In order to work effectively with clients who can benefit from
a 12-step program, the clinician needs to be able to integrate
program principles into the therapeutic process, as well as
identify and interpret potential difficulties inherent in this
dynamic. This will differ somewhat depending on the thera-
pist's theoretical orientation. These differences will be ad-
dressed throughout this chapter.

The most fundamental aspects of any therapeutic relation-
ship are safety and confidentiality. A sense of safety develops
in the therapeutic setting through the client's experience of
the therapist as nonjudgmental and accepting, as well as
knowledge of confidentiality. This same sense of safety
evolves as the client witnesses these elements within the 12-
step program. There is equal emphasis on confidentiality in
all 12-step programs. One aspect of confidentiality, anonym-
ity, is evidenced by the use of the word anonymous in the
name of each program, and is clearly stated in Traditions
Eleven and Twelve. The traditions of all 12-step programs
state that no member will identify another member to any-
one outside of the group, and will not share his/her own ex-

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