Alcoholics Anonymous (AA) is synonymous with abstinence and recovery. It is a worldwide program that strives to help individuals struggling with alcohol dependency achieve lives that are free from the physical and psychological damage that alcohol addiction can cause. AA is founded on 12 steps that are designed to address the mental, physical, and spiritual aspects of alcoholism. Many people view the steps as both spiritual and behavioral because they require spiritual surrender to a higher power and they require action, such as completing a personal inventory of one’s life and performing service work within and outside of AA. Many formal in-patient treatment centers require that their clients attend AA meetings when they leave and encourage the program, the idea of sponsorship, and regular meeting attendance to maintain abstinence.
One of the challenges for researchers seeking to gauge the success of the 12-step program of AA is the fact that completion of the steps is self-reported and does not result in anything tangible. For instance, completing an inventory of one’s life can be done exhaustively, leaving no stone unturned, or it can be done half-heartedly. But regardless, an inventory has been taken. Brenna L. Greenfield of the Department of Psychology at the University of New Mexico decided to compare two existing tools for self-reports to see what method provided the most accurate prediction of alcohol abstinence for individuals in AA. Greenfield used the Alcoholics Anonymous Inventory (AAI) and the General Alcoholics Anonymous Tools of Recovery (GAATOR) to rate step completion over a period of 9 months in a sample of 130 individuals new to AA.
Greenfield found that the participants experienced decreases in daily alcohol consumption and decreased daily drug use as a result of entering AA. However, they did not increase their adherence to the steps during the 9 months. In fact, at the 3-, 6-, and 9-month follow-ups, the rates of step-meeting attendance declined when compared to their attendance upon entering the program. This led to high rates of self-reported step completion but low rates of practical application of the principles taught in the steps, as measured by the AAI and GAATOR. Greenfield believes that this study underscores the importance of accurately assessing the implementation of the behavioral and spiritual principles of the 12 steps to better identify those at risk for alcohol or drug relapse. Greenfield added, “Our findings suggest that indirect measures of step work such as the GAATOR produce fewer false negatives than direct measures.”
Greenfield, B. L., Tonigan, J. S. (2012). The General Alcoholics Anonymous Tools of Recovery: The adoption of 12-step practices and beliefs. Psychology of Addictive Behaviors. Advance online publication. doi: 10.1037/a0029268
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