Alcoholics Anonymous (A.A.) - Detailed Report

• At "open meetings," speakers tell how they drank, how they discovered A.A., and how its program has helped them. Members may bring relatives or friends, and usually anyone interested in A.A. is also welcome to attend "open meetings."
• "Closed meetings" are for alcoholics only. These are group discussions, and any members who want to may speak up, ask questions, and share their thoughts with fellow members. At "closed meetings," A.A. members can get help with personal problems in staying sober and in everyday living. Some other A.A. members can explain how they have already handled the same problems - often by using one or more of the Twelve Steps.

THE TWELVE STEPS OF ALCOHOLICS ANONYMOUS

1. We admitted we were powerless over alcohol-that our lives had become unmanageable.
2. Came to believe that a Power greater than ourselves could restore us to sanity.
3. Made a decision to turn our will and our lives over to the care of God as we understood Him.
4. Made a searching and fearless moral inventory of ourselves.
5. Admitted to God, to ourselves and to another human being the exact nature of our wrongs.
6. Were entirely ready to have God remove all these defects of character.
7. Humbly asked Him to remove our shortcomings.
8. Made a list of all persons we had harmed, and became willing to make amends to them all.
9. Made direct amends to such people wherever possible, except when to do so would injure them or others.
10. Continued to take personal inventory and when we were wrong promptly admitted it.
11. Sought through prayer and meditation to improve our conscious contact with God, as we understood Him, praying only for knowledge of His will for us and the power to carry that out.
12. Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics, and to practice these principles in all our affairs.
    

Tonigan, J. S., Toscova, R., & Miller, W. R. (1996). Meta-analysis of the Alcoholics Anonymous literature: Sample and study characteristics moderate findings. Journal of Studies on Alcohol, 57, 65-72.

Reviews of research on Alcoholics Anonymous (A.A.) have speculated how findings may differ when grouped by client and study characteristics. In this review, meta-analytic procedures were used to summarize the findings of 74 studies that examined A.A. affiliation and outcome. Results were divided by whether samples were drawn from outpatient or inpatient settings. The results were also divided by a global rating of study quality that jointly considered use of subject selection and assignment, reliability of measurement, and corroboration of self-report. Efficacy of dividing study results was examined by changes in magnitude of correlations and unexplained variance. RESULTS: A.A. participation and drinking outcomes were more strongly related in outpatient samples. Better-designed studies were more likely to report positive psychosocial outcomes related to A.A. attendance. In general, A.A. studies lacked sufficient statistical power to detect relationships of interest. CONCLUSIONS: A.A. experiences and outcomes are heterogeneous, and it makes little sense to seek omnibus profiles of A.A. affiliates or outcomes. Well-designed studies with large outpatient samples may afford the best opportunity to detect predictors and effects of A.A. involvement.

Humphreys K. (2003). Alcoholics Anonymous and 12-step alcoholism treatment programs. Recent Developments in Alcoholism, 16, 149-64.

Alcoholics Anonymous (A.A.) self-help groups are the most commonly accessed component of the de facto system of care for alcohol problems in the United States. Further, A.A.'s concepts and approach have strongly influenced a significant number of professional treatment programs. Nevertheless, only a modest number of longitudinal, comparative outcome studies on A.A. and on professional 12-step treatment programs have been conducted, which has limited both the certainty and scope of conclusions that can be drawn about these interventions. Research indicates that participation in A.A. and in 12-step treatment are associated with significant reductions in substance abuse and psychiatric problems. Further it has been found that such interventions reduce health care costs over time in naturalistic, quasi-experimental, and experimental studies. Evaluation studies have also begun to illuminate the processes through which self-help groups and 12-step treatment programs exert their effects. To build on this knowledge base, future research should (1) be methodologically flexible and well-matched to its phenomenon of interest, (2) include evaluation of the unique features of self-help organizations, (3) increase representation of African-Americans and women in research samples, and (4) increase statistical power through larger sample sizes and more reliable measurement. Key content areas for future enquiry include further longitudinal evaluation of the outcomes of participation in A.A. and 12-step treatment (particularly in outpatient samples); better specification of the aspects of A.A. that influence outcome; and individual, community, and health organization-level controlled studies of the health care cost consequences of 12-step interventions.

Kownacki, R.J., Shadish, W.R. (1999). Does Alcoholics Anonymous work? The results from a meta-analysis of controlled experiments. Substance Use and Misuse, 34(13), 1897-1916.

This article reviews the outcome (usually abstinence at 12 months) of 21 controlled studies of A.A., with emphasis on methodological quality. Severe selection biases compromised all quasi-experiments. Randomized studies yielded worse results for A.A. than nonrandomized studies, but were biased by selection of coerced subjects. Attending conventional A.A. meetings was worse than no treatment or alternative treatment; residential A.A.-modeled treatments performed no better or worse than alternatives; and several components of A.A. seemed supported (recovering alcoholics as therapists, peer-led self-help therapy groups, teaching the Twelve-Step process, and doing an honest inventory).

Alcoholics Anonymous World Services, Inc. (1972). A brief guide to Alcoholics Anonymous. Retrieved August 10, 2006, from http://www.aa.org/en_pdfs/p-42_abriefguidetoaa.pdf