Alcoholics Anonymous (A.A.)
About This Program
Target Population: Adults who have identified themselves as alcoholics and are trying to maintain sobriety
Program Overview
A.A. is a voluntary, worldwide fellowship of men and women from all walks of life who meet together to attain and maintain sobriety. The only requirement for membership is a desire to stop drinking. There are no dues or fees for A.A. membership (Description obtained from: www.aa.org)
Program Goals
The program representative did not provide information about the program’s goals.
Logic Model
The program representative did not provide information about a Logic Model for Alcoholics Anonymous (A.A.).
Essential Components
The essential components of Alcoholics Anonymous (A.A.) include:
- At "open meetings," speakers tell how they drank, how they discovered A.A., and how its program has helped them. Members may bring relatives or friends, and usually anyone interested in A.A. is also welcome to attend "open meetings."
- "Closed meetings" are for alcoholics only. These are group discussions, and any members who want to may speak up, ask questions, and share their thoughts with fellow members. At "closed meetings," A.A. members can get help with personal problems in staying sober and in everyday living. Some other A.A. members can explain how they have already handled the same problems — often by using one or more of the Twelve Steps.
- There are Twelve Steps of A.A.:
- We admitted we were powerless over alcohol-that our lives had become unmanageable.
- Came to believe that a Power greater than ourselves could restore us to sanity.
- Made a decision to turn our will and our lives over to the care of God as we understood Him.
- Made a searching and fearless moral inventory of ourselves.
- Admitted to God, to ourselves and to another human being the exact nature of our wrongs.
- Were entirely ready to have God remove all these defects of character.
- Humbly asked Him to remove our shortcomings.
- Made a list of all persons we had harmed, and became willing to make amends to them all.
- Made direct amends to such people wherever possible, except when to do so would injure them or others.
- Continued to take personal inventory and when we were wrong promptly admitted it.
- 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.
- 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.
Program Delivery
Adult Services
Alcoholics Anonymous (A.A.) directly provides services to adults (regardless of whether they are parents or caregivers) and addresses the following:
- Substance abuse
Recommended Intensity:
Varies for each person
Recommended Duration:
No specific duration
Delivery Settings
This program is typically conducted in a(n):
- Hospital
- Community-based Agency / Organization / Provider
Homework
This program does not include a homework component.
Resources Needed to Run Program
The typical resources for implementing the program are:
- Confidential meeting room
Manuals and Training
Manual Information
There is a manual that describes how to deliver this program.
Training Information
There is not training available for this program.
Implementation Information
Pre-Implementation Materials
The program representative did not provide information about pre-implementation materials.
Formal Support for Implementation
The program representative did not provide information about formal support for implementation of Alcoholics Anonymous (A.A.).
Fidelity Measures
The program representative did not provide information about fidelity measures of Alcoholics Anonymous (A.A.).
Implementation Guides or Manuals
The program representative did not provide information about implementation guides or manuals for Alcoholics Anonymous (A.A.).
Research on How to Implement the Program
The program representative did not provide information about research conducted on how to implement Alcoholics Anonymous (A.A.).
Relevant Published, Peer-Reviewed Research
Child Welfare Outcome: Child/Family Well-Being
Two meta-analyses, see citations following, have also been conducted on Alcoholics Anonymous (A.A.) though these articles are not used for rating and therefore are not summarized:
- Tonigan, J. S., Toscova, R., & Miller, W. R. (1996). Meta-analysis of the Alcoholics Anonymous literature: Sample and study characteristics moderate findings. Journal of Studies on Alcohol, 57(1), 65–72. https://doi.org/10.15288/jsa.1996.57.65
- Kownacki, R. J., & Shadish, W. R. (1999). Does Alcoholics Anonymous work? The results from a meta-analysis of controlled experiments. Substance Use and Misuse, 34(13), 1897–1916. https://doi.org/10.3109/10826089909039431
Moos, R. H., & Moos, B. S. (2005). Sixteen-year changes and stable remission among treated and untreated individuals with alcohol use disorders. Drug and Alcohol Dependence, 80(3), 337–347. https://doi.org/10.1016/j.drugalcdep.2005.05.001
Type of Study:
Pretest–posttest study with a nonequivalent control group (Quasi-experimental)
Number of Participants:
461
Population:
- Age — No Help: Mean=32.6 years; A.A.: Mean=33.3 years; Professional Treatment: Mean=33.9 years
- Race/Ethnicity — No Help: 79% Caucasian; A.A.: 86% Caucasian; Professional Treatment: 79 % Caucasian
- Gender — No Help: 39% Female; A.A. Only: 55% Female; Professional Treatment: 53% Female
- Status — Participants were previously untreated individuals with alcohol-use disorder seeking treatment via and information and referral center or detox program.
Location/Institution: Not specified
Summary:
(To include basic study design, measures, results, and notable limitations)
The purpose of the study was to examine changes over a 16-year interval and predictors of stable remission among previously untreated individuals with alcohol-use disorders who did not obtain help or who entered either Alcoholics Anonymous (A.A.) or professional treatment in the first year after initially seeking help. Participants were divided into three groups: Those who did not enter treatment, those who attended A.A. only, and those who sought professional treatment and attended A.A. Measures utilized include the Situational Confidence Questionnaire, the Life Stressors and Social Resources Inventory, and the Coping Inventory. Results indicate that significantly more individuals in the A.A. and treatment group exhibited stable remission than in the untreated group (42.3% versus 24.2%). However, those who entered A.A. or treatment 1 year after initial referral or detox (delayed treatment group) did not show better remission rates than untreated individuals. Limitations include nonrandomization of participants, reliance on self-reported measures, and lack of data on the process and content of treatment.
Length of controlled postintervention follow-up: 16 years.
Moos, R. H., & Moos, B. S. (2006). Participation in treatment and Alcoholics Anonymous: A 16-year follow-up of initially untreated individuals. Journal of Clinical Psychology, 62(6), 735–750. https://doi.org/10.1002/jclp.20259
Type of Study:
Pretest–posttest study with a nonequivalent control group (Quasi-experimental)
Number of Participants:
461
Population:
- Age — No Help: Mean=32.6 years; A.A.: Mean=33.3 years; Professional Treatment: Mean=33.9 years
- Race/Ethnicity — No Help: 79% Caucasian; A.A.: 85% Caucasian; Professional Treatment: 79% Caucasian
- Gender — Not specified
- Status — Participants were previously untreated individuals with alcohol-use disorder seeking treatment via an information and referral center or detox program.
Location/Institution: Not specified
Summary:
(To include basic study design, measures, results, and notable limitations)
The study used the same sample as Moos & Moos (2008). The purpose of the study was to examine duration of participation in Alcoholics Anonymous (A.A.) or professional help in previously untreated individuals with alcohol-use disorders. Participants were divided into three groups: Those who did not enter treatment, those who attended A.A. only, and those who sought professional treatment. Measures utilized include the Situational Confidence Questionnaire, the Life Stressors and Social Resources Inventory, and the Coping Inventory. Results indicate that for both the treatment and A.A.-only groups, participating in 27 weeks or more of treatment or A.A. involvement resulted in significantly better outcomes at 16 years in relation to those who remained untreated. Statistical analysis also showed that for the treatment group, additional participation in A.A. resulted in improved outcomes, over and above treatment alone. Limitations include nonrandomization of participants, obtained information only on 6-month windows of alcohol-related outcomes at each follow-up, and lack of data on the content of treatment.
Length of controlled postintervention follow-up: 16 years.
Kaskutas, L. A., Bond, J., & Avalos, L. A. (2009). 7-year trajectories of Alcoholics Anonymous attendance and associations with treatment. Addictive Behaviors, 34(12), 1029–1035. https://doi.org/10.1016/j.addbeh.2009.06.015
Type of Study:
Pretest–posttest study with a nonequivalent control group (Quasi-experimental)
Number of Participants:
586
Population:
- Age — Mean=34 years
- Race/Ethnicity — 31% Black, 9% Other, and 6% Hispanic
- Gender — 33% Female
- Status — Participants were adults in treatment for alcohol dependency who were recruited from ten public and private programs.
Location/Institution: Northern California
Summary:
(To include basic study design, measures, results, and notable limitations)
The study examined follow-up data after participation in Alcoholics Anonymous (A.A.). The purpose of the study was to determine the relationship between A.A. treatment exposure and attendance. Participants were divided into 4 groups: a low A.A. group (averaging fewer than 5 meetings at most follow-ups), a medium A.A. group (about 50 meetings a year at each follow-up), a descending A.A. group (about 150 meetings year 1, then decreasing steeply), and a high A.A. group (about 200 meetings at 1 year, then decreasing gradually by year 7). Measures utilized include the Diagnostic Interview Schedule for Psychoactive Substance Dependence-DSM-IV, Addiction Severity Index (ASI), AA Affiliation Scale, and the Religious Beliefs and Behaviors Scale. Results indicate that for all four groups, A.A. attendance increased from baseline to the year 1 follow-up, with the increase steepest for the high A.A. and descending A.A. groups. From there, it decreased, except for the medium A.A. group whose attendance levels remained stable. Treatment did not strongly correlate with A.A. meeting trajectories, although the low A.A. group tended to have the lowest treatment rates over time. Limitations include lack of randomization, lack of control group, and missing data on the following: treatment, A.A. attendance, and alcohol consumption during years 2, 4, 6, and 7.
Length of controlled postintervention follow-up: 7 years.
Humphreys, K., Blodgett, J. C., & Wagner, T. H. (2014). Estimating the efficacy of Alcoholics Anonymous without self‐selection bias: An instrumental variables re‐analysis of randomized clinical trials. Alcoholism: Clinical and Experimental Research, 38(11), 2688–2694. https://doi.org/10.1111/acer.12557
Type of Study:
Randomized Controlled Trial - Secondary data analyses from 5 existing randomized controlled trials
Number of Participants:
2,356
Population:
- Age — 35–55 years
- Race/Ethnicity — 80% Non-Hispanic White, 13% Black, 6% Hispanic, and 2% Other
- Gender — Pooled Sample: 72% Male; MATCH Sample: 80% Male
- Status — Participants who participated in the Alcoholics Anonymous program.
Location/Institution: Not specified
Summary:
(To include basic study design, measures, results, and notable limitations)
The study utilized information from The National Institutes of Health RePORTER interface to employ an innovative statistical technique to derive a selection bias-free estimate of Alcoholics Anonymous (A.A.) impact. Six data sets from 5 randomized trials of A.A. facilitation interventions were analyzed using instrumental variables models (1 with 2 independent parallel arms). Results indicate that for most individuals seeking help for alcohol problems, increasing A.A. attendance leads to short- and long-term decreases in alcohol consumption that cannot be attributed to self-selection. However, for populations with high preexisting A.A. involvement, further increases in A.A. attendance may have little impact. Limitations include trials differed in sample size and inclusion/exclusion criteria
Length of controlled postintervention follow-up: Varied by study.
Additional References
Alcoholics Anonymous World Services, Inc. (1972). A brief guide to Alcoholics Anonymous. Retrieved from http://www.aa.org/pdf/products/p-42_abriefguidetoaa.pdf
Krentzman, A. (2007). The evidence base for the effectiveness of Alcoholics Anonymous: Implications for social work practice. Journal of Social Work Practice in Addictions, 7(4), 27-48. https://www.tandfonline.com/doi/abs/10.1300/J160v07n04_03
Contact Information
- Alcoholics Anonymous
- Agency/Affiliation: A. A. World Services, Inc.
- Website: www.aa.org
- Phone: (212) 870-3400
Date Research Evidence Last Reviewed by CEBC: August 2023
Date Program Content Last Reviewed by Program Staff: August 2006
Date Program Originally Loaded onto CEBC: August 2006
