Literacy-Free 12 Step Expressive Arts


The “Literacy-Free 12 Step Expressive Arts Therapy” curriculum is a literacy-free group counseling manual that uses cognitive behavioral (CBT) and rational emotive behavior therapy (REBT) techniques. It guides participants through the 12 Step principles for overcoming addiction as well as related psychoeducational topics. It contains 10 lessons using art, dance, game, horticulture, drama, handicraft and music activities. It is authored by Melissa Davis-Stuebing, MA, CAC-AD and edited by Dr. Lauren Littlefield.

It was specifically developed for hard-to-reach substance dependent populations who might slip through the cracks of standard therapeutic services – such as illiterate and learning disabled populations, as well as participants with social anxiety, difficulty of self expression, trauma and co-occurring disorders. This curriculum requires just 1 facilitator. It goes through each of the 12 steps, forming recovery support groups at the completion of the curriculum so change can be sustainable and community owned. The 12 steps are a set of guiding principles for the person seeking recovery from addiction emphasizing peer support, behavioral change, spiritual wholeness and the importance of community.

It is available in English language/ US culture and Zambian culture versions. Kenyan culture and Spanish language / Latin American culture versions are being field-tested prior to availability.


Each leader pack consists of a Leader Curriculum Guide, Drum Circle Instructional DVD & Long Term Effects Card Game. Because it is literacy-free, there are no workbooks needed for participants – which saves practitioners on cost in the long run.

The cost is $95 USD per leader pack. Bulk discounts are available for orders of 10 or more packs.  Leader packs are available in both Zambian and American versions with culturally appropriate artwork and expressive arts activities respectively.

Twenty percent of your purchase will be donated to Chisomo Centers in Zambia, to help provide for the education, housing and counseling of street youth and children.

Interactive training in this curriculum is available. Email to book a training. 

Maryland  & ONLINE Trainings

Training is free with purchase of curriculum materials. Online trainings are endorsed by MD Board of Professional Counselors & Therapists for 4 Activity A continuing education units. In-person trainings are temporarily suspended due to COVID-19.

Register online here for upcoming May 15th or 22nd trainings- 

Download poster here.

Download pamphlet here.

Curriculum Order Information

 All international orders must contact in advance of payment for shipping estimate.

Checks can be made out to CoLaborers International (EIN:64-0960198) with “Literacy-Free 12 Step Based Expressive Arts Curriculum” on the memo and mailed to PO Box 959 Chestertown MD 21620.


Zambia Trainings

We were funded through a Rotary International Foundation Global Grant to do a large scale training in “Literacy-Free 12 Step Expressive Arts” curriculum across Zambia, Central Africa in 2018.  Thank you Chestertown Rotary, District 7630 and Rotary of Lusaka Central.

Melissa, David, Jason, Ally, Hjordis, Chipo and Mike made up our training team and together we trained 36 organizations and 100 people. The Ministry of Health for the country of Zambia endorsed it for use across the country. Special thanks to Global Outreach Church of Virginia Beach, VA and Hope Fellowship of Chestertown, MD for their giving!




A clinical study of the US version of the curriculum is published here –

Citation: Melissa Davis Stuebing, Hjördis Lorenz & Lauren M. Littlefield (2019) Literacy-Free 12 Step Expressive Arts Curriculum Enhances Engagement and Treatment Outcomes for Dually Diagnosed Substance Use and Mental Health Disorders, Alcoholism Treatment Quarterly, DOI: 10.1080/07347324.2019.1681331

This study was  also presented at the 2017 Eastern Psychological Association’s Annual Conference in Boston. Download official program here

2018-2019 ZAMBIA STUDY

This clinical study will be presented at the 2020 Eastern Psychological Association’s Annual Conference. Download official program here.

Citation: Stuebing, M.D., Lorenz, H. & Littlefield, L.M. (2020, March). Literacy-Free 12 Step Expressive Arts Decreases Stigma and Substance Use in Zambia. Poster presented at the Annual Meeting of the Eastern Psychological Association: Boston, MA.

As part of gauging both the immediate impact of the training as well as the sustainability of the curriculum as it is brought into the communities reached by the attending organizations, we ran a 2 part clinical study. Of 36 organizations, an impressive 25 organizations continued to stay in touch with follow up data. We did 3 check-ins with organizations over the last year in August, Dec and March.

1) The first part of the study looked at the immediate impact of the 2 day training at both sites.

We aimed to determine if a two-day training in a culturally appropriate 12 Step-based curriculum could facilitate change among 100 treatment professionals in their view of the substance user and the value of offering treatment.  A pre-post survey containing six items was used to measure attitudinal change. While attitudes towards substance users did not significantly improve, professionals felt more empowered (p < 0.05) toward offering treatment and toward motivating substance users for treatment.

2) The second part of the study followed organizations and their clients for 6 months after the training.

Using a likert scale of 1 (not at all) to 5 (a lot), on average, organizations reported that groups open conversation for participants to talk about substance use (4.19), found it beneficial to continue to offer these groups (4.65), found it feasible to continue to offer these groups (4.27) and stated that they would recommend this curriculum to other organizations (4.64).

The 25 reporting organizations reached a combined total 8,247 people each month in their communities with their general services. These organizations offered a combined 54 “Literacy-Free 12 Step Expressive Arts” groups reaching 437 participants for drug and alcohol treatment during the year.

Of the 437 participants, we received individual client forms for 197 of these clients. Clients significantly decreased substance use in marijuana, alcohol, cigarettes and inhalants (such as bostic and sticker). Not only that, this intervention has powerful implications in combating stigma as it was found to significantly increase both open sharing by clients in a group setting as well as their personal motivation to change.  These initial findings are in the process of being written in a formal scientific article.


This curriculum was originally developed for street youth in Zambia, Central Africa and has been used in 3 studies there by Brittany Hynson and Hjordis Lorenz , including a longitudinal study by Ally Grace in 2016.

Missionary Mike Peck, CSC-AD continued running these groups as a practitioner in Zambia after the study ended. They are a regular and important part of offerings at Chisomo Centers, drawing social work and psychology students from University of Zambia to volunteer in these groups as part of their educational attachments.


An expressive arts therapy curriculum was offered voluntarily for 11 months to a total of 129 homeless youth with Substance Use Disorder at a community day center in Zambia. A CARF-approved group feedback form was modified for pre/post use. Paired samples found increased hopefulness in lessons on spirituality, self-care and forgiveness. Lessons found to instill hope were the same rated highest for enjoyment.

This study was presented at the 2018 Eastern Psychological Association’s Annual Conference in Philadelphia. Download official program here.

Citation:  Stuebing, M.D., Arnold, A. & Littlefield, L.M. (2018, March). Hope to Change: Expressive Arts in Zambia with Substance Using Homeless Youth. Poster presented at the Annual Meeting of the Eastern Psychological Association: Philadelphia, PA.


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