Introduction
By the year 2007, there were about 2,000,000 members in Alcoholics Anonymous (AA). AA is highly accessible as well as affordable part of treatment for many Americans who suffer from alcohol disorders (National Council on Alcoholism and Drug Dependence, n.d.). Several research findings show that regularly attending and engaging in the AA’s programs improves the drinking results as well as more abstinence rates, giving strong indication in supporting addicts’ participation in the 12-step AA program (Kelly & Moos, 2003). AA facilitates change through several ways such as self-efficacy, social support and network variables, self-determination, positive psychology, working through transition issues, grief, and spirituality as well as meaning.
The challenges in substantiating AA data are because of focus on anonymity and autonomous structure and ethical considerations, therefore, hinders deep methodological examination. However, there is proliferation regarding 12-step-related findings recently(Kelly & Moos, 2003). This paper reviews the efficacy of Alcoholics Anonymous as well as the spiritual aspect.
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Efficacy of Alcoholics Anonymous
Alcoholics Anonymous as a treatment model is indicates positive abstinence results thus making it be superior or equal to other conventional alcoholism treatments. 12-step programs for instance, have indicated to be more effective compared to cognitive behavioural skills training for other drug abusers (Arthur, Tom & Glenn, 2008).
According to Arthur, Tom &Glenn (2008), the study of alcohol addicts realised that patients who actively engaged in self-help groups were better than those who infrequently engaged themselves in the same. Similarly, continual self-help engagement was linked with minimum substance as well as alcohol abuse. On the other hand, nonattendance was related to the highest abuse, even after controlling for duration participant’s severity and formal treatment of their drug use as well as alcohol problem. In addition, drinking outcomes are strongly linked to participation in AA.
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The duration and frequency AA participation is an important projector of drinking outcomes as well as duration of abstinence. Increasing AA involvement in the 12-36 months post treatment improves the odds of abstinence at three years by about thirty-five percent regardless of mental health issues, gender, and religious preferences. Further, it does not depend on whether the addict had previously engaged inother self-help groups or AA (Murray Goggin & Malcarne, 2006). In addition, regular attendance of AA results in positive drinking outcomes compared to those who never participated at all or irregularly attended. Further, those who attended AA either weekly or even more often indicated significant reduction in alcohol abuse as well as more abstinent days.
Moreover, patterns of AA participation play a crucial role in abstinence (Hudson, 2004). The study conducted among dependent drinkers indicated that rates of abstaining at year 5 were about forty-three percent particularly for those who engaged in AA in year one following treatment(Hudson, 2004). Seventy-three percent of alcohol dependants who attended close to sixty meetings each year at 3- as well as 5-year follow-ups. Finally, seventy-nine percent of alcohol dependants who attended AA 200 meetings or more each year at the 3- as well as 5-year follow-ups in abstinence.
Key Activities as Projectors of Abstinence
Several key activities, which predict abstinence within AA, have been recognised.Specific aspects in the twelve-step participation differently affect abstinence depending on the person’s particular substance dependence disorder (Kelly & Moos, 2003).The frequency of meeting attendance as well as the number of activities undertaken predicted abstinence independent of substance dependence disorder. On the contrary, particular activities are linked to abstinence differentially through dependence disorder. In particular, two activities of AA differentiate abstinence for the alcohol dependants, doing service as well as having a sponsor(Kelly & Moos, 2003). Other activities, however, differentiate abstinence particularly for the drug dependents or those who abuse alcohol as well as drugs.
Servicework, which is defined as the execution of a task and which supports the AA group remains to be the strongest predictor as far as abstinence in all groups twelve months after treatment is concerned(Kelly & Moos, 2003). In addition, AA attendance, the number of problem or heavy drinkers in a person’s social network, the number of people in the social network emphasizing reduction of alcohol consumption as well as AA-related support emphasizing reduction of alcohol consumption are also other activities, which play key roles as abstinence predictors.
Mechanisms of change
Besides evaluating as well as quantifying theAA’s efficacy, researchers have examined AA’s effectiveness by looking at proposed change mechanisms through several paradigms. Some of these paradigms include social support as well as social network variables, spirituality and religion, self-efficacy, positive psychology, SDT and working through grief, loss and transition issues (Hudson, 2004).
Regarding the link between social network variable and AA for instance, engagement in AA is linked to a number of positive qualitative as well as quantitative transitions as far as social support networks is concerned, with less effect on family as well other networks and greatest effect friends(Hudson, 2004). Hudson (2004) further indicates that other AA members support is of great importance in recovery as those with prior and existing dangerous social network receive remarkable benefits.
Spiritual aspect and the meaning of Alcoholics Anonymous
Research has not concluded on issues relating to the role played by spirituality as well as religion as change mechanism in AA. However, a number of studies have indicated that attendance of AA generates important changes in God’s beliefs as well as spirituality (Piderman, 2004). Conflicting evidence exist in support of religion and spirituality as predictors of abstinence. Several research findings note AA attendance as a key factor in abstinence as well as reduced drinking regardless of an individual’s spiritual or religious affiliation. Tonigan’s (2007)close look at AA as well as spirituality and religion seems to mirror the outcomes of a number of studies. This includes the fact that he identified that there exists little evidence supporting spirituality and religion as one of the key factors in future abstinence. However, Tonigan (2007) argues that spirituality might have indirect impact since original improvement I spirituality and religion seems to enhance sustained as well as continual attendance and participation of AA, hence, resulting in sustained recovery with time.
According to Robinson et al. (2007), increase in spiritual and religious beliefs takes place among outpatients having alcohol use disorders despite controlling for AA engagement as well as gender. Robinson (2007) further points that using ten measures of religiousness as well as spirituality, beliefs, experiences, behaviours and beliefs involving a study of 123 outpatients having disorders of alcohol use were examined for changes regarding religiousness or spirituality from treatment entry to the sixth-month and whether the notable changes were related to drinking outcomes. Outcomes indicated statistically realisable increases of up to half the religious as well as the spirituality measures over a period of six months in addition to the notable decreases in the use of alcohol.
Harber (2006) points out that the application of qualitative as well as quantitative methodologies to determine the relationship, which is exiting between self-image, God’s image as well as the duration of abstinence particularly among active members of the AA is of no significant statistical relationship between beliefs in God/higher power as well as duration of abstinence. According to Harber (2006), the mean days’ sober number was approximately 68 percent longer for those days’ active members of AA who hadquit at one point AA because of religious reasons than those other people who quit for other reasons.
Harber (2006) further point out that those that had no religious affiliation were sober for a longer period, about 8.3 years, than those who were affiliated to some religion (protestant 7.32 years, Catholic had 5.6 years and other religions had 5.02 years).
Similarly, in the study by Tonigan, Miller and Schermer (2002)showed that attendance of AA was in strong correlation with higher abstinence as well as reduction of alcohol consumption regardless of belief in God. However, agnostic as well as atheist clients attended AA less often than those who were affiliated to spirituality did and religion and religion did, no notable differences were seen in the number of days abstinent as well as drinking intensity were realised between the spiritual and religious versus atheist and agnostic clients.
In the Murray’s et al. (2006) study evaluation of members’perception of the role of God/high power in alcoholism recovery by Alcohol-Related God Locus of Control (AGLOC) scale, a Twelve-item self-support measure. It was done to 144 recovering alcohol addicts attending the meetings of AA and indicated that attribution of control of God were in correlation with cessation of drinking, but not to maintaining abstinence. On the contrary, Piderman (2004) found a correlation between several spiritual well-being as well as abstinence self-efficacy among 49 alcohol addicts. Furthermore, Poage et al. (2004) points out that the length of sobriety is in strong relationship with spirituality regarding his case study examining the duration of sobriety, stress, and contentment as well as spirituality in AA sample participants.
Hudson’s (2004) study on spirituality and religion versus alcohol recover on the other hand yielded positive response. In his case study, Hudson examined the correlation among combined variables of spiritual awareness and alcohol-problem adversity, involvement and participation in AA as well as patterns of AA membership. Though the Drinker Inventory of Consequences as well as the General Alcoholics Anonymous Tools of Recovery (GAATOR) 2.1, he analysed data from about 172 participants finding that the number that reported higher attendance of AA was in strong relationship to relatively fewer negative drinking-related consequences. In addition, the higher GAATOR number had a strong correspondence to fewer consequences.
Conclusion
In brief, Alcoholics Anonymous has played a key role in alcoholics’ recovery as is evident by various researchers. This has been through various mechanisms, which are perceived to be effective. In addition, spirituality as well as religion is also perceived to be components of such mechanisms although some researchers tend to contradict there is no such relationship.
However, it is evident that most researchers have indicated significant increments particularly spiritual beliefs as being part of and alcoholics’ recovery.Researchers, however, tend not to link the increases to attendance of AA as well as affiliation. Finally, more research concerning the causality of the correlation that may exist between the AA and spirituality/religious beliefs should be done to avoid contradicting views by the present researchers so that they have a common stand regarding religion and Alcoholics Anonymous.
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