Say you’ve been diagnosed with a serious, life-altering illness or psychological condition. In lieu of medication, psychotherapy, or a combination thereof, your doctor prescribes nightly meetings with a group of similarly afflicted individuals, and a set of 12 non-medical guidelines for recovery, half of which require direct appeals to God. What would you do?

Especially to nontheists, the concept of “asking God to remove defects of character” can feel anachronistic. But it is the sixth step in the 12 Steps of Alcoholics Anonymous—the prototype of 12-step facilitation (TSF), the almost universally accepted standard for addiction-recovery in America today

From its origins in the treatment of alcoholism, TSF is now applied to over 300 addictions and psychological disorders: drug-use, of course (Narcotics Anonymous), but also smoking, sex and pornography addictions, social anxiety, kleptomania, overeating, compulsive spending, problem-gambling, even “workaholism.”

Although AA does not keep membership records—the idea being pretty antithetical to the whole “anonymity” thing—the organization estimates that as of January 2013, more than 1 million Americans regularly attended meetings with one of roughly 60,000 groups. Dr. Lance Dodes, a recently retired professor of psychiatry at Harvard Medical School, estimates about 5 million individuals attend one or more meetings in a given year. Indeed the 12-step empire is vast, but Dodes thinks it’s an empire built on shaky foundations.

In his new book, released today, The Sober Truth: Debunking the Bad Science Behind 12-Step Programs and the Rehab Industry (co-written with Zachary Dodes), he casts a critical eye on 12-step hegemony; dissecting the history, philosophy, and ultimate efficacy of TSF, lending special scrutiny to its flagship program.

“Peer reviewed studies peg the success rate of AA somewhere between five and 10 percent,” writes Dodes. “About one of every 15 people who enter these programs is able to become and stay sober.” Continue reading →