Re: AA''s recovery rate?

"Harry Andruschak" <adoptsoldcats@xxxxxxx> wrote in message
news:1186423136.176944.70280@xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
The topic was brought up in another thread, thought I'd move the reply
to a new thread. AA has done some surveys in the past and into the
present. They have been published in an AA pamphlet titled "Speaking
at non-AA meetings", so you don't have to take my word for it.

The surveys show that in the first year, 41% stay sober another year.
For those with 1-5 years, 86% stay sober one year.
For those with over 5 years, about 92% stray sober for another year
Hmmmm........
0.41 x 0.86 x 0.86 x 0.86 x 0.86 x .92 and repeat 0.92 to bring it to
23 years, which is what I have. The actual arithmatic is left as an
exercise to the readers. <G>

Obviously, we must keep in mind that many who relapse do return for
another try.

From: http://en.wikipedia.org/wiki/Alcoholics_Anonymous

Research on AA
One reason that many researchers take a skeptical view of AA is that AA
is so unscientific because of its spiritual basis.[33] "Membership is
voluntary and is determined by the individual, not by the group. There
are no membership requirements, no dues or fees, no membership lists. AA
is notoriously difficult to pin down as an organization," writes Maria
Gabrielle Swora.[34] In his book Alcohol: The World's Favourite Drug,
addiction specialist Griffith Edwards argues that a randomised trial of
AA is not possible because members are self-selected, not randomly
selected.[35] In other words, was AA the cause of their sobriety, or did
they simply go to AA when they were ready to stop drinking? In spite of
the obstacles to obtaining direct evidence, many researchers have
tackled the problem of whether AA is effective at creating sobriety.

Project MATCH
Project MATCH was initiated in 1989 and was sponsored by the National
Institute on Alcohol Abuse and Alcoholism (NIAAA).[36] The project was
an 8-year, multisite, $27-million investigation that asked whether
certain types of alcoholics respond best to specific forms of
treatment.[37] MATCH notes "No single treatment approach is effective
for all persons with alcohol problems. A more promising strategy
involves assigning patients to alternative treatments based on specific
needs and characteristics of patients." Three types of treatment were
investigated:
Cognitive Behavioral Coping Skills Therapy, which focuses on correcting
poor self esteem and distorted, negative, and self-defeating
thinking.[38][39]
Motivational Enhancement Therapy, which helps clients to become aware of
and build on personal strengths that can help improve readiness to
quit.[40]
12-Step Facilitation Therapy administered as an independent treatment
designed to familiarize patients with the AA philosophy and to encourage
participation[36]
All the programs were administered by trained psychotherapists, which in
the case of 12-step meant that it was the method and not AA itself that
was studied.
The conclusion of the research was that patient-treatment matching is
not necessary in alcoholism treatment, because the three techniques were
approximately equal in effectiveness. In a December 1996 press
release[36], NIAAA Director Enoch Gordis, M.D. said "These findings are
good news for treatment providers and for patients who can have
confidence that any one of these treatments, if well-delivered,
represents the state of the art in behavioral treatments."
However overall success rates for all treatments were, and continue to
be, less than spectacular. Based on information from Dr. Mark
Willenbring of the NIAAA, Newsweek reported in their February 2007 issue
that "A year after completing a rehab program, about a third of
alcoholics are sober, an additional 40 percent are substantially
improved but still drink heavily on occasion, and a quarter have
completely relapsed."[41]

George Vaillant
Dr. George Vaillant is a board member of Alcoholics Anonymous World
Service who in 1983 undertook a study to research the effectiveness of
AA treatment. He compiled 40 years of clinical studies. He also
conducted an eight-year longitudinal study of his own where Vaillant
reported having followed 100 patients who had undergone Twelve-Step
treatment. Vaillant compared those people to a group of several hundred
other untreated alcohol abusers. The treated patients did no better than
the untreated alcoholics. His studied showed that 95% of alcoholics who
reach AA fail to stay sober.[citation needed]
In his book The Natural History of Alcoholism Revisited, Harvard
psychiatric professor George E. Vaillant posed seven key questions, the
seventh of which was "How helpful is Alcoholics Anonymous in the
Treatment of Alcoholism?"[42] Vaillant's book was partly based on his
experience with "a vast collaborative effort" that had started with two
studies in the late 1930s and was still running after 60 years.[43]
Aware of the difficulties of obtaining direct evidence by statistical
methods, he nevetheless states in his summary of literature and personal
experience that "... research during the last 15 years has revealed
growing indirect evidence that AA is an effective treatment for alcohol
abuse." [44]
Despite his own statistics Vaillant continued to argue that AA shows an
advantage over other treatments in the long term because, as a cheap,
community-based fellowship it is easy for people to keep coming back. He
argues that "AA is the most effective means of long-term relapse
prevention in the physician's armamentarium."[45]
He also writes that AA was formed by people deeply distrustful of
organised religion, and that AA continues to pass the test of
universalism by accepting members regardless of religious conviction.
"Would that all 'religions' and fraternal organizations were as benign,"
he stated.[46]
In 2005, Vaillant produced an extensive study of the efficacy and safety
of AA in the treatment of alcoholism, reviewing the published works from
1940 until the present day. In this paper he acknowledges that, although
AA is not a magic bullet for every alcoholic in that "there were a few
men who attended AA for scores of meetings without improvement."[47],
his overall observation is that "multiple studies that collectively
involved a thousand or more individuals, suggest that good clinical
outcomes are significantly correlated with frequency of AA attendance,
with having a sponsor, with engaging in a Twelve-Step work and with
chairing meetings." Despite a 95% failure rate Vaillant's overall
conclusion is that "Alcoholics Anonymous appears equal to or superior to
conventional treatments for alcoholism, and the skepticism of some
professionals regarding AA as a first rank treatment for alcoholism
would appear to be unwarranted."[48]

Moos and Moos
In a 16-year follow-up study, Rudolf and Bernice Moos examined the
effectiveness of clinical treatment and participation in AA.[49][50]
They reported that clients who had 27 weeks or more of treatment in the
first year had better outcomes 16 years later. After the first year,
continued clinical treatment had little effect on the 16-year outcomes,
whereas continued involvement in AA did help. A conclusion was that
"Some of the association between treatment and long-term alcohol-related
outcomes appears to be due to participation in AA."[51]

The Veterans Study
Moos, Mood, and Humphreys carried out a study of 1,774 low-income,
substance-dependent men who had been enrolled in inpatient substance
abuse treatment programs at 10 Department of Veteran Affairs medical
centers around the U.S.[52]Five of the programs were 12-step based, and
five used cognitive-behavioral therapy. The 12-step programs were found
to be effective in terms of cost and recovery: over 45% of the men in
12-step programs were abstinent one year after discharge, compared to
36% of those treated by cognitive-behavioral therapy. In answer to the
often-posed question as to which comes first, AA participation or
reduced drinking, the study concluded that the answer is AA.[53]Moos
said, however, that the benefits of participation in AA may not
necessarily accrue to all types of individuals: "It is important to
specify the characteristics of individuals who may not need to join AA
in order to overcome their alcoholic-related problems.[54]
[edit] Brandsma et al
A study from 1979 found a correlation between AA and an increased rate
of binge drinking. After several months of participating in AA, the
alcoholics in AA were doing five times as much binge drinking as a
control group that got no treatment at all, and nine times as much binge
drinking as another group that got Rational Emotive Behavior Therapy.
Brandsma argues that teaching people that they are alcoholics who are
powerless over alcohol becomes a self-fulfilling prophecy.[55] Ditman et
al. (1967) found a correlation between participation in AA and an
increase in the alcoholics' rate of multiple arrests for public
drunkenness.[56] Research has indicated that alcoholics reporting a lack
of motivation reverted to their drinking levels soon after leaving
clinical treatment.[57]

J. Scott Tonigan
Tonigan's study found the largest benefit associated with AA attendance
was increased abstinence, followed by reductions in alcohol-related
consequences. "The magnitude of these benefits did not differ between
sites." A slight positive association was also found between AA
attendance and increased purpose in life - the study found that AA
attendance was associated with psychosocial improvement.[58]


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