Alcoholics Anonymous is self-help

Alcoholics Anonymous is self-help, not treatment

Alcoholics Anonymous is not really a treatment for alcoholism but a community resource for those wishing to stop drinking. Uncontrolled studies of AA have shown that people who affiliate with AA tend to stop drinking and find that their lives improve in many respects (Emrick et al. 1993).

However, evaluating AA alongside professionally delivered interventions presents problems and perhaps should not be done.

AA, the original 12 Step program, is not a fixed form of â€œtreatmentâ€ and people are free to participate in different ways. Some go a few times and then drop out. Others go more often, but do not actively participate in meetings or â€œwork the program.â€

It is possible that both dropouts and passive participants gain some benefit from the AA experience, but this has not been adequately researched. Only a minority of those ever exposed to AA seem to become full, active members over a long period and consistently â€œworkâ€ all the steps.

There is evidence that certain types of people may be more likely to fully affiliate with AA than others (Ogborne and Glaser, 1981; Emrick et al., 1993), but more research is needed and some studies may no longer be relevant given the current range and diversity of AA groups. However, it seems likely that AA would appeal to those who have experienced serious alcohol-related problems and who can accept the need for abstinence and the term â€œalcoholicâ€.

When professionals refer clients to AA, as adjunctive therapy, on the assumption that they will benefit from such referrals, it is reasonable to ask about the outcomes of these referrals and to compare these outcomes with those achieved by other means.

Project MATCH (1997) included a 12-step facilitation intervention and results showed that those who were encouraged to go to AA did as well as those provided with other interventions.

50 Most Read Articles January 2008

Sweden Likes AA Too

Predictors of 2-year drinking outcomes in a Swedish treatment sample.

BACKGROUND: Few studies have investigated predictors of short- and longer-term outcomes in relatively well functioning treatment samples.

METHODS: Multivariate logistic regression analyses were used to identify predictors of continuous abstinence in 188 individuals during their 2nd year after private 12-step treatment in Sweden, and findings are related to a previous report on 1-year outcomes.

RESULTS: Individual baseline characteristics were not directly related to 2nd year outcomes, while a higher 1st-year drinking severity decreased the likelihood of 2nd-year abstinence.

affiliation with Alcoholics Anonymous â€¦ increased the likelihood of 2nd-year abstinence

Satisfaction with treatment and affiliation with Alcoholics Anonymous, but not program aftercare during the 1st year increased the likelihood of 2nd-year abstinence.

CONCLUSION: Results are consistent with previous studies showing that shorter-term outcomes are likely to be maintained, and that baseline characteristics and treatment factors account less for outcomes over longer terms.

Research; Bodin MC, RomelsjÃ¶ A. Predictors of 2-year drinking outcomes in a Swedish treatment sample. Eur Addict Res. 2007;13(3):136-43.

Research Support for TSF

Concise Alcoholics Anonymous and TSF Research Summary

All the elements of TSF have moderate to strong research support, most of which has been replicated.

NB: AA does not participate in research but individual members do. The huge volume of peripheral research supports a strong case for recommending AA participation by alcoholics. Additionally, testimony of the effectiveness of AA are the two million current sober members of Alcoholics Anonymous.

We know: -

that Twelve Step Facilitation reduces alcohol abuse, improves related consequences, and improves employment prospects.
that Alcoholics Anonymous has good efficacy, and that Peer Sponsoring/social support is an essential element in AA’s success.
that recovering people who help recovering people maintain better sobriety and have greater involvement in the general community.
that men, women, adolescence, African-Americans, Hispanics and gay men benefit from AA. That all socio-demographic groups are represented.
that AA is also suitable for head trauma victims, and methadone patients.
that AA has wide acceptance and is readily available in almost all communities. The current global membership of AA is approximately 2.06 million.
that participation in Alcoholics Anonymous improves medication compliance for mental health patients, improves psychological functioning, Improves coping, reduces child abuse and domestic violence, reduces healthcare usage, reduces hospitalization, reduces medical symptoms, reduces subsequent treatment demand, reduces mortality, and reduces associated costs.
that healthcare workers have good success rates for substance abuse treatment and recovery from alcoholism that can be improved with AA participation.
that alcoholics with social networks supportive of drinking have better outcomes if they initiate AA attendance while in treatment.
that affiliation with AA is enhanced if prospects gain an awareness of the culture and methods used by AA and that sobriety is better than drinking prior to attending AA.
that 80% of Australian, 87% of USA, and 65% of UK doctors believe that Alcoholics Anonymous is the treatment of choice for alcoholism, but overall they do not understand how AA works.
that more than 80% of specialist alcohol and drug treatment staff support Alcoholics Anonymous treatment referral and 92% of another specialist A & D service requested training in 12 Step approaches.
that AA Peer Sponsor contact at the healthcare worker office/institution increases initiation and sustained attendance at AA meetings.
that active and regular AA participation is one of the more effective ways to effect lifestyle changes for alcoholics.
that routinely engaging patients in continuing outpatient care is likely to yield better outcomes..
that most people in the early stages of alcoholism seek help from GP’s or Community Health Centers.
that individuals with substance abuse medical conditions benefit from integrated medical and substance abuse treatment, and approaches such as TSF can be cost-effective.
that for every $1.00 invested in intervention with alcoholics $4.30 is saved in future healthcare costs.

Symptoms of alcoholism

The Symptoms of Alcohol Dependence or Alcoholism

What symptoms of alcoholism does adjunctive Brief-TSF address?

Brief-TSF and the symptoms of alcohol abuse.

Medical, psychosocial and spiritual professional healthcare workers are regularly presented with symptoms of alcohol abuse that are readily assessed or which may be masked by other symptoms; or denied.

The Brief-TSF course explores the signs and symptoms of alcohol abuse and dependence and provides screening and assessment tools along with best practice evidence based application of their use.

Medical symptoms of alcoholism.

The medical symptoms of alcoholism are; Hangovers, blackouts, injuries, lethargy, weight gain or loss, poor coordination, high blood pressure, impotence, vomiting, nausea, cirrhosis of the liver, pancreatic disease, brain damage, peripheral neuropathy and tolerance to alcohol.

Psychological signs of alcohol dependence.

The psychological symptoms of alcohol dependence are; Poor concentration, sleep problems, cloudy thinking, depression, anxiety/stress, aggression, loss of control of drinking, denial of effects of alcohol.

Social aspects of alcohol abuse

The social aspects of alcohol abuse are; Difficulties and arguments with family or friends, difficulties performing at work or home, unemployment, withdrawal from friends and social activities, legal problems, financially insecure.

Spiritual affect of alcohol addiction.

The spiritual affect of alcohol addiction are; Dysthymia or mild chronic depressed, â€˜restless, irritable and discontentâ€™ (Alcoholics Anonymous, 1976 p Page xxviii), self-centered, insecure, self-pitying, resentful, fearful and feeling useless.

Healthcare workers such as nurses, doctors, psychologists, social workers, faith based workers (pastors, Rabbis, priests, ministers, other clergy), counselors and trained volunteers will recognize these symptoms and be able to address them after completion of the Brief-TSF training course.

Brief-TSF incorporates screening, assessment, disturbing denial, identifying loss of control of alcohol, taking an alcohol abuse and treatment history, assessing effects of alcohol and drugs, relapse prevention, psychological aspects and an overview of Alcoholics Anonymous (AA).

How do alcoholics get to AA?

Stages of Affiliation with Alcoholics Anonymous

How do alcoholics get to AA?¹

AA has grown to over 100,000 groups with more than two million members simply on word-of-mouth recommendation. Often the recommendation has come from friends, family, employers, healthcare workers or law courts.

People progress through stages of affiliation with others and with Alcoholics Anonymous in pursuit of solutions to their problems. Two paths are identified; Direct Affiliation and Facilitated Affiliation².

The stages are not necessarily discrete where a person moves in clear progression from one stage to the next. A person is more likely to move up and down, sometimes jumping a stage in regression or progression. However, AA reports that 51% of current members stayed sober from their first meeting.

Facilitation plays a significant part in the process of AA affiliation as approximately 60%³ of AA members seek help from the helping professions prior to attending AA.

These stages of affiliation generally follow Prochaska and DiClemente Stages of Change model and are;