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Gauging the Effectiveness of One Component of Alcoholics AnonymousAllan Schwartz, LCSW, Ph.D. Gauging the Effectiveness of One Component of Alcoholics Anonymous
Maria Pagano, PhD, assistant professor of psychiatry at Case Western Reserve University School of Medicine, established an empirical model to quantify and gauge an alcohol abuser's level of engagement in Alcoholics Anonymous(AA), and in their related helping activities(AAH) at AA. The study, "Running Ahead: Service to Others in Sobriety(SOS)," was published in the spring 2010 issue of Alcoholism Treatment Quarterly.
This research is an extension of Dr.Pagano's 2004 study, "Helping others in Alcoholics Anonymous and drinking outcomes: Findings from Project MATCH," published in the Journal of Studies on Alcoholism (65, 766-773).The study involved 1,726 treatment seeking alcohol abusers in Project MATCH. In this study, Dr. Pagano demonstrated that AAH(Alcoholics Anonymous Related Helping) cut the risk of relapse in half in the year following discharge.
According to Dr. Pagano, "Service activities measured by the SOS are free, accessible, available to all patients regardless of education, gender, or racial background, and can be encouraged right from the start." Such activities can begin with preparing the coffee pot and making coffee for each meeting.
While I am aware that there are those who are opposed to AA, it is important to pause and consider the ramifications of the findings. The fact is that addiction is extremely complex and, as a result, not available to simple solutions. In no way do I believe that service activities are a panacea for addiction. What are the complexities of addiction?
There are multiple varieties of addictions, as there are reasons for becoming and remaining addicted.
Causes of addiction:
1. Personality disorders.
2. History of childhood sexual or physical abuse and neglect.
3. Severe mental illness.
4. Depression and low self esteem.
5. Extreme trauma and Post Traumatic Stress Disorder.
6. Genetic or inherited pre disposition to addiction.
7. Growing up in the midst of domestic violence.
8. Teenage ADHD and seeking solace and self medication through drugs.
This is not a complete list.
Just as there are complex reasons for addiction, there are equal complexities for why some people recover, while others remain addicted or quickly relapse. Of course, brain damage due to drugs will mitigate against recovery. This is also true of some cases of severe mental illness or diminished intellectual capacity.
The research cited above indicates that some people are helped to recovery and abstinence because of the kind of psychological support provided by the opportunity to give service to others. This does not mean that it will work for everyone. Whatever the combination factors such as personality, family support, genetics and environmental factors are, it is important to know and utilize the fact that at least some are being helped by this aspect of AA and other support programs. One does not have to buy in to all of AA in order to find help there and elsewhere.
It should be kept in mind that psychotherapy in conjunction with AA or other support groups also helps people towards recovery and maintenance. In criticizing AA, it's important not to "throw out the baby with the bath water."
Your comments are encouraged and appreciated.
Allan N. Schwartz, PhD
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