Welcome to CyberPsych.
|
Welcome to CyberPsych. |
|
See other areas of interest Eating Disorders Information | Find-A-Therapist | PenPals for Anxiety Disorders | Support Groups | Teen OCD | Apology Project | CyberPsych Home |
|
There is no professional intervention, and it is not intended to be psychological treatment or education. For HotLine help, especially for suicidal feelings, try 1.800.SUICIDE (784.2433). Also dialing 211 can refer you to help in many areas of the US. HotLine for Eating Disorders is 1.800.931.2237
|
| |
Discussion of Alcoholism
Re: Recovery rate: Twelve-Step programs
Posted By: Steve Hibbard In Response To: Re: Recovery rate: Twelve-Step programs (Marty Jones)
Date: Monday, 6 June 2005, at 4:33 a.m.
I am somewhat new to the list, but this thread was of interest to me. I am a professional clinical psychologist, and I also am a tenured prof in a clinical psych training program (UWindsor ON, Canada). I have also attended thousands of AA meetings. This thread strikes me as very wrong headed.
The 12 traditions of AA make it essentially a bottom up group, there being no cnetralized authority and no centralized administration. The local group is essentially autonomous. This makes for a kind of benevolent anarchy. In its entire history, AA World Publishing has had one and only one money making product of any significance, the "Big Book of Alcoholics Anonymous". AA has been lucky if its other publications have been "break even" status. A mark of how anarchically AA is run can be seen from the fact that sometime in the 1980s, AA World Publishing neglected to renew the copyright on "the Big Book", and so other groups (mostly incorporated recovery places) began publishing the book and selling it! AA has aboslutely no interest in making money.
AA does not hold itself out as a treatment for alcoholism. I don't mean by this simply that it is not non-profit organization, but that since its inception, it has always represented itself, not as a recovery product, but as a way of life, more like Buddhism or Judaism, only without any theology. It does say that many people following this way of life have also conquered (or better, relinquished) their alcohol compulsion, but it has never offered itself as a treatment program. If you were to compare the characteristics of a treatment program with AA, this would become very clear. There is no admnistration, no therapists, no one who applies the treatment, no intake, no insurance for those who treat. There is no set time for receiving the treatment, no place at which the treatment takes place, no licensing. AA does not operate any recovery house, any treatment center, and hospitalization program, etc. According to AA traditions, no group should own its own meeting place. Meeting spots are either donated by churches, etc., or they are rented by the AA group.
I went to Penn and Teller's website, as Marty suggested. Penn and Teller misrepresented the triennial survey done by AA of its members as if it were some kind of efficacy study. This is predictable because Penn and Teller don't have and don't use standard research skills employed by social scientists. The AA survey is not and does not pretend to be a scientific study. There are no confidence intervals, no upper and lower bounds. Nor could there be. There are thousands of AA groups at any one time that are not even registered with the national office in New York.
The question originally posed in this thread is misframed, it is sort of a "category mistake". AA does not have a success rate because AA is not a form of treatment for alcoholism, per se. It is not possible to judge its "success rate" because there is no such thing as a "beginning of treatment". There is no such thing as a "course of treatment". There is no such thing as an "end of treatment". What if someone came to AA for 5 meetiings and never drank again. Is that an "effect of treatment" or is it "spontaneous recovery"? I personally have met such people. How often that happens, no one knows, and no one can possibly know because the scientifically respectable ways of determining answers to these sorts of questions about the efficacy of AA are impossible to determine, precisely because it is an anonymous organization. No one officially collects names, addresses, or phone numbers, there is no membership directory at even the most local level. It is simply impossible to determine the "success rate". One would first have to define "success rate" in a way comparable to the way in which most treatment studies define it, and this is not possible. People come and go for various periods of time in AA, although those who attend regularly for a long time (years) are primarily people who are predominantly non-drinking, "recovered" alcoholics. There is no follow up on people who discontinue coming after a few months or weeks, and so there is no way of knowing what happens to them, whether they quit for a time or don't, whether they come back some time later, and so forth. The most important point here is that AA (the people of AA and the intentions and principles of AA as written in the major documents) have no interest in this question. Their sole interest is to be of service to people who have an interest in getting rid of their alcohol problem by showing those people the way in which the recovered people were able to succeed. It's really that simple.
This means that, even if Penn and Teller were correct--who knows?--and even if it were possible to determine the "success rate" of AA by, say, tracking every individual who has a first contact with AA and checking their status at 90 days, even if that number were 5%, AA could care less. AA does not sell itself and it makes no effort to do so. Anyone familiar with the 12 traditions of AA knows that AA has absolutely no interest in recruiting people. Contrary to what Penn and Teller imply, no one in AA makes money other than a handful of salaried employees. The vast majority of these salaried employees are people who keep the "district" offices open. Their jobs are clerical, they have no authority over anything. The same thing is true for the New York office. There is no "president" or "ceo". Every decision is made by delegates. It is entirely a bottom up organization. The delegates are all volunteers. AA has no objective or purpose to be gained by whatever its "recovery rate" might be. It's objective or purpose is to be of service to people who have an alcohol problem. Attendance at AA meetings is free, in the same sense that attendance at most churches in the US is free: members who feel they have benefitted spiritually come to realize that they have an obligation to donate. One of the traditions, by the way, is that if a local group has too much money sitting in the bank, it is advised to dispose of it in some such way as having a potluck or a dance or upping the quality of the medalions it gives away or buying literature to give away.
This is pretty long winded as an initial posting to this site, but I was so taken with the thread that I thought I needed to say something about it.
Steve
| |
Discussion of Alcoholism is maintained by Administrator with WebBBS 5.12. hosted by CyberPsych.org