Study IDs Key Components of Alcoholics Anonymous

By Rick Nauert PhD Senior News Editor

Reviewed by John M. Grohol, Psy.D.

September 13, 2011

Researchers believe they have discovered key factors responsible for the success of Alcoholics Anonymous (AA) programs.

Although the program helps members stay sober in many ways, two key areas of assistance include AA’s environment that allows individuals to receive social support from peers who support the individual’s efforts towards sobriety; and the AA culture that increases an individual’s confidence that he or she can maintain abstinence in challenging social situations.

In short, AA creates a supportive environment where people receive social support from colleagues encouraging and reinforcing behavioral changes.

The new study is the first to focus on the behavior changes associated with participation in AA and their importance to successful recovery from addiction.

A complete discussion of the findings will appear in the journal Addiction and have been released online.

“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,” said study leader John F. Kelly, Ph.D., associate director of the Massachusetts General Hospital (MGH) Center for Addiction Medicine.

“This study is the first to investigate exactly how AA helps individuals recover by examining the independent effects of several mechanisms simultaneously.”

While the short-and long-term success of AA are well-documented, the quest to discover the precise factors that permit recovery has been an area of study for more than two decades.

A broad range of factors associated with AA participation have been identified as contributing to recovery – including changes in social networks, maintaining motivation, confidence in the ability to cope with the demands of recovery, decreased depression symptoms and increased spirituality – but until now, no study as yet has been able to determine the relative importance of those mechanisms.

In the current study, researchers analyzed data from more than 1,700 study participants enrolled at nine U.S. centers as part of a federally funded trial known as Project MATCH.

The objective of Project MATCH was to compare three alcohol treatment approaches.

Almost 1,000 were recruited into the study directly from the community, and another 775 had received prior inpatient treatment, indicating a greater degree of alcohol dependence.

The study evaluated three treatment approaches – cognitive-behavioral therapy, motivational enhancement therapy, and a 12-step therapy. In addition to the treatment protocols, participants were free to attend AA meetings.

At follow-up sessions 3, 9 and 15 months after completing the Project MATCH therapies, participants were assessed on several measures including:

• 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;
• Specialized 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.
Overall results indicated that greater participation in AA during the first three months of the study period was independently associated with more successful recovery over the following year.

Of the behavioral changes associated with AA attendance, changes in social networks – more contacts with people who supported abstinence and fewer with those would encourage drinking – and greater confidence in the ability to maintain sobriety in social situations were most strongly connected with recovery success.

Reduced depression and increased spirituality or religious practices also had a significant independent role in the recovery of participants who had received inpatient treatment and probably had been more seriously dependent on alcohol.

“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 adept at facilitating and supporting 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.”

© Massachusetts General Hospital


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