Alcoholics Anonymous: Who Benefits?
Year: 1994
Type: article
Abstract: Alcoholics Anonymous (AA) is the most popular self-help organization for individuals with alcohol-related problems. This includes both alcohol-dependent and, to a lesser extent, alcohol-abusing drinkers. For many people, self-help through AA is the only alcoholism treatment they receive. Other members join the fellowship before entering professional treatment or are introduced to AA as a component of their professional treatment. Attendance at AA also commonly is recommended as aftercare following professional treatment. Yet experience shows that not all clients benefit from AA to the same extent. Therefore, two questions arise: Who does well in AA, and why do these people succeed? These questions do not have simple answers, however, because outcome (i.e., reduction of drinking or improvement of psychological and social characteristics) associated with AA, as with any kind of alcoholism treatment, is influenced by many characteristics of the clients and the AA groups. For example, the success of AA participation depends not only on an individual's initial decision to attend AA but also on the degree of his or her involvement in AA (e.g., frequency of attendance at meetings, sharing at meetings, or serving as or having an AA sponsor). Even similar levels of AA involvement may result in different outcomes for different people, depending on the individual's characteristics and experiences with professional treatment. Despite four decades of AA research, no clear picture has emerged as to which patient characteristics can predict a positive outcome with AA and, therefore, can be used as criteria for matching patients to AA. This is due in part to the limitations and variability of methodological approaches used in the studies. Most investigators recruit their samples from patients in inpatient or outpatient treatment settings. Some studies retrospectively analyze patients with previous AA experience to identify personal characteristics that predicted AA involvement. In other studies, patients are monitored after professional treatment to determine which characteristics may motivate them to join AA and how AA affiliation influences outcome. In both approaches, the kind and impact of the professional treatment often is ignored. Other confounding factors in research about AA include an incomplete understanding of processes within AA and differences among various AA groups. To date, only three randomized clinical trials have examined the efficacy of AA participation, either with or without additional simultaneous treatment approaches (Ditman et al. 1967; Brandsma et al. 1980; Walsh et al. 1991). The vast majority of AA studies, however, have focused on two narrower questions: Which factors predict whether a person will join AA? And how does involvement in AA predict outcome? In an attempt to answer these two questions, Emrick and colleagues (1993) reviewed 107 previously published AA studies. Although their analysis provided estimates of the magnitude of the relationships determining AA affiliation and drinking outcome, it also acknowledged that many relationships may differ when study findings are grouped by client characteristics. Tonigan and colleagues (1994) extended the initial analyses by taking into account factors such as sample gender and origin (i.e., inpatient versus outpatient). This article integrates the findings of these two reviews and concludes with recommendations for future research of AA. WHO JOINS AA? To determine which drinkers were most likely to join AA, Emrick and colleagues (1993) reviewed 33 studies(1) that addressed this question, analyzing 31 demographic and drinking-related client characteristics. The characteristic most strongly correlated with joining AA was the drinkers' previous use of external support mechanisms to stop drinking. The drinkers' demographic characteristics, such as gender, age, and education, were not related to whether or not they joined AA. Factors related to alcohol consumption, such as quantity consumed daily, obsessive preoccupation with alcohol, severity of physical dependence, and loss of control while drinking, however, had some correlational value. …
Source: PubMed Central
Authors: J Scott Tonigan, Susanne HillerSturmhöfel
Institution: University of New Mexico
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W25867824