Alcoholics Anonymous (AA) is the most widely used organization for the treatment of alcoholism. AA's philosophy has changed how many people view themselves and their substance use. The majority of substance abuse programs in the United States use the 12 steps, either by making them the basis of their treatment program, or by introducing AA to clients as a means of recovery. Research is not clear, however, as to whether working the AA program is helpful in achieving sobriety. Based on a review of the literature, this article examines differences between AA and professional counseling, and explores AA's philosophy. An existential approach to therapy is reviewed with regard to case conceptualization, assessment and interventions in treating individuals suffering with alcohol-related issues.