The key to Alcoholics Anonymous’ success
By William Smith
The programme provided by Alcoholics Anonymous (AA) to help their members to stay sober is very comprehensive and yet researchers have identified two key areas which seem to hold the key to recovery from addiction.
Whilst AA helps its members to stay sober in many different ways,the two areas identified as being of the greatest importance are:
- The provision of an environment that allows individuals to receive social support from peers who support individual’s efforts towards sobriety.
- The AA culture that increases an individual’s confidence that he or she can maintain abstinence in challenging social situations.
In other words AA provides a supportive environment in which people receive social support from colleagues which encourages and reinforces behavioural changes.
This study is the first to focus on the behavioural changes which are associated with participation in AA and their role in the successful recovery from addiction.
The study is published online in the journal ‘Addiction and a complete discussion of the findings will also appear in the journal.
The study leader, John F. Kelly, Ph.D., associate director of the Massachusetts General Hospital (MGH) Centre for Addiction Medicine, said ‘AA is the most commonly sought source of help for alcohol addiction and alcohol-related problems in the United States and has been shown to help people attain and maintain long-term recovery.’
‘This study is the first to investigate exactly how AA helps individuals recover by examining the independent effects of sever mechanisms simultaneously,’ Kelly added.
Discovering the precise factors that allow recovery has been an area of study for more than 20 years. A broad range of factors associated with AA participation have been found to contribute to recovery. These include changes in social networks, maintaining motivation, decreased depression symptoms and increased spirituality, and confidence in the ability to cope with the demands of recovery. This is the first study to determine the relative importance of these mechanisms.
Researchers analysed data from more than 1,700 individuals who were enrolled at nine U.S. centres as part of a federally funded trial which is known as the Project MATCH.
Project MATCH was launched to compare three different alcohol treatment approaches.
Around 1,000 participants were recruited into the study from the community and an additional 775 people were recruited who had received prior inpatient treatment which indicates a greater degree of alcohol dependence.
The three treatment approaches which were evaluated in this study are cognitive-behavioural therapy, motivational enhancement therapy and a 12-step therapy. The participants were free to attend AA meetings in addition to receiving treatment which fell into one of the three categories being evaluated.
After completing the Project MATCH therapies, the participants were assessed at follow-up sessions at 3, 9 and 15 months. They were assessed on several measures which included:
• Reports of alcohol consumption – based on both the frequency and the intensity of recent drinking
• Details regarding attendance at AA meetings, and spiritual and religious practices
• Specialised assessments of confidence in their ability to remain abstinent in social situations and when experiencing unpleasant emotions
• Listing level of depression symptoms
• And, whether their close social ties supported or discouraged their efforts to maintain abstinence.
The overall results indicated that the most successful recovery over the following year was associated with greater participation in AA during the first three months of the study period.
Behavioural changes associated with AA attendance and most strongly connected with recovery success are:
- Changes in social networks – more contact with people who support abstinence and fewer with those who would encourage drinking
- Greater confidence in the ability to maintain sobriety in social situations.
For the participants who had received inpatient treatment and probably had been more seriously dependent on alcohol it was found that reduced depression and increased spirituality or religious practices had a significant independent role in their recovery.
‘Our findings are shedding light on how AA helps people recover from addiction over time,’ said Kelly. ‘The results suggest that social context factors are key - the people who associate with individuals attempting to begin recovery can be crucial to their likelihood of success.’
AA appears to facilitate and support those social changes.
‘Further questions we need to investigate are whether particular groups of individuals – women or men, young or old people, those with or without accompanying psychiatric disorders – benefit from AA in the same or in different ways,’ Kelly concluded.
Source: Massachusetts General Hospital
