Measuring the AA

Evaluations of AA encounter definitional problems from the start. Programs and studies vary in their definitions and measurement of recovery, of success and failure, even of the term alcoholism itself.

Although AA contends that upward of 75 percent of its members maintain abstinence, the evidence that is used to make this claim is typically testimonials of long-term, abstinent participants and ignores dropouts, who may be more likely to continue or resume drug and alcohol use. Approximately 50 percent of AA participants will drop out within the first three months of attendance, and only about 13 percent of initial attendees will maintain a long-term relationship with AA.

In an extensive research effort Robert Fiorentine reports that any participation in twelve-step programs is associated with lower levels of drug and alcohol use and that the magnitude of the association is about the same for both illicit drug and alcohol use.

Less-than-weekly participants, who were more likely to be problematic drinkers, had levels of drug and alcohol use that were no different from those of nonparticipants. Fiorentine’s findings suggest that weekly or more frequent twelve-step participation is associated with drug and alcohol abstinence.

However, commitment to attend a twelve-step program might be a predictor of success; the program itself might actually do little or nothing to generate abstinence. A study comparing the results of AA with those of other forms of treatment found that twelve-step programs were neither more nor less effective than, for example, the cognitive approach discussed earlier. Doing the treatment program is like connecting a gas stove (Подключить газовую плиту), its easy but its risky if you don’t know how to do it. So these kind of treatment requires professional along the program.

Despite the paucity of research on its effectiveness, the twelve-step approach is very popular, some arguing that it has become a fad. The rise in the number of twelve-step programs and members and the inclusion of twelve-step philosophy in treatment programs are, of course, evidence only of its popularity, not of its effectiveness.