Alcoholics Anonymous AA: Meetings, How to Join, & the 12 Steps
Furthermore, the observation of others who are sustaining recovery in AA can instill much‐needed hope for a better future. AA also provides an arena for members to learn, and model, effective communication and coping skills, as well as specific strategies for abstaining from alcohol. Members are encouraged to obtain a ‘sponsor’ ‐ a recovery mentor well‐established in sobriety ‐ who can offer guidance, daily support, and accountability to help new members stay sober. The 12‐step program is intended alcoholics anonymous to facilitate the internal psychological, emotional, and spiritual changes deemed necessary to sustain abstinence and lead to enhanced psychological well‐being and improved relationships that can compete with the more immediate rewards provided by alcohol use (Alcoholics Anonymous 2001; Kelly 2013b). AA has an ostensibly ‘spiritual’ basis, which some members consider central to the program, and which may underlie the altruistic behavior that can help promote recovery (Zemore 2004).
- The GRADE system uses the following criteria for assigning grades of evidence.
- The get-togethers can be fantastic outlets for those working on recovery, with groups of others in similar situations offering support through comradery, advice, or even just active listening.
- One reason that several of the other trials may not have found positive effects for AA/ TSF is because many individuals randomized to the non-AA/non-TSF conditions also attended AA; thus, the AA or TSF condition ended up being compared to a condition consisting of an alternative treatment plus AA.
- Results are shown using figures, with the percentage abstinent from alcohol along the y axis and the AA exposure along the x axis.
- Zoom Meetings can be joined by clicking the meeting’s “Zoom” button.
- In fact, knowledge of participation in a psychosocial intervention is part of the therapeutic effect; therefore, we think that lack of blinding of participants and personnel does not introduce bias.
Others attend due to pressure from a loved one or because they are required by the court, such as after being arrested for drunk driving. There are no other requirements to join this fellowship and attend a meeting. Group consisted of only Bill, Dr. Bob, and a patient at an Akron hospital.
Criteria for considering studies for this review
We included randomized controlled trials (RCTs), quasi‐RCTs and non‐randomized studies that compared AA or TSF (AA/TSF) with other interventions, such as motivational enhancement therapy (MET) or cognitive behavioral therapy (CBT), TSF treatment variants, or no treatment. The second study, Project MATCH (discussed above; see criterion 4), randomized subjects to 12-step facilitation treatment (TSF), cognitive behavioral therapy (CBT), or motivational enhancement (MET). In the aftercare arm, there were no significant differences between the three treatments, with over two-fifths abstinent at the 1-year follow-up (results not shown).
This is, perhaps, surprising given that the major focus of AA/TSF interventions is on complete abstinence, rather than reductions in intensity, which may be of a focus in CBT‐oriented relapse prevention interventions. Of note, however, was that despite a greater relative emphasis on reducing the intensity of any drinking that might occur in CBT interventions (e.g. through a focus on coping with the abstinence violation effect) in no case did AA/TSF fare worse on this outcome, and, where there were https://ecosoberhouse.com/ differences, AA/TSF showed an advantage. Consquently, these findings do not support the once‐popular theory that by emphasizing the uncontrollability of alcohol consumption (i.e. ‘powerlessness’ over alcohol), AA creates an abstinence violation effect that makes the relapses more severe (Marlatt 1985). Follow‐up after intervention ranged from three to 60 months, with a modal length of 12 months (see Table 8). On the whole, study samples were quite large and adequately powered to detect effects.
Sources of support
The longer you continue to use, the more complicated it can become to stop using, especially if it is a substance on which your body can become physically dependent, such as alcohol. While no path in recovery is a straight line, a person in recovery actively attempts abstinence, harm-reduction education, and application of said education. The lack of reporting of any outcomes regarding quality of life, functioning, or psychological well‐being was noteworthy.
- We rated attrition bias as unclear in approximately half of the studies (14 studies) and low in four studies.
- We pooled and analyzed study effects wherever possible using meta‐analyses.
- Alcohol use disorder (i.e. alcoholism) is a concerning individual and public health problem worldwide.
- For detection bias we rated 22 studies as being at unclear risk because insufficient information was provided to enable us to make a judgement of high or low risk, four studies as low risk, and one study as high risk because there was no blinding of outcome assessments.
- We also discuss who can join Alcoholics Anonymous and what research has found about the effectiveness of attending these meetings when overcoming alcohol misuse or abuse.
There was some inconsistency in the evidence across studies that could be due to variation in the clinical characteristics of the samples used, follow‐up time points, error in memory recall for certain outcomes, and differences in intervention durations, or therapist effects. There were some small sample sizes and larger variability around mean estimates of the longest periods of abstinence, and high variability around mean estimates of DDD. Although we observed heterogeneity in the magnitude of the effects for AA/TSF in comparison to other treatments or TSF variants, the direction of the findings in almost every case was in the same direction, with AA/TSF doing as well as, or better than, comparison interventions. There was only one instance where this was not the case, as detailed above in the results section (i.e. Lydecker 2010). For instance, in MATCH 1997 the proportion of participants completely abstinent throughout the entire first year following the intervention among outpatients who were assigned to the AA/TSF intervention was 24%, whereas 15% and 14% of participants assigned to CBT and MET, respectively, were completely abstinent during that timeframe. This reflects an absolute advantage of 9 percentage points in favor of AA/TSF, and a relative advantage for AA/TSF compared to CBT of 60% in the number of participants completely abstinent, and when compared to MET, reflects an increase of 64% in the number of participants completely abstinent.
For the economic analyses (4 studies; 5 reports), we rated three studies as being at unclear risk of bias (Humphreys 1996; Mundt 2012; MATCH 1997), and one study as low risk (Ouimette 1997). As noted in Assessment of risk of bias in included studies, we rated all reports across seven risk of bias dimensions using the standard Cochrane ‘Risk of bias’ ratings criteria (see Appendix 2; Figure 4; Figure 5). These criteria apply to risk of bias ratings for randomized as well as for observational, prospective, studies. In the latter case, random sequence generation and allocation concealment are automatically rated as ‘high risk’; we awarded such ratings in this review (i.e. for the 5 included observational, prospective studies). In future updates of this review, if we include a larger number of observational, prospective studies, then it may also be prudent to conduct a separate ‘Risk of bias’ rating specifically designed for evaluating risks in such studies, for example ROBINS‐I (Sterne 2016). Most studies were conducted in the USA, with one study from the UK (Manning 2012), and one from Norway (Vederhus 2014).
However, sample sizes were highly variable and skewed across studies, ranging from a low of 48 participants in Kahler 2004 to a high of 3018 in Ouimette 1997, with an average of 400 participants per study (mean 406.4; SD 616.2; median 201). Measurement in the included studies comprised psychometrically validated assessment tools. The original AA intervention is purported to work via its social fellowship and 12‐step program (Alcoholics Anonymous 2001). The social components operate through peer support and role modeling of successful AUD recovery, and through providing close mentoring and recovery management oversight through ‘sponsorship’. The common suffering of AA group members may provide a sense of belonging or universality that can help to diminish negative affect, particularly shame, loneliness and guilt, which is similar to some forms of group psychotherapy (Yalom 2008).