Effectiveness of 12-Step Programs

Research

Research of this topic will be pursued by using scientific journals that contain articles about alcoholism and reliable university research studies.

The main branches of science that will be used are psychology and psychiatry with a focus on addiction studies.

A wide range of options are available for the treatment of alcohol abuse or alcoholism. Included in treatment options are in-patient and out-patient plans, 12- step programs, and individual therapy. These options may be used individually or in combination with one another. In terms of continued sobriety, there is scientific evidence that concludes the combining alcohol abuse treatment with participation in Alcoholics Anonymous has the best outcome. Specifically, in-patient or out-patient treatment for alcoholism along with Alcoholics Anonymous attendance is the most successful plan for continued abstinence from alcohol. Research studies that focus on this issue specifically or as a component of a study strongly support this stance.

The study conducted by Campbell, Davis, Lieber and Tax (2002) examines the success of standard treatment for alcohol abuse, group and individual therapy with an emphasis on AA, compared to a minimal treatment approach consisting of alcohol education movies and the ensuing affects of abstinence from alcohol over a six-month period. At intake both screener and patient remained blind to the study until eligibility was determined. Once eligibility was established the study became open. Eligibility requirements consisted of patients who had alcohol dependence or abuse that had consumed alcohol recently. Patients in both treatment groups totaled 105 men ages 29-65 with comparable socio-economic backgrounds. A main conclusion of the study found that those in standard treatment attending AA had higher alcohol abstinence rates then those in minimal treatment.

Similarly, this study also showed evidence that AA involvement has a positive affect on continued sobriety. An open twenty-four month longitudinal study discusses the positive influence of 12-step programs, primarily AA, on sobriety. In this study a total of 262 sample patients completed three interviews after attending treatment for alcoholism. The demographics were comprised of 42% African-American, 29% Latino, 29% European American, with the rest consisting of Asian or Native Americans. Approximate ages of the participants were from 18 to 54 years with majority under age 35. Nearly half the population was compromised of women. Fiorentine (1999) found that attending one AA meeting or more weekly suggests a greater rate of abstinence than those who attend meetings less than once a week.

Bond, Kaskutas, and Weiner (2003) also argue the affect of AA involvement related to alcohol abstinence proceeding in-patient treatment. The open study occurs at different treatment center locations throughout California that include a total of 10 public and private rehabilitation centers. A demographical cross section of patients was used. The baseline sample of 367 men and 288 women accepting treatment were interviewed at intake, 1 and 3 years later to collect data about consumption, dependence symptoms, social support and AA participation. Bond et al. (2003) assert that AA attendance between the 12 -36 month time period bettered the odds of abstinence upwards of 35% above those at 12 months. Moreover, involvement in AA after a treatment episode demonstrates the significant importance of membership. AA membership is key to the alcoholic for ongoing abstinence post-treatment.

Another study on alcohol addiction, treatment, and AA involvement focuses on 337 male clients who participated in outpatient treatment and aftercare. The ethnicity of the men consisted primarily of White, Hispanic and Black. Project match consisted of two parallel multi-site independent matching studies. The first study focuses on male clients recruited from outpatient settings, while the parallel study focuses on male patients receiving aftercare treatment following in-patient care. There was random assignment to three types of therapies that included; twelve-step facilitation, cognitive-behavioral coping skills, and motivational enhancement therapy.

Patients were followed for one year reporting abstinence at 3-month intervals following the 12-week treatment period. Connors, Tonigan, and Miller (2001) measured three constructs: intake symptomatology, AA participation, and outcome. Self-reporting was used to assess abstinence and, as a result, careful attention was given to reliability, evaluation and validity. Self-reports were correlated with gamma glutamyl transpeptidase levels in the blood. High levels of this liver enzyme can be indicative of heavy alcohol consumption.

In addition, the Alcoholics Anonymous Inventory (AAI) was administered in the beginning of treatment and again at 6 and 12 months post-treatment. The AAI has strong reliability and test re-test correlations. Connors et al. (2001) could determine from the test whether the client considered himself a member of AA, had gone to meetings, celebrated a monthly or one year sobriety date, had an AA sponsor or had been an AA sponsor. The conclusion shows that regardless of in-patient or out-patient treatment, AA participation was positively and significantly related to higher percentage rates of abstinence compared to those men who did not use AA as an ongoing treatment tool.

Further evidence of the increased abstinence success rate of treatment and AA are detailed in a clinical alcohol study. The study follows 466 problem drinkers, 51% who are male with comparable baseline socio-demographic characteristics, for 8 years after initial contact with a treatment center. Finney, Lesar, Moos and Timko (2000) examine the way in which type and timing of treatment over a period of 8 years correlates with abstinence. Participants in the study were self-selected into four groups: no treatment, AA only, formal treatment, and formal treatment including AA. Participants completed questionnaires at the studies inception followed by continued inventory throughout.

Finney et al. (2000) reported that inventory results indicate participants who attended AA only, but had no alcohol abuse treatment were more likely to be abstinent at the 1, 3 and 8 year time frames. Also, those individuals that had formal treatment plus AA compared to those that had no treatment were also more likely to be abstinent at the given time frames. Furthermore, participants who had formal treatment followed by AA involvement showed higher abstinent rates through 1-3 years then those just attending treatment. The conclusion, in regards to abstinence rates, once again shows that participants who attended some form of treatment and AA meetings fared much better then those who had no treatment or treatment without AA involvement.

Similar conclusions were drawn from an investigative 6-month longitudinal research study that focuses on the connection between attending AA meetings, before, during and after inpatient treatment and continued abstinence. One-hundred-fifty cross demographical subjects were interviewed at intake and 120 of the subjects were interviewed again 6 months after the completion of treatment. Best et al., (2003) finds that attending AA once weekly or more correlates with better abstinent outcomes compared to those patients who attend minimally or not at all. These findings maintain the role of AA as a beneficial resource for abstinence following a treatment episode. In addition, this study contributes more evidence to the stance that higher abstinence rates occur with a combination of treatment and AA.