The internet has exploded with criticism of traditional 12 step programs. The longer the battle ensues, the more personal opinion and emotion trumps logic and objective presentation. As a result, statistics have been abused, studies on A.A. misstated and opinions formed based on a single study rather than a holistic view of research data.
So how do you know if Alcoholics Anonymous really works? Before you look at the data, be sure to check your feelings and prejudices and to approach the question with an open mind.
Understand the limits
Even without all the bias, it is nearly impossible to objectively measure the success of A.A. Considering that A.A. is an anonymous, informal organization, obtaining accurate and reliable data has been a challenge for researchers for decades. Also, many variables are outside the researchers’ control: for instance, they cannot measure personal motivation, which is often the determining factor for success.
Top that with the hundreds of ways you can conduct a study, and we get a plethora of reports with contrasting results. For example:
- Positive: According to 1997 results of Project Match, A.A. compared favorably with cognitive-behavioral therapy and motivational enhancement therapy. Alcohol-free days among participants of all three groups rose from 20% to 80% a year after treatment ended. The Fix mentions a 2007 study by the National Council on Alcoholism’s medical journal that reported how the success of 12-step programs after one year were 12% higher than those who participated in cognitive behavioral therapy for one year.
- Negative: A study published by Substance Use & Misuse said attending A.A. meetings had worse results than no treatment or an alternative treatment. A 1990 summary of A.A.’s membership surveys (from 1977 through 1989) reported that only 5% of A.A. attendees had been attending meetings for more than one year.
With all the competing data out there, which sources can you actually trust?
The answer itself is contradictory: All of them and none of them. Even the most well-designed studies have limitations. Treatment isn’t one size fits all. In the end, it is up to you to decide what treatment path and support works best for you.
From A.A.
A.A. does not conduct studies on itself, but they do hold periodic membership surveys. The most recent data is from the 2007 survey, which shows
- 31% were sober less than a year
- 24% sober for 1– 5 years
- 12% sober for 5–10 years, and
- 33% sober for over 10 years
However, these studies do not reveal the total number of years members have been in the program, whether or not members were in other treatment programs, or other factors which strongly influence the overall outcome.
“It was the initial decision to get better that determined a person’s chances of succeeding,” an expert says. “What followed made little difference. Although AA doubtless helps some people, it is not magic.” –The Fix.
What determines success?
Besides intrinsic motivation, an individual’s personal success in A.A. is influenced by his or her level of involvement:
- Length of attendance (5 months or 5 years)
- Frequency of attendance (monthly or weekly)
- When you begin to attend meetings
- Combining A.A. with other treatments
- Having a sponsor
- Personal responsibility
Length of attendance
Studies have proved that higher levels of A.A. attendance correspond with higher rates of abstinence. In other words, more meetings equals longer abstinence. This is true for all self-help groups 12-Step groups.
In fact, a study from the Journal of Clinical Psychology (2006) reports that nearly 70% of previously untreated alcoholics who attended over 27 weeks of A.A. meetings were abstinent from alcohol after 16 years. As unbelievable as that sounds, numerous other studies emphasize the benefits of long-term participation in a community-based self-help program such as A.A.
Frequency of attendance
The more frequent the A.A. meetings the better, but a report from the American Journal of Alcohol Abuse (1999) showed that at least one meeting a week is required for positive results.
This study showed that over 70% of those attending 12-Step groups weekly for about 2 years were still sober, but those who attended less than weekly had similar results as those who never attended any meetings during that period.
A.A. is most effective in the first few years
When you attend A.A. meetings is significant too. In studies published by the Journal of Studies on Alcohol and the Journal of Consulting and Clinical Psychology, individuals who participated in A.A. in the first two to three years after seeking help had better outcomes than those who attended A.A. after the fourth year.
Combining A.A. with other treatments
Various studies have also found that patients who attend both 12-Step groups and treatment have better outcomes than patients involved only in treatment (Journal of Substance Abuse and Treatment, 2000; Journal of Clinical Psychology, 2001).
Having a sponsor
Sponsors are a vital part of how A.A. works, and numerous studies prove that sponsership significantly increases the changes of abstinence. An article from the Psychology of Addictive Behaviors reported that participants with sponsors who have attended A.A. for 3 months were three times more likely to be abstinent from alcohol three months later when compared to those without a sponsor.
“Sponsorship is an experience that you must not miss. Sponsorship is the heart, the heart of the A.A. approach to recovery. Everybody in this room knows that the heart is the most vital organ of your body. Without the heart, you die. Without the heart, there is nothing.” —Gene Duffy
Personal responsibility
Alcoholics Anonymous is a support group, but it will not do what it’s supposed to do until you let it. Many people attend the meetings but never really give it a chance. They do not engage, they do not seek to connect with others, and thus they do not experience the benefits of the program.
Recovery does not happen passively; you must not only be committed in attendance, but be proactive during the meetings. As with any other program, a willing attitude, a humble spirit and a deep sense of ownership are the secret ingredients to lasting recovery. A.A. can be a nurturing and enriching experience that truly makes a difference in your life, or it can be a mandatory activity in a stuffy church basement. In the end, your attitude determines your experience.
What A.A. has to offer
Alcoholics Anonymous has a rich history: its legacy includes the tens of thousands of alcoholics who are sober today. Over two million members participate in some 115,000 groups worldwide, about half of them in the U.S. There’s a reason why A.A. groups have sprung up around the world, inspired the founding of other 12-Step programs and is recommended by nearly every treatment program—because it works, it has worked in the past and it can still work today.
A.A. provides opportunities to share one’s own struggles, increase motivation to abstain and be encouraged by hearing others talk about how A.A. has helped them. It is a supportive community that provides direction, accountability and a positive environment for sobriety.
“When we say spirituality, we’re talking about connection. People who are addicted become disconnected. And spirituality, as it’s emphasized in the program of the 12 Steps, is profoundly reconnecting.” —Rev. Jack Abel, on National Geographic