Reflection Circles: How Using a 12 Step Approach Can Benefit Students

Updated: May 22, 2020

"It is in sharing our stories, we see ourselves in one another, and we are no longer alone."

- Julie Lepianka

In twelve step programs, such as Alcoholics Anonymous (AA), people share their experience, strength, and hope with one another in order to recover, on a daily basis, from the disease of alcoholism (W.,B., 1976). Most AA meetings use the following approach in their meetings:

-Anonymity, "what's said here, stays here" -Everyone has a chance to talk/share -Sharing/talking is optional -No cross talk or advice giving

These guidelines make AA meetings feel like a safe space for those who attend. I feel that this same approach is critical to encourage a healthy classroom community. I recently attended a training program to facilitate a process known as Templeton Reflection Rounds (GWish Templeton Reflection Rounds). Throughout the training I was reminded over and over again of the practices mentioned above. Essentially, the process followed the twelve step philosophy and provided a safe space for medical students to share about patient experiences that impacted them emotionally.

This past summer, I attended an amazing spiritual, wilderness retreat in the Rocky Mountains of Colorado (Animas Valley, Soulcraft Retreat). During this retreat we gathered as a 'council', where again, participants were provided a safe space to share with one another, without the fear of judgment.

I have known many friends and family whose lives have been transformed by having the space to discuss their feelings in a supportive environment. In my own life I have often said, "if you point the finger at me, I will give you 'the finger' right back... but if you hold up a mirror for me, by telling me your story, I will see myself... and be changed for the better."

As an educator, I have found that many nursing students are emotionally exhausted by the physical and emotional trauma they witness in the clinical setting. I have also observed that they often carry a tremendous amount of emotional pain, whether that stress stems from school, finances, or personal relationships. The truth is that almost all of us have experienced these types of stresses at one point or another in our lives. I felt that students did not have a safe place in the classroom or clinical setting in which to share these experiences. I am familiar with these feelings and the type of isolation this can bring. In my experience as a home care/home hospice nurse I spent my days caring for the needs of others and witnessing great emotional and physical pain, without having anywhere to go with these feelings.

Holding this pain put stress on my marriage, as well as my physical, emotional and spiritual well-being.

Nurses experience a tremendous amount of secondary trauma, which can lead to high levels of burn out or a condition known as compassion fatigue (Zimmerman, 2017). In my personal experience, having a space to share these emotions made a tremendous difference in my ability to be resilient and therefore, be more 'present' for my patients.

I have begun providing a safe space for students to share about feelings that may be impacting them and/or their ability to be fully present in the clinical or classroom setting. The feedback has been overwhelmingly positive and I found that providing this type of a sacred space has not only benefited my students, but has allowed me to grow as a nurse, an educator, and as a spiritual being.


W., Bill. (1976). Alcoholics Anonymous : the story of how many thousands of men and women have recovered from alcoholism. New York :Alcoholics Anonymous World Services

Zimmerman, B. (2017). Survey: 70% of nurses report burnout in current position. Becker’s Hospital Review.


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