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Running head: ALCOHOLICS ANONYMOUS

1

An Empirical Research Study on Alcoholics Anonymous Statistical Effectiveness

<name redacted>

Wayland Baptist University

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List of Nomenclature

 Abstinence: The practice of restraining from alcohol.

 Alcoholics Anonymous (AA): A fellowship of men and women who share their experience,

strength, and hope with each other that they may solve their common problem and help others to

recover from alcoholism.

 Assessment: A total evaluation of the program through each of the participants’ responses.

 Experimental group: The group that receives the treatment during the study.

 Percent Days Abstinent (PDA): Self-reported drinking data for the recorded time frames.

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Chapter 1

Introduction

After 85 years of Alcoholics Anonymous (AA), results have been recorded to prove and

confirm its effectiveness. Testimony after testimony has revealed satisfactory results from

current and former members. Nonetheless, on the contrary, experts have challenged the 12-step

hegemony. It is proclaimed that if the program does not work, it is the participant's lack of

interest in committing fully to the program. Although this could be the reason for the lack of

effectiveness in the participants, what if the program itself is insufficient to transform people’s

lives?

This research study seeks to understand and determine the overall effectiveness of one of

the most common and successful addiction recovery organizations in the nation. The primary

focus of the study will be to test the traditional 12-step program since is the core of their

treatment process. The study will also target their main philosophy which is to help the alcohol-

struggling individual to stop drinking, maintain sobriety, and find holistic healing of the mind,

body, and spirit. However, taking recovery ownership is a very difficult journey that not all those

who participate in the program get to enjoy. Thus, the focus of the study is to determine the

success rate of middle-age adults who will participate in the program for a year. Their Percent

Days Abstinent (PDA) will be measure at certain time frames and will be recorded for data

analysis.

Method

An experimental group of alcohol-dependent adults will be assessed during a time frame

of 18 months to measure the effectiveness of AA. Participants will attend closed meetings twice

a week for 12 months and commit to a trial period of 6 months for a final evaluation of their total

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results. Participants will be asked to meet with a counselor at their cite after concluding sessions

in order to record data.

Participants

The participants in this study are individuals who self-identified as alcohol-dependent

adults. The group consists of 30 men and 30 women between the ages of 20-30 years of age. The

participant will not be forced to finish the program; thus, they can drop out at any time they see

appropriate. The study does not discriminate against gender, race, or religion. However, personal

data will be recorded for a deeper understanding of the final results.

Materials

AA Twelve Steps (Alcoholics Anonymous, 1981)

1. We admitted we were powerless over alcohol — that our lives had become unmanageable.

2. Came to believe that a Power greater than ourselves could restore us to sanity.

3. Made a decision to turn our will and our lives over to the care of God as we understood Him.

4. Made a searching and fearless moral inventory of ourselves.

5. Admitted to God, to us and to another human being the exact nature of our wrongs.

6. Were entirely ready to have God remove all these defects of character.

7. Humbly asked Him to remove our shortcomings.

8. Make a list of all persons we had harmed and became willing to make amends to them all.

9. Made direct amends to such people wherever possible, except when to do so would injure

them or others.

10. Continued to take personal inventory and when we were wrong promptly admitted it.

11. Sought through prayer and meditation to improve our conscious contact with God, as we

understood Him, praying only for knowledge of His will for us and the power to carry that out.

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12. Having had a spiritual awakening as the result of these steps, we tried to carry this message

to alcoholics and to practice these principles in all our affairs.

Procedure

Participants are required to attend AA closed meetings twice a week for 12 months. They

will be required to participate, engage, and commit to the AA Twelve Steps. There will be a pre-

treatment assessment, during-treatment assessment at 6 months, and final treatment assessment

at 12 months, and a follow-up assessment at 18 months. Data will be recorded for each member

individually to measure the effectiveness of the program. At each of the time-periods,

participants will record the PDA. In other words, participants will record the average percent of

days that they were abstinent during each time frame.

Purpose of the Study

The purpose of the study is to collect data based on participants’ self-reports to evaluate

the effectiveness of AA. It is very difficult and close to impossible to create a rehab program that

works effectively for everyone. Each alcoholic is different, thus, each one needs and deserves the

attention and treatment necessary to overcome not only their drinking problem but to solve the

deep-rooted problem that brought them to their lowest point. Therefore, this study is relevant to

understand how beneficial this program for middle-age adults who are trying to cope with the

ups and downs of life.

Research Questions

This study follows the research question: Does the number of PDA start to increase or

decrease as time progresses?

The study will examine the following hypotheses:

1. Are the participants to remain abstinent even when they are no longer in the program,

that is, the time between the 12 months and 18 months frame?

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2. Is the effectiveness of Alcoholics Anonymous restrained for a certain amount of

time?

Limitations of the Study

The study will record data based on participants' self-reports to their appointed

counselors. Thus, there might be a lack of veracity and legitimacy from the participants'

responses. Additionally, since the is only conducted for 12 months, this might affect how

participants would have reacted if the study was conducted for a longer or shorter time.

Additionally, since the study will be using a nonexperimental research design, there

might be a limitation as to demonstrating cause and effect. In other words, certain components of

the study will not be evaluated and that might be key components of the overall effectiveness of

the study. Such as that participants might feel pressure to complete the program and lower their

PDA just because they know that they are being documented for the experiment.

Significance

Since the beginnings of AA in 1935, there has been great controversy regarding its

effectiveness and success. AA and other 12-step programs claim to be saving lives and families,

but there is not much data available corroborate the evidence. This study will help to provide

additional data regarding how effective this program is for 12 months in a group of middle-age

adults.

CHAPTER II

LITERATURE REVIEW

What is the effectiveness of AA? In order to answer this question, one must first ask if

alcoholism is a moral failing, psychological problem, or a medical disorder. AA has been widely

recognized as being a representative example of abstinence-based treatment with a spiritual

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affiliation. Nonetheless, there has been a great debate on the effectiveness of AA because

research and studies done on this organization approached it from different points of view. If

alcoholism comes from a moral failing, then it should be treated by the church; if it comes from a

psychological problem, then it should be treated by psychiatry; and lastly, if it comes from a

medical disorder, then it should be treated by medical care.

AA has been greatly criticized for treating alcoholism from a spiritual approach. As eleven

out of the twelve steps talk about redemption and restoration, eight steps refer to God or a Power

greater than humanity who is capable of transforming and changing any human failure, and just

one refers to alcohol alone. There is no denying that spirituality is embedded in the 12 steps,

thus, the procedure has been used in countless spiritual groups and local churches. However, AA

has claimed that they are not “allied with any sect, denomination, politics, organization or

institution,” (“Frequently Asked Questions About AA,” 2009) and greatly emphasized that

anyone can join regardless of their spiritual stand.

Regardless of the great skepticism that religion can improve a person’s alcohol addiction,

research demonstrates a positive correlation between these two concepts. According to Unity

Behavioral Health, “Spirituality or religion can help a person find purpose in his or her life, fill a

void, cope with mental distress and adhere more to morality (2007).” In other words, spirituality

influences positively a person's abstinent process and increases the chance of succeeding in the

quest for sobriety (Landau, 2010).

Contrary to the spiritual approach, some argue that AA has a deep problem by confusing

correlation with causation, meaning that drunkenness is associated or caused by immorality.

Hence, since most of the 12-steps refer to spiritual connection, it is understood that those who do

not believe in the existence of a higher power could find the program to be conflicting,

problematic, and challenging. There is a clear absence of scientific evidence in the twelve steps

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and their approach. For those holding this position, they state that meetings and prayers are not

enough to combat a medical disorder. There is a great need to “overhaul our treatment system

and provide more evidence-based options” (Szalavitz, 2017).

Regardless of all the mentioned opinions and positions, good or bad, AA is an abbreviation

that most Americans recognize because this organization has been around since 1935. According

to data, in 2000, “90 percent of American addiction treatment programs employed the 12-step

approach” (Szalavitz, 2017). Additionally, the following are results done by a 2007 Alcoholics

Anonymous Random Survey done in 8,000 anonymous members (“Efficiency of Alcoholics

Anonymous,” 2014):

 33% had been sober for 10 years or more

 12% had been sober for between five years and 10 years

 24% had been sober for between one year and five years

 31% had less than a year of sobriety under their belts

It is important to clarify once again that “although the 12-steps include references to God,

AA is not a religious organization. Members may interpret the idea of a higher power in any way

they like” (“How Alcoholics Anonymous works,” 2007, p. 4). Likewise, there is a misconception

about AA rejecting medicine or psychotherapy, which is quite the opposite. Members are

“encouraged to seek psychological help and/or take psychiatric drugs if needed” (“How

Alcoholics Anonymous works,” 2007, p. 5).

Others simply doubt its efficacy to treat a world-wide problem that has existed throughout

history. They argue that there is no compelling evidence that AA is effective in reducing alcohol

abuse. The results mentioned above are put into question for several reasons (“Efficiency of

Alcoholics Anonymous,” 2014):

 Respondents were not asked how long they had been taking part in AA

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 Respondents were not asked if they relapsed or slipped during their period of

sobriety.

 There is no indication of how many people started to use AA and left to find sobriety

through other means.

 There is no indication of how many people left AA and relapsed.

In addition to the bullet points provided by the American Addiction Centers Editorial

Staff, positive results are disputed because it is impossible to determine the effectiveness of a

program when there are no studies that include the people who tried it and did not find it helpful.

Thus, this lack of evidence undoubtedly puts into question AA success rates.

Summary

AA started as a small Christian organization and it has grown into a well-known social

organization consisting of autonomous local groups. Its popularity consists of a free of charge

membership with the only requirement for those wanting to join is a true desire to stop drinking.

(Swora, 2004, p. 187-188). As simple as it seems, it is not. There has been a great debate for its

efficacy and ability to help those wanting to change their alcohol dependency and transform their

lives for the better. Those doubting its efficacy believe that there is a very low possibility that

members will succeed in reaching sobriety. Unless there are added interventions such as medical

and psychological, their efficacy will continue to stay low. On the contrary, those in support state

that 85+ years of practice are more than enough to prove its effectiveness.

Ending with the question stated in the beginning, what is the effectiveness of AA? It

depends on person to person. For some people, it works wonders, and for others, it simply does

not work. The only sure thing in all of this is that there is help available for those in need,

whether it be AA or other organizations. The first step is recognizing that there is a problem and

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the second step is to look for a support group that would help those to achieve and maintain

sobriety.

CHAPTER III

METHODOLOGY

As mentioned in Chapter 1, this study is designed to answer the following questions: (1)

Does the number of PDA start to increase as time progresses? (2) Are the participants to remain

abstinent even when they are no longer in the program, that is, the time frame between the 12

months and 18 months? (3) Is the effectiveness of Alcoholics Anonymous restrained for a certain

amount of time? The methodology used in this study is described in the following sections:

research design, instrumentation, procedure, participants, and data analysis.

Research Design

The study research design is a relational meaning that these questions will describe the

relationship between AA and PDA. Furthermore, the study is a quantitative design in the type of

nonexperimental research study. The study is designed to determine the overall effectiveness of

AA in a cohort of individuals in 12 months of attendance.

Instrumentation

The primary resource that will be used is an AA meeting group as well as the traditional

12-step program. Participants will be placed in three different local AA meeting groups based on

proximity to their home locations. Participants will also be responsible to maintain a journal in

which they will provide their PDA for that specific time frame.

Procedure

The research study will be conducted for approximately 18 months. First, participants

who self-identify as having drinking problems will be chosen and divided into three different

groups. Each group will be required to attend AA closed meetings twice a week for 12 months.

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Second, there will be a pre-treatment assessment, during-treatment assessment at 6 months, and

final treatment assessment at 12 months, and a follow-up assessment at 18 months. Participants

will meet with a counselor at their site at the mentioned time frames and hand over their reports.

Counselors will not conduct any type of intervention in order to not interfere with the therapy

given at AA meetings. Their only responsibility will be to collect data related to the research.

The third and final step will be for participants to continue with the follow-up even when the AA

meetings have stopped. They will have a scheduled meeting with their appointed counselor 6

months after their last AA meeting.

Participants

Participants for this research study will be randomly selected with the only criteria being

that they must be alcoholics wanting to become sober. The participants must self-identified as

alcohol-dependent adults with an unbiased attitude towards the AA program. The participant

pool will consist of 30 men and 30 women between the ages of 20-30 years of age from various

cultural backgrounds. Maintain the anonymity of the participants will be a priority, thus,

participants will never be asked to reveal their names and identities in their reports. Reports will

only be asked for race, age, and gender to have more concrete data all while maintaining the

participants' privacy.

Data Analysis

The final results will be analyzed and displayed in a frequency distribution table with the

listed columns being PDA Frequencies and Time. The PDA scores of the participants will be

averaged up for each time frame: the pre-treatment assessment, during-treatment assessment at 6

months, final treatment assessment at 12 months, and a follow-up assessment at 18 months.

Additionally, the same data will be presented as a histogram bar for a clearer illustration of the

data.

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Table 1

PDA Frequencies Time

X Day 1

X 6 Months

X 12 Months

X 18 Months

Note: Since the Table starts from day 1, participants will be asked if they are sober on the first

day of treatment. If yes, it will be counted as 1 for each participant; if answered no, it will be

counted as 0 for each participant.

Figure 1 - Histogram

Note: Histogram graph does not contain actual data.

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References

Alcoholics Anonymous World Services, Inc. (1981). Twelve steps and twelve traditions. New

York.

Alcoholics Anonymous World Services, Inc. (2009). Frequently Asked Questions About A.A.

New York.

American Addiction Centers Editorial Staff. (2014, March 20). Efficiency of Alcoholics

Anonymous. Retrieved April 7, 2020, from https://luxury.rehabs.com/alcohol-

treatment/efficiency-of-aa/

How Alcoholics Anonymous works. (2007). Harvard Mental Health Letter, 24(1), 4–6.

Swora, M. G. (2004). The rhetoric of transformation in the healing of alcoholism: The

twelve steps of alcoholics anonymous. Mental Health, Religion & Culture, 7(3), 187–

209. https://doi-org.waylandbu.idm.oclc.org/10.1080/13674670310001602445

Szalavitz, M. (2014, February 10). After 75 Years of AA, It's Time to Admit We Have a

Problem. Retrieved April 7, 2020, from https://psmag.com/social-justice/75-years-

alcoholics-anonymous-time-admit-problem-74268

UMHealthSystem. (2007, March 19). Spirituality increases as alcoholics recover. Retrieved

April 9, 2020, from https://www.eurekalert.org/pub_releases/2007-03/uomh-

sia031907.php