of a drinker, and for teens (Alateen). Also suits clients whose relative uses drugs and who will tolerate an alcohol focus [source: Al-Anon FAQ].
• Distinctive features:
  • Topic-based discussion, with a different member chairing each week.
  • Groups marked "open" welcome anyone interested.
  • Many Alateen groups meet at the same time and place as an Al-Anon group. Where there is no Alateen group, teens may attend Al-Anon.
  • Alateen Group Sponsors must be active Al-Anon members, at least 21, with two or more years in Al-Anon, no felony convictions or child-abuse charges, and certification under state or provincial safety and behaviour requirements. Local areas may add requirements [source: Al-Anon FAQ].
  • A professional may suggest or help start a group, but members conduct it, and Alateen still requires certified sponsors [source: Al-Anon FAQ].
  • UK & Eire format: occasional AA speakers can be invited, but they should focus on family recovery [source: UKG7].
• Example language (illustrative): "There's an Alateen group that meets at the same time as the Al-Anon meeting your mum might try. The adults who run it are vetted and certified."
• Watch for: teens being unable to get to meetings without the drinking parent. Online Alateen chat (13–18) is an option [source: Al-Anon FAQ].

B2. Nar-Anon

• Purpose / when: for family and friends of a person using drugs.
• Distinctive features:
  • Readings include "About Addiction" and optional newcomer readings: Detachment, Enabling, and "An Open Letter to My Family".
  • The format ends with a Do's and Don'ts list. One example paraphrased from it: don't keep checking up on your addict.
  • Members don't name other programmes, institutions or treatment centres.
  • Meetings don't discuss drug types, treatment options or treatment drugs.
  • Nar-Anon neither encourages nor discourages interventions.
  • Literature includes the Blue Booklet (Steps, Traditions, Concepts and readings) and the SESH daily reader.
  • The Twelve Concepts of Service guide service work.
  [source: Nar-Anon leaflet; Nar-Anon local format].
• Example language (illustrative): "In Nar-Anon they won't discuss treatment options for your son. That's something we can do here. The meeting is for you."
• Watch for: parents seeking treatment advice in meetings and leaving frustrated. Redirect that need to therapy or family treatment.

B3. Gam-Anon (and Gam-A-Teen)

• Purpose / when: for anyone affected by a loved one's gambling.
• Distinctive features:
  • Meetings usually run alongside Gamblers Anonymous in a separate room [source: GA Toronto].
  • Tools include writing and the Pressure Relief Group Meeting [source: Gam-Anon tools]. That meeting helps members handle debts in the gambler's name, joint names or the member's own name, and work toward a livable budget covering family needs and all debts.
  • A 20-question self-check is published. Six or more "yes" answers suggests living with a compulsive gambler [source: GA Toronto]. Do not reproduce the items; direct the client to the fellowship's own page.
  • Gam-A-Teen exists. Its format is [uncertain].
• Steps for clinician use [synthesis]:
  1. Screen early for financial harm.
  2. Explain that the Pressure Relief meeting is a fellowship meeting, often held jointly with the gambler (GA practice; joint format not confirmed [uncertain]).
  3. Pair it with independent financial or debt advice and protection of the family member's own accounts and credit.
• Example language (illustrative): "Gam-Anon has a meeting specifically about debts and a family budget. Alongside that, let's get you independent debt advice so your own money is protected."
• Watch for: pressure on the family member to take on the gambler's debts, and financial abuse. See section 5.

B4. Co-Anon

• Purpose / when: for those affected by someone's cocaine use (described as cocaine dependence). There is an international e-meeting, and literature can be ordered from its website [source: Faces & Voices listing, secondary]. Its official meeting format and tools are [uncertain]. It is presumed to follow the shared Twelve Step/Twelve Tradition structure in 4A [uncertain].
• Clinician use [synthesis]: offer it when the client identifies specifically with cocaine or stimulant problems or prefers a small fellowship. Nar-Anon, FA or Al-Anon are alternatives where Co-Anon has no local meetings.

B5. COSLAA (and S-Anon, COSA)

• Purpose / when: for partners, family and friends of people with sex or love addiction. SLAA states it runs no meetings for spouses, family or significant others. One SLAA intergroup lists COSLAA, COSA and S-Anon as related Twelve Step/Twelve Tradition groups, without endorsing them [source: SLAA FWS family page; Sacramento SLAA links]. COSLAA's own site is not drawn on, so its current activity, meeting availability and format are unverified [uncertain].
• Published alternatives:
  • S-Anon: in-person, phone and online meetings, its own literature, one-to-one phone support, and S-Ateen for ages 12–19.
  • COSA: confidential, peer-led, free. The focus is on the member's own healing rather than managing the addict's behaviour. It has resources for LGBTQIA+ members, men, and Spanish speakers.
  [source: SLAA FWS family page].
• Clinician use [synthesis]: many partners present after discovering a betrayal and with trauma symptoms. Assess for betrayal trauma, sexual coercion and sexually transmitted infection risk before referral. Check that the client is not being told their own reactions caused the partner's behaviour.

B6. Families Anonymous (FA)

• Purpose / when: for relatives and friends concerned about someone's substance use or related behavioural problems. It suits parents of adolescents and young adults, and situations that are mixed or unclear [source: FA 5003].
• Distinctive features:
  • Six basic readings, including "About Substance Use Disorder", "Four Destructive Forces" and "Helping".
  • Topic meetings in which members rotate leadership.
  • Explicit crosstalk rule, 3–5-minute shares, and a chance at the end for those who haven't spoken.
  • Newcomer letter, and the January 1 reading from Today A Better Way.
  • Virtual and hybrid rules (see A4 and A11).
  • Six-meeting (or six-week) trial.
  [source: FA 5003; FA 6001]. "Helping" frames the helper's role as modelling qualities rather than doing things for others, and as changing one's own reactions rather than controlling others [source: FA 5003, paraphrase].
• Example language (illustrative): "FA is used by a lot of parents whose kids' problems aren't only drugs. The reading on helping might speak to what you've been trying to do."

4C. Clinician procedures for referral and joint work

All of 4C is [synthesis] unless a source is tagged. It is built on the fellowships' published self-descriptions and standard clinical practice.

C1. Assess fit and match the fellowship

• Purpose / when: at intake of any family member affected by someone's addiction.
• Steps:
  1. Identify the substance or behaviour and the relationship (partner, parent, child, sibling, friend, employer).
  2. Match the fellowship:
     • alcohol → Al-Anon or Alateen
     • drugs → Nar-Anon, Co-Anon (cocaine), FA or Al-Anon
     • gambling → Gam-Anon
     • sex or love addiction → COSLAA if active locally; otherwise S-Anon or COSA
     • mixed substances or behaviours, or a parent of a young person → FA
  3. Ask about the client's beliefs and past experiences of groups. Explain that the programme is spiritual, not religious, and the Higher Power is self-defined [source: Al-Anon FAQ].
  4. Check practical access: local, online, phone, childcare, language, LGBTQ+-friendly options (COSA lists such resources [source: SLAA FWS family page]).
  5. Offer the referral as an option, not a condition of therapy.
• Example language (illustrative): "Some people find it helps to be in a room with others living the same thing. Would you be open to trying a few meetings and telling me what you think?"
• Watch for: the client agreeing only to please you. Ask what they would really want to get from a meeting.

C2. Domestic-violence and safety screen before and during attendance

• Purpose / when: abuse is common in this population. In Al-Anon's 2018 member survey, 56% reported experiencing abuse and 11% were still experiencing it. Al-Anon states it does not provide counselling or immediate domestic-violence resources [source: Al-Anon DV blog]. So screen every client, and re-screen when the loved one's use escalates, when the client starts setting boundaries, or when the client plans to separate.
• Steps:
  1. Ask directly and privately about physical, sexual, emotional, financial and coercive-control abuse, threats, weapons in the home, strangulation history, and the safety of children.
  2. If risk is present, use a structured risk assessment, make a written safety plan and refer to specialist domestic-violence services. Emergency services are for immediate danger [source for emergency step: Al-Anon DV blog].
  3. Plan for risks that attendance itself creates:
     • Will the partner see attendance as betrayal?
     • Are phone or online meetings overheard?
     • Are the phone list or literature visible at home?
     • Is the client's device or location monitored?
  4. Agree a cover story or safe times if needed. Prefer meetings away from home or a private device and room for online meetings (FA asks virtual attendees to join from a private space [source: FA 5003]).
  5. Name the limits of fellowship concepts explicitly:
     • Detachment and "focus on yourself" do not mean staying in danger or accepting abuse.
     • Powerlessness applies to the other person's drinking or using, not to one's own safety.
     • Amends never mean apologising for being abused.
     Al-Anon's own blog says safety should be a top priority and quotes the idea of putting "extra distance between myself and the situation" [source: Al-Anon personal-safety blog, quoting Courage to Change].
  6. Boundary-setting homework from meetings, such as refusing money or stopping cover-ups, can provoke retaliation. Review each planned boundary for safety before the client acts on it.
  7. Children: follow local child-protection procedures if children are exposed to violence or neglect. Fellowship anonymity does not change the clinician's statutory duties.
• Example language (illustrative): "Before you try saying no to him about money, let's think through how he might react and what you'd do if it got unsafe."
• Watch for:
  • The client minimising violence as "part of his disease".
  • Self-blame reinforced by misreading inventory work.
  • The abuser attending the same fellowship's partner meeting, such as GA or AA held alongside, or joint Pressure Relief meetings. Help the client choose a different meeting or time.

C3. Prepare the client for the first meeting

• Purpose / when: reduces drop-out after one meeting.
• Steps:
  1. Walk through the typical sequence (A1) and the etiquette (A2).
  2. Tell the client that no appointment is needed, there are no fees, a first name is enough, and they may pass on sharing [source: Al-Anon FAQ; UKG7].
  3. Suggest arriving early or staying after to ask questions [source: Nar-Anon leaflet].
  4. Agree on a trial of about six meetings, possibly at different groups, before judging [source: Nar-Anon leaflet; FA 5003; FA 6001].
  5. Suggest picking up the phone list and one piece of newcomer literature.
• Example language (illustrative): "Groups differ a lot. If the first one feels wrong, that tells you about that group, not the whole fellowship."

C4. Debrief meetings in therapy

• Purpose / when: after each of the first few meetings, then periodically.
• Steps:
  1. Ask what the client noticed and identified with, and what jarred.
  2. Explore any reading or slogan that stuck, positively or negatively.
  3. Link insights to therapy goals.
  4. Respect anonymity: discuss the client's experience, not identifiable details about other members (A4).
• Example language (illustrative): "What did you hear that sounded like your life? Was there anything you disagreed with?"
• Watch for:
  • Rising hope and lower isolation are signs it's working.
  • Increased guilt, rigid slogan use, or withdrawal from other supports are warning signs.

C5. Integrate fellowship concepts with therapy

• Purpose / when: once the client attends regularly.
• Steps:
  1. Translate concepts into skills:
     • focus on self → noticing one's own emotional reactions
     • not checking up → response prevention for monitoring and checking
     • "Helping" (modelling rather than doing) → stopping rescuing behaviours [source for concepts: Nar-Anon format; FA 5003]
  2. Name where therapy goals and fellowship stances differ. For example, Nar-Anon neither encourages nor discourages interventions [source: Nar-Anon leaflet]. If the client also wants to help the loved one into treatment, that can be done in therapy with a structured approach such as CRAFT (Community Reinforcement and Family Training) [synthesis; CRAFT materials not drawn on].
  3. Help the client hold both without feeling disloyal to either.
• Watch for: the client experiencing therapy and fellowship as contradictory. Name the difference openly.

C6. Children and adolescents

• Steps:
  1. Offer age-appropriate options: Alateen (pre-teen to teen, chat 13–18), S-Ateen (12–19), and Gam-A-Teen (not verified [uncertain]) [source: Al-Anon FAQ; SLAA FWS family page].
  2. Check consent requirements for minors locally.
  3. Confirm the group has certified sponsors (Alateen) [source: Al-Anon FAQ].
  4. Arrange transport that does not depend on the using parent.
  5. Pair attendance with individual or family support.
• Watch for: child-protection concerns disclosed in therapy. Act on them per local law [synthesis].

C7. Financial protection (gambling, and other addictions with financial harm)

• Steps:
  1. Ask about joint accounts, credit, hidden debts and pressure to pay.
  2. Introduce Gam-Anon's Pressure Relief meeting [source: Gam-Anon tools].
  3. Add independent debt or legal advice and practical protection of the client's own finances.
  4. Treat financial control as possible abuse (C2).

C8. Working alongside the fellowships as a professional

• Steps:
  1. Keep current local and online meeting lists.
  2. Groups' contact persons can answer questions [source: Al-Anon FAQ].
  3. If your service hosts a group, provide the room only. Members run meetings, and groups are self-supporting and unaffiliated [source: Al-Anon FAQ; FA 5003].
  4. To start an Al-Anon or Alateen group, contact the fellowship's world service office (Al-Anon gives an email and phone line for this) [source: Al-Anon FAQ].
  5. Never attend as an observer without checking whether the meeting is open.

5. Handling problems

The fellowships' own published guidance covers only a few of these problems: try six meetings, use the phone list, focus on yourself, prioritise safety. Everything else here is [synthesis] unless tagged.

• Won't go, or goes once and stops.
  • Explore the barrier: shame, fear of being recognised, religion, social anxiety, or "I'm not the one with the problem".
  • Use the fellowships' own trial suggestion: about six meetings, at different groups if possible [source: Nar-Anon leaflet; FA 5003; FA 6001].
  • Offer online or phone meetings as a lower-exposure first step.
  • Accept a "no". Attendance is voluntary and therapy continues.
• "It's too religious."
  • The Higher Power is self-defined, the programme is spiritual not religious, and meetings avoid discussing religion [source: Al-Anon FAQ; UKG7; FA "Four Destructive Forces"].
  • Suggest trying another group.
  • Respect a persisting objection and offer non-Twelve-Step family support or family-focused therapy [synthesis].
• "Nobody responded to what I said" (feels unheard). Explain the no-crosstalk norm (A2). Process the content in therapy and encourage a one-to-one conversation after the meeting or by phone.
• Wants advice on the loved one's treatment or on interventions. Nar-Anon meetings don't discuss treatment options and neither encourage nor discourage interventions [source: Nar-Anon leaflet]. Offer that work in therapy (C5).
• Overwhelm or retraumatisation from others' stories.
  • Grounding before and after meetings.
  • Permission to step out or to pass on sharing [source: UKG7 on no pressure to speak].
  • Choose smaller meetings or speaker-free topic meetings.
  • Increase therapy support during the trial.
• Self-blame from Step inventory or amends work. Separate responsibility for one's own conduct from responsibility for another's addiction or abuse. The slogan of not causing, controlling or curing the addiction (member account) is a useful counterweight [source: Al-Anon DV blog]. Check what the sponsor is suggesting.
• Detachment or powerlessness misused to tolerate abuse. Treat as a safety issue (C2). Re-frame: powerlessness over the other's drinking or using sits alongside full responsibility for one's own safety. Al-Anon itself directs members in danger to emergency services and stresses distance from danger [source: Al-Anon DV blog; Al-Anon personal-safety blog].
• The abusive or addicted person attends nearby, or knows the meeting. Gam-Anon often meets alongside GA [source: GA Toronto]. Choose a different group, night or online meeting, and plan transport and timing.
• Boundary-setting escalates conflict or violence. Pause the boundary and risk-assess. Plan the timing, wording, support people and an exit route before trying again (C2).
• Problems with a sponsor or member (advice beyond peer role, romantic or sexual approach, financial exploitation, intrusive contact, recruitment).
  • Members don't give direction [source: Al-Anon FAQ], and solicitation through the phone list is prohibited [source: Nar-Anon local format].
  • Help the client set limits, change sponsor, or change group.
  • Alateen groups have certification and safety requirements, and concerns about adults with teens should go to the local Al-Anon area or WSO [source: Al-Anon FAQ].
  • Report any child-safeguarding concern through statutory routes.
• Rigid slogan use or over-identification with the fellowship. Help the client use slogans flexibly. Keep space in therapy for anger, grief and ambivalence that slogans can cut short.
• Conflict between therapy and fellowship (rupture risk).
  • Don't criticise the fellowship or the client's sponsor. Ask what the client values in each.
  • Name your clinical view separately.
  • Repair if the client felt judged for attending or for not attending.
• Confidentiality dilemmas. If the client reports another member's risk to a child, you cannot investigate. Follow your own statutory duties based on what the client knows, and discuss with supervision.
• Teen non-attendance. Usually transport or permission depends on the using parent. Arrange alternatives, such as Alateen chat for ages 13–18 [source: Al-Anon FAQ], and involve the non-using caregiver or school support.
• Financial crisis (gambling). Pressure Relief meeting [source: Gam-Anon tools], plus urgent independent debt advice and protection of the client's own accounts (C7).
• No local meeting of the specific fellowship (common for Co-Anon and COSLAA). Use the e-meeting (Co-Anon [source: Faces & Voices listing]), or a broader fellowship: Nar-Anon or FA for any drug, S-Anon or COSA for sex addiction [source: SLAA FWS family page]. Al-Anon may also suit when drinking is part of the picture [source: Al-Anon FAQ].
• Suicidal ideation in the family member. Do a standard suicide risk assessment and safety planning in therapy. The fellowship is not a crisis service.

Sources

Sources:

• Al-Anon – Frequently Asked Questions by Professionals
• Al-Anon UK & Eire – UKG7 Suggested Format for Al-Anon/Alateen Meetings
• Al-Anon blog – Domestic violence
• Al-Anon blog – Practicing personal safety
• Nar-Anon – New to Nar-Anon or Thinking About Attending a Meeting
• Nar-Anon meeting format, local US group, 11/16/2020 (via SHARE! self-help)
• Gam-Anon – A brief synopsis of the tools of Gam-Anon
• Gamblers Anonymous Toronto – Gam-Anon
• Families Anonymous – 5003 Suggested Meeting Format with Basic Readings (2025-06-18)
• Families Anonymous – WSOF-26 Sponsorship Guidelines (2024-02-01)
• Families Anonymous – 6001 Letter to the Newcomer
• SLAA Fellowship-Wide Services – Family
• Sacramento SLAA – Links & resources (lists COSLAA, COSA, S-Anon)
• Faces & Voices of Recovery – Family- and friend-focused mutual aid (Co-Anon, FA, Gam-Anon listings)

Further reading (not drawn on) [uncertain]: COSLAA's own website; Co-Anon's own website; Gam-A-Teen pages; Gam-Anon "Suggestions" page; FA booklet #1020 Families Anonymous and Sponsorship; Al-Anon's formal group safety guidelines and Alateen certification documents; CRAFT manuals.

Fellowship literature referred to (not drawn on): Al-Anon Family Groups, Courage to Change (B-16), quoted only as cited in the Al-Anon personal-safety blog; Nar-Anon Blue Booklet and SESH; Families Anonymous, Today A Better Way and FA Tools of Recovery (#5001).