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Alcoholics Anonymous

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AA meeting sign

Alcoholics Anonymous (AA) is a worldwide mutual aid society[1] self-decribed as a fellowship of men and women with a desire to stop drinking alcohol while helping others to do so through a program of character development by following its invention, the Twelve Steps.[2][3] AA was started by two Americans, Bill Wilson and Dr. Bob Smith (commonly known as Bill W. and Dr. Bob), but its intentionally broad philosophy has aided AA in spreading "across diverse cultures holding different beliefs and values." AA's independence and removal from other organizations and avoidance of "outside issues" has helped its spread to geopolitical areas otherwise resistant to grassroots movements.[4] Although approximately two-fifths of people who participate in AA drop out within the first three months[5] its program can help alcoholics maintain sobriety.[6] Noting that brief treatment is ineffective for patients who can't maintain sobriety, the American Psychiatric Association recommends sustained treatment in conjunction with community resources such as AA.[7]

AA is named after it self-published book, "Alcoholics Anonymous", first published in 1939, which describes its program of recovery and is informally known as The Big Book.

History

Main article: History of Alcoholics Anonymous

In 1934 Bill Wilson's drunkenness had ruined a promising career in finance. Ebby Thacher, a former drinking friend, introduced Wilson to a six step spiritual solution for alcoholism that he picked up as a member of the Oxford Group, a Christian society that promoted sobriety. Wilson subsequently stopped drinking for good, but during a 1935 business trip to Akron, Ohio, Wilson's obsession for alcohol returned. In an effort to stay sober, he met with another alcoholic, Dr. Bob Smith, with whom he related how he stayed sober with the help of a power greater than himself. Wilson and Smith continued to meet and became convinced that working with another alcoholic helped them to stay sober. For the benefit of other alcoholics, they co-founded AA. The last day Smith drank alcohol—June 10, 1935—is the anniversary date of AA.[8]

By 1937, Wilson and Smith counted 40 alcoholics they helped to get sober, and two years later, they counted 100 members (including one woman). To promote the fellowship, Wilson and other members wrote Alcoholics Anonymous, the book for which the fellowship is named. Informally referred to by members as "The Big Book", it suggests a twelve-step program in which members admit powerlessness over alcohol, acceptance of a Higher Power, taking of a moral inventory, making amends to those harmed, and seeking direction, guidance, and power from a God "of one's own understanding". In 1941 interviews on American radio and favorable articles in US magazines, particularly by Jack Alexander in The Saturday Evening Post, were followed by increased book sales and membership.[9] By 1946, the growing fellowship was confused and quarreling over practices, finances, and publicity. Wilson's corrective was to write the guidelines for non-coercive group management, Twelve Points to Assure our Future, that eventually became known as the Twelve Traditions.[2] At the 1955 St. Louis convention, in Missouri, Wilson relinquished stewardship of AA to the General Service Conference.[10] In this era, AA started to expand internationally and grew to an estimated two million by 2001.[11]

Organization

Main article: Twelve Traditions
A regional service center for Alcoholics Anonymous.

In 2006 AA reported 1,867,212 members and 106,202 AA groups worldwide.[11] The Twelve Traditions informally guide how AA groups function, and the Twelve Concepts for World Service guide how AA is structured globally.[12]

A member who accepts a service position or an organizing role is a "trusted servant" with terms rotating and limited, typically lasting three months to two years and determined by group vote and/or the nature of the position. Each group is a self-governing entity with AA World Services acting only in an advisory capacity. AA is served entirely by alcoholics, except for seven "nonalcoholic friends of the fellowship" out of twenty-one members of the AA Board of Trustees.[11]

AA groups are self-supporting and not charities. There are no dues or membership fees. Groups rely on voluntary member donations to pay for expenses like room rental, refreshments, and literature. Typically, a basket is passed during the meeting. The Twelve Traditions of AA are read (including the Seventh Tradition, which states: "Every A.A. group ought to be fully self-supporting, declining outside contributions"). In the United States, for example, people often put a dollar or two in the basket. Any contribution is voluntary and not required of anyone.[11] AA GSO discourages individuals from making large donations by limiting contributions to US$3,000 per annum, and it returns contributions mailed from sources outside of AA.[13] Beyond the group level, AA may hire outside professionals for services that either require specialized expertise and/or are full time responsibilities.[2]

AA receives proceeds from books and literature which constitute more than 50% of the income for the General Service Office (GSO).[14] Unlike individual groups the GSO is not self-supporting and maintains a small salaried staff. It also maintains service centers which coordinate activities like printing literature, responding to public inquiries, and organizing conferences. They are funded by local members and responsible to the AA groups they represent. Other International General Service Offices (i.e., Australia, Costa Rica, Russia, etc.) are independent of AA World Services in New York.[15]

Program

See also: Twelve-step program: The Twelve Steps

The scope of AA's program is much broader than just changing drinking behavior.[16] Its goal is to effect enough change in the alcoholic's thinking "to bring about recovery from alcoholism"[17] while abstaining from alcohol, one day at a time. A spiritual awakening is achieved from following the Twelve Steps,[18] and sobriety is furthered by volunteering for AA[19] and regular AA meeting attendance[20] or contact with AA members.[18] Members are encouraged to find an experienced fellow alcoholic called a sponsor to help them understand and follow the AA program. The sponsor should preferably have experience of all twelve of the steps, be the same gender as the sponsored person, and refrain from imposing personal views on the sponsored person.[21] Following the helper therapy principle, sponsors in AA benefit as much, if not more, from their relationship than do those they sponsor. Helping behaviors correlate with increased abstinence and lower probabilities of binge drinking.[22]

AA's program is an inheritor of Counter-Enlightenment philosophy. AA shares the view that acceptance of one's inherent limitations is critical to finding one's proper place among other humans and God. Such ideas are described as "Counter-Enlightenment" because they are at variance with the Enlightenment's ideal that humans have the capacity to make their lives and societies a heaven on earth using their own power and reason.[16]

Sociologists David Rudy and Arthur Greil evaluated AA's literature and observed AA meetings for sixteen months. They note that although AA's ideology denies AA is religious in nature, for an AA member to remain sober a high level of commitment is necessary. This commitment is facilitated by a change in the member's world view. To help members stay sober AA must, they argue, provide an all-encompassing world view while creating and sustaining an atmosphere of transcendence in the organization. To be all-encompassing AA's ideology places an emphasis on tolerance rather than on a narrow religious world view that could make the organization unpalatable to potential members and thereby limit its effectiveness. AA's emphasis on the spiritual nature of its program, however, is necessary to institutionalize a feeling of transcendence. A tension results from the risk that the necessity of transcendence, if taken too literally, would compromise AA's efforts to maintain a broad appeal. As this tension is an integral part of AA, Rudy and Greil argue that AA is best described as a quasi-religious organization.[23]

Meetings

AA meetings are "quasi-ritualized therapeutic sessions run by and for any alcoholics".[24] They are usually informal and often feature discussions. Local AA directories list a variety of weekly meetings. Those listed as "closed" are only for those with "a desire to stop drinking",[2] while "open" meetings are available to anyone. Speaker meetings have one or two members tell their stories, while discussion meetings allocate the most time for general discussion. Some meetings are devoted to studying and discussing the AA literature. Except for men's and women's meetings, most meetings for specific demographics (including newcomers, gays, and young people) do not exclude other alcoholics. While AA has pamphlets suggesting meeting formats,[25][26] AA groups have the autonomy to hold and conduct meetings as they wish "except in matters affecting other groups or A.A. as a whole".[2] Different cultures affect ritual aspects of meetings, nonetheless around the world "many particularities of the AA meeting format can be observed at almost any A.A. gathering".[27]

Confidentiality

Although a statement is read during meetings saying that what is said there should remain confidential, AA members, unlike lawyers or clergy, are not legally bound to maintain confidentiality.[28][29]

Disease of alcoholism

Main article: Disease theory of alcoholism

AA has spread and popularized the disease concept of alcoholism, first postulated by Benjamin Rush in the eighteenth century. [30]. Though AA initially carefully avoiding calling it a disease, conference approved literature later categorically stated "...we had the disease of alcoholism."[31] Regardless of official positions, from inception most AA members have related to alcoholism as a disease.[32]

AA has no opinion on the medical nature of alcoholism, and although in The Big Book's introductory statement by Dr. William Silkworth's titled "The Doctor's Opinion" suggests that the inability of alcoholics to moderate drinking "may be the manifestation of an allergy", AA withheld its endorsement of the doctor's idea saying: "The doctor’s theory that we have an allergy to alcohol interests us. As laymen, our opinion as to its soundness may, of course, mean little. [33] AA, in fact, later acknowledged that "Technically, in strictly scientific terms, alcoholism is not a true allergy, the experts now inform us."[34]

AA historian Ernest Kurtz says, "The closest the book Alcoholics Anonymous comes to a definition of alcoholism appears on p. 44, at the conclusion of the first paragraph of the 'We Agnostics' chapter, where we are told that alcoholism 'is an illness which only a spiritual experience will conquer'." [35] This definition is the statement, "If, when you honestly want to, you find you cannot quit entirely, or if when drinking, you have little control over the amount you take, you are probably alcoholic."[36]

In 1960, Bill Wilson gave a speech to the National Catholic Clergy Conference on Alcoholism. During the ensuing question and answer discussion, Wilson was asked why he did not use the term "disease" when he spoke of alcoholism. He replied, "We AAs have never called alcoholism a disease because, technically speaking, it is not a disease entity. For example, there is no such thing as heart disease. Instead there are many separate heart ailments or combinations of them. It is something like that with alcoholism. Therefore, we did not wish to get in wrong with the medical profession by pronouncing alcoholism a disease entity. Hence, we have always called it an illness or a malady — a far safer term for us to use."[37]

Canadian and US demographics

AA's New York General Service Office regularly surveys AA members in North America. Its 2004 survey of over 7,500 members in Canada and the United States concluded that, in North America, AA members who responded to the survey were 65% male and 35% female. Average member sobriety is eight years with 36% sober more than ten years, 14% sober from five to ten years, 24% sober from one to five years, and 26% sober less than one year. Before coming to AA, 64% of members received some type of treatment or counseling, such as medical, psychological, or spiritual. After coming to AA, 65% received outside treatment or counseling, and 84% of those members said that that outside help played an important part in their recovery. The same survey showed that AA received 11% of its membership from court ordered attendance.[38]

Effectiveness

Main article: Effectiveness of Alcoholics Anonymous

Limitations on research

The study of AA tends to polarize observers into believers and non-believers,[39] and discussion of AA often creates controversy rather than objective reflection.[40] A randomized trial of AA is very difficult because members are self-selected, not randomly selected from the population of chronic alcoholics,[41] with the possible exception of those who participate in AA to comply with a court mandate. Two opposing types of self-selection bias are that drinkers may be motivated to stop drinking before they participate in AA, and AA may attract the more severe and difficult cases.[42] Control groups with AA versus non-AA subjects are also difficult because AA is so easily accessible.

Studies

Research into AA's efficacy has led to inconsistent results between studies. While some studies have suggested an association between AA attendance and increased abstinence or other positive outcomes,[43][44][45][46][47][48] other studies have not.[49][50][51][52][53] A Cochrane Review of eight studies, published between 1967 and 2005, measuring the effectiveness of AA, found no significant difference between the results of AA and twelve-step facilitation approaches compared to other treatments. To determine further the effectiveness of AA, the authors suggested that more studies comparing treatment outcomes with control groups were necessary.[54]

Attrition

See also: Effectiveness of Alcoholics Anonymous: Results from Triennial Surveys

According to AA, most who start attending AA meetings drop out.[55] Every third year since 1968 AA issues a pamphlet summarizing its latest triennial survey of meeting attendants. Additional published comments and analysis for academics and professionals have supplemented the survey results from 1970 through 1990.[5] The 1990 commentary evaluated data of triennial surveys from 1977 through 1989 and found that one quarter (26%) of those who first attend an AA meeting are still attending after one year. Furthermore, nearly one third (31.5%) leave the program after one month, and by the end of the third month, over half (52.6%) have left.[55] After the first year, the rate of attrition slows. Only those in the first year were recorded by month.[55] About 40% of the members sober for less than a year will remain another year. About 80% of those sober less than five years will remain sober and active in the fellowship another year. About 90% of the members sober five years or more will remain sober and active in the fellowship another year. Those who remained sober outside the fellowship could not be calculated using the survey results.[55]

Health care costs

As a volunteer-supported program, AA is a free service. This stands in contrast to treatments for alcoholism such as inpatient treatment, drug therapy, psychotherapy and Cognitive Based Therapy. Research has noted that institutional use of AA in certain circumstances has reduced health care expenditures by 45%.[46]

Relationship with institutions

Prisons

In the United Kingdom and New Zealand, Alcoholics Anonymous holds meetings in prisons. AA prison and probation liaisons cooperate with staff and AA volunteers give talks to staff in the legal profession.[56] In the United States AA meetings are held in hundreds of correctional facilities. The AA General Service Office has published a workbook with detailed recommendations for methods to approach correctional facility officials with the intent of developing an in-prison AA program.[57] In addition, a variety of pamphlets are published by AA specifically for the incarcerated alcoholic.[58] Additionally, the AA General Service Office also provides a pamphlet with guidelines for members working with incarcerated alcoholics.[59]

Court rulings

United States courts have ruled that inmates, parolees, and probationers cannot be ordered to attend AA. Though AA itself was not deemed to be a religion, it was ruled that it contained enough religious components to make coerced attendance at AA meetings a violation of the Establishment Clause of the First Amendment of the constitution.[60] In September 2007, United States Court of Appeals for the Ninth Circuit stated that a parole office can be sued for ordering a parolee to attend AA.[61][62]

American treatment industry

Although Alcoholics Anonymous does not endorse and is not allied with any outside facility, since 1949 when Hazelden treatment center was founded by some AA members, alcoholic rehabilitation clinics have frequently incorporated precepts of the AA program into their own treatment programs.[63] A reverse influence has also occurred with AA receiving 31% of its membership from treatment center referrals.[38]

United Kingdom treatment industry

A cross-sectional survey of substance misuse treatment providers in the West Midlands found fewer than ten percent integrated twelve-step methods in their practice and only a third felt their consumers were suited for Alcoholics Anonymous or Narcotics Anonymous membership. Less than half were likely to recommend self-help groups to their clients. Providers with nursing qualification were more likely to make such referrals than those without. A statistically significant correlation was found between providers self-reported level of spirituality and their likelihood of recommending AA or NA.[64]

Criticism

See also: Twelve-step program: Criticism

Moderation or abstinence

For more details on this topic, see Alcoholism: Management

AA acknowledges that not all drinkers are alcoholics, but advocates total abstinence for those who are.[65] Critics such as Stanton Peele and Nancy Shute argue, however, that some AA groups apply the disease model to all problem drinkers, whether or not they are "full-blown" alcoholics,[66] and believe that more options should be available to problem drinkers who can manage their drinking with the right treatment.[67]

Cultural identity

One review of AA warned of detrimental iatrogenic effects of twelve-step philosophy and concluded that AA uses many methods that are also used by cults.[68] A subsequent study concluded, however, that AA's program bore little semblance to religious cults because the techniques used appeared beneficial.[69] Another difference is that, unlike what happens in cults, AA does not seek to prevent a member leaving or renouncing the movement. In this regard there is complete freedom. Another study found that the AA program's focus on self-admission of having a problem increases deviant stigma and strips members of their previous cultural identity replacing it with the deviant identity.[70] A survey of group members, however, found they had a bicultural identity and saw AA's program as a complement to their other national, ethnic, and religious cultures.[71] There is no absolutely uniform experience in AA with members adopting a wide variety of religion beliefs, political opinions and life-styles. Despite the emphasis on a "Higher Power" and the use of the word "God" in AA literature such as the 12 Steps and the Big Book, there is no common way of understanding this phrase and some AA members even claim to be atheist or agnostic.

Other notable criticism

  • "Thirteenth-stepping" is a disparaging euphemism referring to AA members who seek to seduce new members.[72] To avoid this type of behavior, AA typically suggests that men be sponsored by men, and women be sponsored by women.[73] In some cases, however, men may be sponsored by women and vice versa; particularly with members who are homosexual.[citation needed]
  • Arthur H. Cain argued that AA members rely too heavily on dogmatic slogans and become overly dependent on the group.[74]

Literature

Alcoholics Anonymous publishes several books, reports, pamphlets and other media including a periodical known as the AA Grapevine.[75] Two books are used primarily - Alcoholics Anonymous (the "Big Book") and Twelve Steps and Twelve Traditions, the latter explaining AA's fundamental principles in depth.

  • Alcoholics Anonymous (June 1, 1976). Alcoholics Anonymous. Alcoholics Anonymous World Services. ISBN 0916856593. OCLC 2353981.
  • Alcoholics Anonymous (February 10, 2002). Twelve Steps and Twelve Traditions. Alcoholics Anonymous World Services. ISBN 0916856011. OCLC 13572433. {{cite book}}: More than one of |author= and |last= specified (help)
  • The A.A. Grapevine. Alcoholics Anonymous. ISSN 0362-2584. OCLC 50379271 http://www.aagrapevine.org/index.php. {{cite journal}}: Missing or empty |title= (help)

See also

Notes

  1. ^ Mäkelä 1996, p. 3
  2. ^ a b c d e "The Twelve Traditions". The A.A. Grapevine. 6 (6). Alcoholics Anonymous. 1949. ISSN 0362-2584. OCLC 50379271. {{cite journal}}: Unknown parameter |month= ignored (help)
  3. ^ Chappel, JN; Dupont, RL (1999). "Twelve-Step and Mutual-Help Programs for Addictive Disorders". Psychiatric Clinics of North America. 22 (2): 425. doi:10.1016/S0193-953X(05)70085-X. PMID 10385942.
  4. ^ Tonigan, Scott J; Connors, Gerard J; Miller, William R (2000). "Special Populations in Alcoholics Anonymous" (PDF). Alcohol Health and Research World. 22 (4): 281–285. PMID 15706756. {{cite journal}}: Unknown parameter |month= ignored (help)
  5. ^ a b McIntire, Don (2000). "How Well Does A.A. Work? An Analysis of Published A.A. Surveys (1968–1996) and Related Analyses/Comments". Alcoholism Treatment Quarterly. 18 (4): 1–18. doi:10.1300/J020v18n04_01. {{cite journal}}: Unknown parameter |month= ignored (help)
  6. ^ Timko, C; Debenedetti, A (2007). "A randomized controlled trial of intensive referral to 12-step self-help groups: One-year outcomes". Drug and Alcohol Dependence. 90 (2–3): 270–279. doi:10.1016/j.drugalcdep.2007.04.007. PMID 17524574. {{cite journal}}: Unknown parameter |month= ignored (help)
  7. ^ Connelly, John C.; Foster, Douglas L.; Miller, Derek; Riordan, Charles; Weisman, Maxwell N. (1980). "Substance Abuse: Position Statement". American Psychiatric Association. Archived from the original on 2010-01-26. Retrieved 2010-01-26. {{cite journal}}: Cite journal requires |journal= (help); Unknown parameter |month= ignored (help)
  8. ^ Pass It On 1984, p. 131–149
  9. ^ Jack Alexander (1 March 1941). "Alcoholics Anonymous". Saturday Eventing Post (Reprinted in booklet form ed.). Alcoholics Anonymous World Services. ISBN 0896381994. Archived from the original (PDF) on 2009-12-12. Retrieved 2009-12-12.
  10. ^ Pass It On 1984, p. 359
  11. ^ a b c d "AA Fact File". General Service Office of Alcoholics Anonymous. 2007. Archived from the original (PDF) on 2009-12-12. Retrieved 2008-10-28. {{cite journal}}: Cite journal requires |journal= (help)
  12. ^ Wilson, Bill. "The A.A. Service Manual Combined with Twelve Concepts for World Services". Alcoholics Anonymous World Services, Inc. Archived from the original (PDF) on 2009-12-12. Retrieved 2009-12-12.
  13. ^ "A.A. GSO Guidelines: Finances". Alcoholics Anonymous General Service Office. Archived from the original (PDF) on 2009-12-12. Retrieved 2009-12-12. {{cite journal}}: Cite journal requires |journal= (help)
  14. ^ "GSO 2007 Operating Results". Alcoholics Anonymous General Services Office. Archived from the original on 2009-12-12. Retrieved 2009-12-12. Gross Profit from Literature ~8,6M (57%), Contributions ~$6.5M (43%)
  15. ^ "Alcoholics Anonymous : International General Service Offices". Alcoholics Anonymous website. Archived from the original on 2009-12-12. Retrieved 2009-10-08.
  16. ^ a b Humphreys, Keith; Kaskutas, Lee Ann (1995). "World Views of Alcoholics Anonymous, Women for Sobriety, and Adult Children of Alcoholics/Al-Anon Mutual Help Groups". Addiction Research & Theory. 3 (3): 231–243. doi:10.3109/16066359509005240.
  17. ^ Bill W. 2002, Appendix II
  18. ^ a b "This is AA". Alcoholics Anonymous Work Services, Inc. 1984. Archived from the original (PDF) on 2009-12-12. Retrieved 2009-12-12. {{cite journal}}: Cite journal requires |journal= (help)
  19. ^ AA.org
  20. ^ ""A Newcomer Asks... "". Alcoholics Anonymous World Services, Inc. 1980. Archived from the original (PDF) on 2009-12-12. Retrieved 2009-12-12. {{cite journal}}: Cite journal requires |journal= (help)
  21. ^ Questions and Answers on Sponsorship 2005
  22. ^ Zemore, S. E., Kaskutas, L. A., & Ammon, L. N. (2004). "In 12-step groups, helping helps the helper". Addiction. 99 (8): 1015–1023. doi:10.1111/j.1360-0443.2004.00782.x. PMID 15265098. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  23. ^ Rudy, David R.; Greil, Arthur L. (1989). "Is Alcoholics Anonymous a Religious Organization?: Meditations on Marginality". 50 (1): 41–51. doi:10.2307/3710917. {{cite journal}}: Cite journal requires |journal= (help)
  24. ^ Leach, Barry; Norris, John L.; Dancey, Travis; Bissell, Leclair (1969). "Dimensions of Alcoholics Anonymous: 1935–1965". Substance Use & Misuse. 4 (4): 509. doi:10.3109/10826086909062033.
  25. ^ "The A.A. Group". Archived from the original (PDF) on 2009-12-12. Retrieved 2009-12-12. {{cite journal}}: Cite journal requires |journal= (help)
  26. ^ "Suggestions For Leading Beginners Meetings". Alcoholics Anonymous World Services, Inc. Archived from the original (PDF) on 2009-12-12. Retrieved 2009-12-12. {{cite journal}}: Cite journal requires |journal= (help)
  27. ^ Mäkelä 1996, p. 149-150
  28. ^ Coleman, Phyllis (2005). "Privilege and Confidentiality in 12-Step Self-Help Programs: Believing The Promises Could Be Hazardous to an Addict's Freedom". The Journal of Legal Medicine. 26 (4): 435–474. doi:10.1080/01947640500364713. ISSN 0194-7648. OCLC 4997813. PMID 16303734. {{cite journal}}: Unknown parameter |month= ignored (help)
  29. ^ Hoffman, Jan (15 June 1994). "Faith in Confidentiality of Therapy Is Shaken". New York Times. Retrieved 2008-10-23.
  30. ^ https://www.csam-asam.org/fckfiles/csamnews_win09.pdf
  31. ^ http://www.aa.org/pdf/products/p-3_isaaforyou.pdf
  32. ^ http://www.bhrm.org/papers/AAand%20DiseaseConcept.pdf
  33. ^ Alcoholics Anonymous page xxx
  34. ^ Living Sober p 68
  35. ^ http://www.bhrm.org/papers/AAand%20DiseaseConcept.pdf
  36. ^ Alcoholics Anonymous p44
  37. ^ http://www.nccatoday.org/conversation.htm
  38. ^ a b "Alcoholics Anonymous 2004 Membership Survey". Alcoholics Anonymous World Services' General Service Office. 2005. Archived from the original (PDF) on 2009-12-12. Retrieved 2009-12-12. {{cite journal}}: Cite journal requires |journal= (help)
  39. ^ Vaillant, 1995, p 255.
  40. ^ Vaillant, 1995, p 265.
  41. ^ Griffith 2002, p. 103-117
  42. ^ Humphreys, Keith (2002). "Alcoholics Anonymous and 12-Step Alcoholism Treatment Programs". Recent Developments in Alcoholism. 16. Springer US: 149–164. doi:10.1007/b100495. ISBN 978-0-306-47258-9. PMID 12638636.
  43. ^ Moos, Rudolf H.; Moos, BS (2006). "Participation in Treatment and Alcoholics Anonymous: A 16-Year Follow-Up of Initially Untreated Individuals". Journal of Clinical Psychology. 62 (6): 735–750. doi:10.1002/jclp.20259. PMC 2220012. PMID 16538654. {{cite journal}}: Unknown parameter |month= ignored (help)
  44. ^ Moos, Rudolf H.; Moos, BS (2006). "Rates and predictors of relapse after natural and treated remission from alcohol use disorders". Addiction. 101 (2): 212–222. doi:10.1111/j.1360-0443.2006.01310.x. PMC 1976118. PMID 16445550. {{cite journal}}: Unknown parameter |month= ignored (help)
  45. ^ Moos, Rudolf H.; Moos, BS (2004). "Long-Term Influence of Duration and Frequency of Participation in Alcoholics Anonymous on Individuals with Alcohol Use Disorders". Journal of Consulting and Clinical Psychology. 72 (1): 81–90. doi:10.1037/0022-006X.72.1.81. PMC 1976118. PMID 16445550. {{cite journal}}: Unknown parameter |month= ignored (help)
  46. ^ a b Humphreys, Keith; Moos, R (2001). "Can encouraging substance abuse patients to participate in self-help groups reduce demand for health care? A quasi-experimental study". Alcoholism: Clinical and Experimental Research. 25 (5): 711–716. doi:10.1111/j.1530-0277.2001.tb02271.x. ISSN 1530-0277. PMID 11371720. {{cite journal}}: Unknown parameter |month= ignored (help) Cite error: The named reference "HUMPHREYS2001" was defined multiple times with different content (see the help page).
  47. ^ Morgenstern, Jon; Laboview, Erich; McCrady, Barbara S; Kahler, Christopher W; Frey, Ronni M (1997). "Affiliation with Alcoholics Anonymous after treatment: a student of its therapeutic effects and mechanisms of action". Journal of consulting and clinical psychology. 65 (5): 768–888. doi:10.1037/0022-006X.65.5.768. PMID 9337496. {{cite journal}}: Unknown parameter |month= ignored (help)
  48. ^ Tonigan, J. Scott (2001). "Benefits of Alcoholics Anonymous Attendance -- Replication of Findings Between Clinical Research Sites in Project MATCH". Alcoholism Treatment Quarterly. 19 (1): 67–77. doi:10.1300/J020v19n01_05.
  49. ^ Ditman, Keith S; Crawford, George G; Forgy, Edward W; Moskowitz, Herbert; MacAndrew, Craig (1967). "A controlled experiment on the use of court probation for drunk arrests". American Journal of Psychiatry. 124 (2): 160–163. PMID 4951569. {{cite journal}}: Unknown parameter |month= ignored (help)
  50. ^ Brandsma, Jeffery M; Maultsby, Maxie C; Welsh, Richard J (1980). Outpatient treatment of alcoholism: a review and comparative study. Baltimore, MD: University Park Press. ISBN 0839113935. OCLC 5219646.
  51. ^ Larimer, Mary E; Palmer, RS; Marlatt, GA (1999). "Relapse prevention. An overview of Marlatt's cognitive-behavioral model". Alcohol research & health : the journal of the National Institute on Alcohol Abuse and Alcoholism. 23 (2): 151–160. ISSN 1535-7414. OCLC 42453373. PMID 10890810.
  52. ^ Ståhlbrandt, Henriettæ; Johnsson, Kent O.; Berglund, Mats (2007). "Two-Year Outcome of Alcohol Interventions in Swedish University Halls of Residence: A Cluster Randomized Trial of a Brief Skills Training Program, Twelve-Step Influenced Intervention, and Controls". Alcoholism: Clinical and Experimental Research. 31: 458. doi:10.1111/j.1530-0277.2006.00327.x.
  53. ^ Terra, Mauro Barbosa; Barros, Helena Maria Tannhauser; Stein, Airton Tetelbom; Figueira, Ivan; Palermo, Luiz Henrique; Athayde, Luciana Dias; Gonçalves, Marcelo de Souza; Da Silveira, Dartiu Xavier (2008). "Do Alcoholics Anonymous Groups Really Work? Factors of Adherence in a Brazilian Sample of Hospitalized Alcohol Dependents". American Journal on Addictions. 17 (1): 48. doi:10.1080/10550490701756393. PMID 18214722.
  54. ^ Ferri, MMF; Amato, Laura; Davoli, Marina; Ferri, Marica (2006). "Alcoholics Anonymous and other 12-step programmes for alcohol dependence". Cochrane Database of Systematic Reviews. 2006 (3). doi:10.1002/14651858.CD005032.pub2.
  55. ^ a b c d "Comments On A.A. Triennial Surveys". Alcoholics Anonymous World Services. 1990. {{cite journal}}: Cite journal requires |journal= (help); Unknown parameter |month= ignored (help)
  56. ^ "Alcoholics Anonymous UK: Legal Professionals". Archived from the original on 2009-12-12. Retrieved 2008-11-28.
  57. ^ "Corrections Workbook". New York, NY: Alcoholics Anonymous Word Services, Inc. 1995. Archived from the original (PDF) on 2009-12-12. Retrieved 2009-12-12. {{cite journal}}: Cite journal requires |journal= (help)
  58. ^ "Corrections Catalog". Archived from the original on 2009-12-12. Retrieved 2009-12-12. Some of the titles include: Carrying the Message into Correctional Facilities, Where Do I Go From Here?, A.A. in Prison: Inmate to Inmate, A.A. in Correctional Facilities, It Sure Beats Sitting in a Cell, Memo to an Inmate Who May be an Alcoholic, A Message to Corrections Administrators
  59. ^ "AA Guidelines from GSO: Cooperating with Court, DWI and Similar Programs". Archived from the original (PDF) on 2009-12-12. Retrieved 2009-12-12. {{cite journal}}: Cite journal requires |journal= (help)
  60. ^ Honeymar, (1997). "Alcoholics Anonymous As a Condition of Drunk Driving Probation: When Does It Amount to Establishment of Religion". Columbia Law Review. 97 (2): 437. doi:10.2307/1123367.{{cite journal}}: CS1 maint: extra punctuation (link)
  61. ^ Egelko, Bob (8 September 2007). "Appeals court says requirement to attend AA unconstitutional". San Francisco Chronicle. Archived from the original on 2009-12-12. Retrieved 2007-10-08.
  62. ^ Inouye v. Kemna, 504 F.3d 705, 11889 (9th Cir. 2007).
  63. ^ Roberson 1988, p. 220
  64. ^ Day, E; Gaston, RL; Furlong, E; Murali, V; Copello, A (2005). "United Kingdom substance misuse treatment workers' attitudes toward 12-step self-help groups". Journal of Substance Abuse Treatment. 29 (4): 321–327. doi:10.1016/j.jsat.2005.08.009. PMID 16311185. {{cite journal}}: Unknown parameter |month= ignored (help)
  65. ^ Bill W. 2002, p. 17-29
  66. ^ Peele 1989
  67. ^ Shute, Nancy (1997). "The drinking dilemma: by calling abstinence the only cure, we ensure that the nation's $100 billion alcohol problem won't be solved". U.S. News & World Report. 123 (9): 54–64. {{cite journal}}: Unknown parameter |month= ignored (help)
  68. ^ Alexander, Francesa; Rollins, Michele (1985). "Alcoholics Anonymous: the unseen cult". California Sociologist. 17 (1). Los Angeles: California State University: 33–48. ISSN 0162-8712. OCLC 4025459. Archived from the original (PDF) on 2009-12-12. Retrieved 2009-12-12.
  69. ^ Right, Kevin B. W (1997). "Shared Ideology in Alcoholics Anonymous: A Grounded Theory Approach". Journal of Health Communication. 2 (2): 83. doi:10.1080/108107397127806. PMID 10977242.
  70. ^ Levinson, D. (1983). Galanter, Marc (ed.). "Current status of the field: An anthropological perspective on the behavior modification treatment of alcoholism". Recent Developments in Alcoholism. 1. New York: Plenum Press: 255–261. ISSN 0738-422X. PMID 6680227.
  71. ^ Wilcox 1998, p. 109-124
  72. ^ Bogart, Cathy J.; Bogart, Cathy J. (2003). "'13th-Stepping:' Why Alcoholics Anonymous Is Not Always a Safe Place for Women". Journal of Addictions Nursing: A Journal for the Prevention and Management of Addictions. 14 (1): 43–47. doi:10.1080/10884600305373. ISSN 1548-7148. OCLC 34618968.
  73. ^ Questions and Answers on Sponsorship, p. 10
  74. ^ Cain, Arthur H. (1963). "Alcoholics Anonymous: Cult or Cure?". Harper's Magazine. ISSN 0017-789X. Archived from the original on 2003-09-01. {{cite journal}}: Cite journal requires |journal= (help); Unknown parameter |month= ignored (help)
  75. ^ A Worldcat search for materials authored by Alcoholics Anonymous and more specific divisions of the organization (AA Grapevine, World Services, General Service Conference, World Service Meeting) yields well over 500 results.

References

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