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*AA has been described as having substantial religious components,<ref>[http://www.ca9.uscourts.gov/ca9/newopinions.nsf/6FA63303852632AC8825734F0059D078/$file/0615474.pdf?openelement Inouye vs. Kemna page 11889]</ref><ref> United States 2nd Circuit Court of Appeals "DESTEFANO v EMERGENCY HOUSING G" August Term, 1999 Argued: March 16, 2000 Decided: April 20, 2001 Errata Filed: May 7, 2001) Dockett No.00-99146</ref> which some alcoholics find unacceptable and one reason for the provision of secular programs by other recovery groups.<ref>http://www.smartrecovery.org/resources/faq.htm#Q.%20How%20is%20SMART%20Recovery%AE%20different%20from%20traditional%20Twelve%20Step%20programs</ref>
*AA has been described as having substantial religious components,<ref>[http://www.ca9.uscourts.gov/ca9/newopinions.nsf/6FA63303852632AC8825734F0059D078/$file/0615474.pdf?openelement Inouye vs. Kemna page 11889]</ref><ref> United States 2nd Circuit Court of Appeals "DESTEFANO v EMERGENCY HOUSING G" August Term, 1999 Argued: March 16, 2000 Decided: April 20, 2001 Errata Filed: May 7, 2001) Dockett No.00-99146</ref> which some alcoholics find unacceptable and one reason for the provision of secular programs by other recovery groups.<ref>http://www.smartrecovery.org/resources/faq.htm#Q.%20How%20is%20SMART%20Recovery%AE%20different%20from%20traditional%20Twelve%20Step%20programs</ref>


*[[Eric Berne]] who developed the theory of [[Transactional analysis]] in his book [[Games People Play (book)]] describes [[Eric Berne|The Transactional Analysis of Drinking]]. The role of organizations such as Alcoholics Anonymous, the people in it assume the role of the rescuer and without new members to involve themselves with, there was no way to continue the game , resulting in an entire chapter of AA losing all of its members. .<ref> Berne, Eric (1964). Games People Play p. 73-76, The Basic Hand Book of Transactional Analysis. New York: Ballantine Books. ISBN 0-345-41003-3.</ref>
*[[Eric Berne]] who developed the theory of [[Transactional analysis]] in his book [[Games People Play (book)]] describes [[Eric Berne|The Transactional Analysis of Drinking]]. The role of organizations such as Alcoholics Anonymous, the people in it assume the role of the rescuer and without new members to involve themselves with, there was no way to continue the game , resulting in an entire chapter of AA losing all of its members. In game theory the psychological cure is for the Alcoholic to stop playing the game, by relinquishing the roles of the rescuer needing others to save, or victim and needing to rescued, or persecutor. In Transactional Anaysis, it holds that the former alcoholic, one who has become game free, should be able to socially drink.<ref> Berne, Eric (1964). Games People Play p. 73-76, The Basic Hand Book of Transactional Analysis. New York: Ballantine Books. ISBN 0-345-41003-3.</ref>

The psychological cure of an alcoholic also lies in getting him to stop playing the game altogether, rather than simply change from one role to another. In some cases this is feasible, although it is a difficult task to find something else as interesting to the Alcoholic as continuing his game. Since he is classicly afraid of intimacy, the substitute may have to be another game rather than a game-free relationship. Often so-called cured alcoholics are not very stimulating company socially, and possibly they feel a lack of excitement in their lives and are continually tempted to get back to their old ways. The criterion of ‘game cure’ is that the former Alcoholic should be able to drink socially without putting himself in jeopardy. The usual ‘total abstinence’ cure will not satisfy the game analyst.


== Literature ==
== Literature ==

Revision as of 23:14, 8 August 2008

AA meeting sign

Alcoholics Anonymous (AA) is an informal meeting society for recovering alcoholics. Its members state their primary purpose as, "to stay sober and help other alcoholics to achieve sobriety."[1] AA suggests that alcoholics follow its program and abstain from alcohol in order to recover from alcoholism, and share their experience, strength, and hope with each other that they may solve their common problem.[2][3][4] AA was the first twelve-step program and has been the model for similar recovery groups like Narcotics Anonymous. Al-Anon/Alateen are programs designed to provide support for relatives and friends of alcoholics. Although AA is not for everyone and attrition rates tend to be high,[5] there is evidence supporting the effectiveness of AA as a treatment for alcoholism.[6]

==History==

Main article: History of Alcoholics Anonymous

By 1934 alcoholic Bill Wilson had ruined a promising Wall Street career with his constant drunkenness. He was introduced to the idea of a spiritual cure by old drinking buddy Ebby Thacher who had become a member of a Christian movement called the Oxford Group. Wilson was treated at Charles B. Towns hospital with theThe Belladonna Cure by Dr. William Silkworth, who promoted a disease concept of alcoholism. While in the hospital, Wilson underwent what he believed to be a spiritual experience and, convinced of the existence of a healing higher power, he was able to stop drinking. On a 1935 business trip to Akron, Ohio, Wilson felt the urge to drink again and in an effort to stay sober, he sought another alcoholic to help. Wilson was introduced to Dr. Bob Smith, and Smith also found sobriety through spiritual means including Oxford Group practices.

Wilson and Smith co-founded AA with a word of mouth program to help alcoholics. Smith's last drink on June 10, 1935 is considered by members to be the founding date of AA.[7] By 1937, Wilson and Smith determined that they had helped 40 alcoholics get sober, and two years later, with the first 100 members, Wilson expanded the program by writing a book entitled Alcoholics Anonymous which the organization also adopted as its name. The book, informally referred to by members as "The Big Book," described a twelve-step program involving admission of powerlessness, moral inventory, and asking for help from a higher power. In 1941 book sales and membership increased after radio interviews and favourable articles in national magazines, particularly by Jack Alexander in The Saturday Evening Post. By 1946, as membership grew, confusion and disputes within groups over practices, finances, and publicity led Wilson to write the guidelines for noncoercive group management that eventually became known as the Twelve Traditions. AA came of age at the 1955 St. Louis convention when Wilson turned over the stewardship of AA to the General Service Board.[8] In this era AA also began its international expansion, and by 2001 the number of members worldwide was estimated at two million.

Organization

Main article: Twelve Traditions
A regional service center for Alcoholics Anonymous.

In 2006 there were a reported 1,867,212 AA members in 106,202 AA groups worldwide.[9] The Twelve Traditions informally guide how AA groups function, and the Twelve Concepts for World Service guide how AA is structured globally.[10]

A member who accepts a service position or an organizing role is a "trusted servant" with terms rotating and limited, typically lasting three months to two years and determined by group vote. Each group is a self-governing entity with AA World Services acting only in an advisory capacity. AA is served entirely by alcoholics, except for seven "nonalcoholic friends of the fellowship" out of twenty-one members of the AA Board of Trustees.[11]

AA groups are self-supporting and not charities, and they have no dues or membership fees. Groups rely on member donations, typically $1 collected per meeting in America, to pay for expenses like room rental, refreshments, and literature.[12] No one is turned away for lack of funds.[13]

AA receives proceeds from books and literature which constitute more than 50% of the income for the General Service Office (GSO),[14] which unlike individual groups is not self-supporting and maintains a small salaried staff. It also maintains service centers which coordinate activities like printing literature, responding to public inquiries, and organizing conferences. They are funded by local members and responsible to the AA groups they represent.

Program

See also: Twelve-step program: The Twelve Steps

The suggested AA recovery program for alcoholics includes abstaining from alcohol one day at a time, following Twelve Steps,[15] helping with duties and service work in AA,[16] and regular AA meeting attendance[17] or contact with AA members.[15] Members are encouraged to ask their group for help in finding an experienced fellow alcoholic called a sponsor to help them follow the AA program, ideally one that has enjoyed sobriety for at least a year and is of the same sex as the sponsee, and who does not impose personal views on sponsees but only teaches the suggested AA program.[18]

Meetings

Anyone is allowed to attend "open" AA meetings, while "closed" meetings are reserved to those who have a desire to stop drinking. [19] There are groups restricted to men or women, groups angled at gay people, and groups for speakers of minority languages. Most AA meetings begin with socializing. Formats vary between meetings, for example, a beginner's meeting might include a talk by a long-time sober member about his or her personal experience of drinking, coming to AA and what was learned there of sobriety. A group discussion on topics related to alcoholism and the AA program might follow.[20]

In a standard meeting, the chairperson starts by calling the meeting to order and offering a short prayer, meditation, and/or period of silence. Then, a section from "The Big Book" may be read aloud, typically the beginning of Chapter Five, entitled "How It Works". Announcements from the leader and/or group members follow. Many groups celebrate newcomers, visitors, and sobriety anniversaries with rounds of applause. Following the announcements, donations are collected, usually by passing a basket around the room. Depending on the type of meeting, there follows either a talk by a speaker relating their personal experience with alcoholism and AA or a discussion session with topics chosen by the chairperson, the speaker, and/or the attendees.[21] A hallmark of these types of AA meeting is the "no crosstalk" rule, whereby responding to another member's comments is discouraged. After the discussion period, appreciation may be expressed to the speaker and the meeting is ended with a prayer, usually the Serenity Prayer or often in the US, the Lord's Prayer. These ending prayers are often undertaken by the entire group forming a circle and holding hands. More socializing typically follows the formal meeting, and it is common for members to gather at nearby coffee shops. Other meeting formats also exist where specific AA related topics are discussed in more detail. A common example is a Step Study meeting where one or more of the 12 steps are discussed at length.

Disease of alcoholism

Main article: Disease theory of alcoholism

The disease theory is generally accepted by the medical community, which argues that genetic, neurological and behavioral studies distinguish those with alcohol dependence from problem drinkers.[22] AA also regards alcoholism as a disease[23][24] (though Bill Wilson once stated that it was more comparable to an illness or malady),[25] and uses the concept to challenge the belief of chronic, compulsive drinkers that they can stay sober by willpower alone.[26] Dr William Silkworth introduced to Wilson and AA the idea that alcoholism is a disease consisting of an obsession to drink alcohol, and an allergy, which was the compulsion to continue drinking once the first drink had been taken.[27] Alcoholics, he argued, can never safely use alcohol in any form at all, since once forming the habit, they cannot break it.[28]

Demographics

AA's 2004 survey of over 7500 members in Canada and the United States concluded that AA is composed of 89.1% white, 65% male, and 35% female members. Average member sobriety is eight years with 36% sober more than ten years, 14% sober from five to ten years, 24% sober from one to five years, and 26% sober less than one year. Before coming to AA, 64% of members received some type of treatment or counselling, such as medical, psychological, or spiritual. After coming to AA, 65% received outside treatment or counselling, and 84% of those members said that that outside help played an important part in their recovery.[29] A survey conducted in 2004 showed that AA received 11% of its membership from court ordered attendance.Cite error: A <ref> tag is missing the closing </ref> (see the help page).

Effectiveness

Main article: Effectiveness of Alcoholics Anonymous

Limitations on research

The study of AA tends to polarize observers into believers and non-believers, and discussion of AA often creates argument rather than objective reflection. Many researchers take a skeptical view of AA because some of AA's methods are spiritual, not scientific.[30] A randomized trial of AA is very difficult because members are self-selected, not randomly selected.[31] Two opposing types of self-selection bias are that drinkers may be motivated to stop drinking before they attend AA, and AA may attract the more severe and difficult cases.[32] Control groups with AA versus non-AA subjects are also difficult because AA is so easily accessible.[32]

Studies

Many studies have demonstrated an association between AA attendance and increased abstinence or other positive outcomes.[33][34][35][36][37][38][39][40] Other studies have concluded that AA attendance can lead to poorer outcomes than other therapies.[41][37][42][43][44]

Attrition

In a 1989 internal AA report based on an average of five surveys, it was estimated that of those who attended AA for the first time, 19% remained in AA after one month and 5% remained after twelve months. After the first year, the rate of attrition continues at a slower rate. About 40% of the members sober for less than a year will remain another year, About 80% of those sober less than five years will remain sober and active in the fellowship another year. About 90% of the members sober five years or more will remain sober and active in the fellowship another year, however the survey states that this information does not predict the number that will remain sober, and those who remain sober but not in the fellowship cannot be calculated. These figures have been repeated within a few percentage points using the same calculations since 1974.[5]

Tactics

George Vaillant. psychiatrist, researcher and a member of AA's board of Trustees, describes AA as a moral and religious system . He states that it works like many religions in that it indoctrinates its members into a new belief system. Members learn to see their former 'friend' alcohol as an enemy.[45] - In 1985 two sociologigists, Alexander and Rollins measured AA against criteria developed by Robert Jay Lifton, in his work on Thought Reform and concluded that AA uses many methods that are also used by cults. [46][47]

AA and institutions

The prison and court systems

In the United Kingdom, Alcoholics Anonymous, holds meetings in prisons. AA prison and probation liaisons cooperate with staff and AA volunteers give talks to staff in the legal profession.[48] In the United State the AA General Service Office provides a pamphlet with guidelines for members involved in doing the twelfth step work, that is "carrying the message to those who still suffer ". The pamphet instructs members how to work within correctional facilties.[49]

Influences on US treatment industry

Since 1949 when Hazelden treatment center was founded by members of Alcoholics Anonymous, some alcoholic rehabilitation clinics have frequently incorporated precepts of the AA program into their own treatment programs.[50] A reverse influence has also occurred with AA receiving 31% of its membership from treatment center referrals.[29] Alcoholics Anonymous, however, does not endorse and is not allied with any rehabilitation center or outside facility.

Court rulings

In the United States, Since 1996 Courts across the United States, in a number of different cases, have ruled that inmates, parolees, and probationers cannot be ordered to attend a religious based program such as AA or other recovery programs that have substantial religious components since such coercion is in violation of the Establishment Clause of the First Amendment of the Constitution. In September 2007, United States Court of Appeals for the Ninth Circuit stated that a parole office can be sued for ordering a parolee to attend Alcoholics Anonymous. [51][52]

AA though not judged to be a religion was determined to be religious based and to have substantial religous components, as per the Establishment Clause, by the facts that the participants in this program were told to pray to God for help in overcoming their affliction; the program places a heavy emphasis on spirituality and prayer; the program engages in Proselytism.[53][54][55]

Criticism and controversy

See also: Twelve-step program: Criticism

Moderation or abstinence

AA acknowledges that not all drinkers are alcoholics, but advocates total abstinence for those who are.[56] Critics argue that AA groups apply the disease model to all problem drinkers, whether or not they are full-blown alcoholics,[57] and believe that more options should be available to problem drinkers who can manage their drinking with the right treatment.[58]

A 2002 U.S. study by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) showed that 17.7% of individuals diagnosed as alcohol dependent more than one year prior returned to low-risk drinking. However, this group showed fewer initial symptoms of dependency.[59] A follow-up study, using the same NESARC subjects that were judged to be in remission in 2001-2002, examined the rates of return to problem drinking in 2004-2005. The major conclusion made by the authors of this NIAAA study was "Abstinence represents the most stable form of remission for most recovering alcoholics". [60] A long-term (60 year) follow-up of two groups of alcoholic men concluded that "return to controlled drinking rarely persisted for much more than a decade without relapse or evolution into abstinence."[61]

Cultural identity

One review of AA warned of detrimental iatrogenic effects of twelve-step philosophy, and concluded that AA uses many methods that are also used by cults. [46] However, a further study concluded that AA's program bore little semblance to a religious cult's because the techniques used appeared beneficial.[62] Another study found that an AA program's focus on self-admission of having a problem increases deviant stigma and strips members of their previous cultural identity replacing it with the deviant identity.[63] A survey of group members, however, found they had a bicultural identity and saw AA's program as a complement to their other national, ethnic, and religious cultures.[64]

Other notable criticism

  • AA undertakes no external restriction, screening, or vetting of its members.[65]
  • "Thirteenth-stepping" is a euphemistic term describing the practice of targeting new AA members for dates or sex.[66]
  • Although a statement is read during meetings that what is said there should remain confidential, AA members, unlike lawyers or clergy, are not legally bound to maintain confidentiality.[67] As communication between AA members is not covered under client, patient, or clergy privilege, they can be called upon to testify against other AA members in a court of law. Even though two people may promise not to disclose a shared confidence, the courts are not bound to honor that promise.[68][69]
  • Critics have noted that some AA members rely too heavily on dogmatic slogans and become overly dependent on the group.[70]
  • AA has been described as having substantial religious components,[71][72] which some alcoholics find unacceptable and one reason for the provision of secular programs by other recovery groups.[73]
  • Eric Berne who developed the theory of Transactional analysis in his book Games People Play (book) describes The Transactional Analysis of Drinking. The role of organizations such as Alcoholics Anonymous, the people in it assume the role of the rescuer and without new members to involve themselves with, there was no way to continue the game , resulting in an entire chapter of AA losing all of its members. In game theory the psychological cure is for the Alcoholic to stop playing the game, by relinquishing the roles of the rescuer needing others to save, or victim and needing to rescued, or persecutor. In Transactional Anaysis, it holds that the former alcoholic, one who has become game free, should be able to socially drink.[74]

The psychological cure of an alcoholic also lies in getting him to stop playing the game altogether, rather than simply change from one role to another. In some cases this is feasible, although it is a difficult task to find something else as interesting to the Alcoholic as continuing his game. Since he is classicly afraid of intimacy, the substitute may have to be another game rather than a game-free relationship. Often so-called cured alcoholics are not very stimulating company socially, and possibly they feel a lack of excitement in their lives and are continually tempted to get back to their old ways. The criterion of ‘game cure’ is that the former Alcoholic should be able to drink socially without putting himself in jeopardy. The usual ‘total abstinence’ cure will not satisfy the game analyst.

Literature

  • Alcoholics Anonymous (1976-06-01). Alcoholics Anonymous. Alcoholics Anonymous World Services. ISBN 0916856593. OCLC 32014950.
  • Alcoholics Anonymous (2002-02-10). Twelve Steps and Twelve Traditions. Alcoholics Anonymous World Services. ISBN 0916856011. OCLC 13572433.
  • Alcoholics Anonymous (1984). Pass It On. Alcoholics Anonymous World Services. ISBN 0916856011. OCLC 13572433.

See also

References

  1. ^ "What is AA? Defining "Alcoholics Anonymous"". The General Service Board of Alcoholics Anonymous (Great Britain). Retrieved 2006-11-27.
  2. ^ AA Preamble
  3. ^ AA Fact File, 'The Recovery Program'
  4. ^ Alcoholics Anonymous : the story of how many thousands of men and women have recovered from alcoholism. 4th ed. New York : Alcoholics Anonymous World Services, 2001. ISBN 1893007162. Available online at www.AA.org
  5. ^ a b "Comments On A.A. Triennial Surveys" (PDF, 2 MB), Dec. 1990, Alcoholics Anonymous World Services.
  6. ^ Practice Guideline for the Treatment of Patients With Substance Use Disorders, 2nd ed. American Psychiatric Association, August 2006, p 98. [1]
  7. ^ Pass It On, p 131-149.
  8. ^ Pass It On p 359
  9. ^ AA Fact File
  10. ^ The AA Service Manual/Twelve Concepts for World Service (BM-31).
  11. ^ The AA Fact File, 'The Structure of AA'
  12. ^ Once Upon A Time... Mitchel K. 04/08/98
  13. ^ [2]AA Fact File p 17
  14. ^ GSO 2005 Operating Results, 'Gross Profit from Literature ~$6.7M (55%), Contributions ~$5.4M (45%)'
  15. ^ a b http://www.alcoholics-anonymous.org/en_pdfs/p-1_thisisAA.pdf This is AA pamphlet
  16. ^ http://www.alcoholics-anonymous.org/en_services_for_members.cfm?PageID=98&SubPage=119 Sponsorship-A Vital Stepping Stone to Service & Sobriety
  17. ^ http://www.alcoholics-anonymous.org/en_is_aa_for_you.cfm?PageID=14 A Newcomer Asks pamphlet
  18. ^ http://www.alcoholics-anonymous.org/en_pdfs/p-15_Q&AonSpon.pdf Questions and Answers on Sponsorship pamphlet
  19. ^ http://www.alcoholics-anonymous.org/en_information_aa.cfm?PageID=10 AA at a Glance pamphlet
  20. ^ [3] Suggestions for Leading Beginners Meetings pamphlet
  21. ^ Kirkpatrick, Kayla EJ. "Interpreting AA (and other 12-step) Meetings." American Sign Language Interpreting Resources, 10 December 1999. <http://asl_interpreting.tripod.com/situational_studies/kejk1.htm>. 12 March 2008.
  22. ^ Alcohol - Frequently Asked Questions, US Centers for Disease Control and Prevention (CDC)
  23. ^ A Newcomer Asks (AA pamphlet)
  24. ^ The Alcoholic Can Recover (AA pamphlet)
  25. ^ "A Conversation with Bill W." 2003. Retrieved 2006-10-20. {{cite web}}: Cite has empty unknown parameter: |coauthors= (help)
  26. ^ Alcoholics Anonymous (2001). "Chapter 3: More About Alcoholism". Alcoholics Anonymous (PDF) (4th edition ed.). New York, New York: Alcoholics Anonymous World Services. pp. 30–43. ISBN 1893007162. OCLC 32014950. {{cite book}}: |edition= has extra text (help); Unknown parameter |month= ignored (help)
  27. ^ Dale Mitchel, Silkworth: The Little Doctor Who Loved Drunks. Hazelden, 2002.
  28. ^ Alcoholics Anonymous The Doctor's Opinion page xxviii.
  29. ^ a b http://www.alcoholics-anonymous.org/en_pdfs/p-48_04survey.pdf AA 2004 Membership Survey
  30. ^ Vaillant, George Eman (1995). "Chapter 4: Paths into Abstinence". The Natural History of Alcoholism Revisited (2nd edition ed.). Harvard University Press. pp. 231–277. ISBN 0674603788. OCLC 31605790. {{cite book}}: |edition= has extra text (help); Unknown parameter |month= ignored (help)
  31. ^ Edwards, Griffith (2002). "Chapter 8: Alcoholics Anonymous". Alcohol: The World's Favorite Drug (1st edition ed.). Thomas Dunne Books. pp. 103–117. ISBN 0312283873. OCLC 48176740. {{cite book}}: |edition= has extra text (help); Unknown parameter |month= ignored (help)
  32. ^ a b Humphreys, Keith (2002). "Alcoholics Anonymous and 12-Step Alcoholism Treatment Programs". Recent Developments in Alcoholism. Vol. 16. Springer US. pp. 149–164. doi:10.1007/b100495. ISBN 978-0-306-47258-9. PMID 12638636.
  33. ^ Moos, Rudolf H. (2006). "Participation in Treatment and Alcoholics Anonymous: A 16-Year Follow-Up of Initially Untreated Individuals". Journal of Clinical Psychology: 735–750. doi:10.1002/jclp.20259. PMID 16538654. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help); Unknown parameter |month= ignored (help)
  34. ^ Moos, Rudolf H. (2006). "Rates and predictors of relapse after natural and treated remission from alcohol use disorders". Addiction. 101 (2): 212–222. doi:10.1111/j.1360-0443.2006.01310.x. PMID 16445550. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help); Unknown parameter |month= ignored (help)
  35. ^ Moos, Rudolf H. (2004). "Long-Term Influence of Duration and Frequency of Participation in Alcoholics Anonymous on Individuals with Alcohol Use Disorders". Journal of Consulting and Clinical Psychology. 72 (1): 81–90. doi:10.1037/0022-006X.72.1.81. PMID 16445550. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help); Unknown parameter |month= ignored (help)
  36. ^ Humphreys, Keith (2001). "Can encouraging substance abuse patients to participate in self-help groups reduce demand for health care? A quasi-experimental study". Alcoholism: Clinical and Experimental Research. 25 (5): 711–716. doi:10.1111/j.1530-0277.2001.tb02271.x. ISSN 1530-0277. PMID 11371720. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help); Unknown parameter |month= ignored (help)
  37. ^ a b J. Morgenstern et al. "Affiliation with Alcoholics Anonymous after treatment: a study of its therapeutic effects and mechanisms of action." (Department of Psychiatry, Mount Sinai School of Medicine, New York, 1997 Oct;65(5):768-7)
  38. ^ J. Scott Tonigan PhD. "Benefits of Alcoholics Anonymous Attendance" (University of New Mexico, 2001) pp 67 - 77
  39. ^ (August 1967). "A Controlled Experiment on the Use of Court Probation for Drunk Arrests". American Journal of Psychiatry 124 (2): Abstract.
  40. ^ Atkins, R. G. & Hawdon, J. E. Journal of Substance Abuse Treatment "Religiosity and participation in mutual-aid support groups for addiction", Vol. 33, Issue 3, Oct. 2007, pp. 321-331 available online at www.sciencedirect.com
  41. ^ Brandsma, Jeffrey, Phd. , Maultsby , Maxie, Welsh, M.D. Richard, M.S.W. The OutPatient Treatment of Alcoholism
  42. ^ Larimer, Mary E (1999). "Relapse prevention. An overview of Marlatt's cognitive-behavioral model". Alcohol research & health : the journal of the National Institute on Alcohol Abuse and Alcoholism. 23 (2): 151–160. ISSN 1535-7414. OCLC 42453373. PMID 10890810. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)
  43. ^ Two-Year Outcome of Alcohol Interventions in Swedish University Halls of Residence: A Cluster Randomized Trial of a Brief Skills Training Program, Twelve-Step-Influenced Intervention, and Controls Authors: Ståhlbrandt, Henriettæ1; Johnsson, Kent O.1; Berglund, Mats1 Source: Alcoholism Clinical and Experimental Research, Volume 31, Number 3, March 2007, pp. 458-466(9) Publisher: Blackwell Publishing http://www.ingentaconnect.com/content/bsc/acer/2007/00000031/00000003/art00014
  44. ^ Do Alcoholics Anonymous Groups Really Work? Factors of Adherence in a Brazilian Sample of Hospitalized Alcohol Dependents - American Journal on Addictions: The official Journal of the American Academy of Addiction Psychiatry
  45. ^ The Natural History of Alcoholism 1983, p. 194-199 Harvard University Press , 1983
  46. ^ a b Alexander, F. (1985). "Alcoholics Anonymous: the unseen cult". California Sociologist. 17 (1). Los Angeles: California State University: 33–48. ISSN 0162-8712. OCLC 4025459. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)
  47. ^ Alexander and Rollins Alcoholics Anonymous the Unseen cult pdf file http://ww.silkworth.net/sociology/Soc63OCR.pdf
  48. ^ http://www.alcoholics-anonymous.org.uk/prof/legal.shtml
  49. ^ AA Guidlines from GSO, "Cooperating with Court, DWI and Similiar Programs. http://alcoholics-anonymous.org/en_pdfs/mg-o5_coopwithcourt.pdf
  50. ^ N. Roberson, Getting Better:Inside Alcoholics Anonymous (London: Macmillan, 1988), p 220
  51. ^ name="EGELKO2007">Egelko, Bob (2007-09-08). "Appeals court says requirement to attend AA unconstitutional". San Francisco Chronicle. Retrieved 2007-10-08.
  52. ^ Inouye vs. Kemna page 11889
  53. ^ United States 2nd Circuit Court of Appeals "DESTEFANO v EMERGENCY HOUSING G" August Term, 1999 Argued: March 16, 2000 Decided: April 20, 2001 Errata Filed: May 7, 2001) Dockett No.00-99146
  54. ^ Griffin vs. Coughlin {IN THE MATTER OF DAVID GRIFFIN, APPELLANT, v. THOMAS A. COUGHLIN III, AS COMMISSIONER OF THE NEW YORK STATE DEPARTMENT OF CORRECTIONAL SERVICES, ET AL.. RESPONDENTS. - 1996 N.Y. Int. 137. June 11, 1996. No. 73 [1996 NY Int. 137] . Decided June 11, 1996 http://www.morerevealed.com/archives/arc_fed_court_griffin.jsp.
  55. ^ Honeymar, Michael G. "*437 Alcoholics Anonymous As a Condition of Drunk Driving Probabtion: When does it Amount to the Establishment of Religion? Columbia Law Review 1997
  56. ^ Alcoholics Anonymous (2001). Alcoholics Anonymous (PDF) (4th edition ed.). New York, New York: Alcoholics Anonymous World Services. ISBN 1893007162. OCLC 32014950. {{cite book}}: |edition= has extra text (help); Unknown parameter |month= ignored (help)
  57. ^ Stanton Peele The Diseasing of America. Lexington, MA: Lexington Books, 1989, http://www.peele.net/lib/diseasing.html
  58. ^ Shute, Nancy (1997). "The drinking dilemma: by calling abstinence the only cure, we ensure that the nation's $100 billion alcohol problem won't be solved". U.S. News & World Report. 123 (9): 54–64. {{cite journal}}: Unknown parameter |month= ignored (help)[4]
  59. ^ Dawson DA, Grant BF, Stinson FS, Chou PS, Huang B, Ruan WJ. 2005. Recovery from DSM-IV alcohol dependence: United States, 2001-2002.  : Addiction. Mar;100(3):281-92
  60. ^ Dawson DA, Goldstein RB, Grant BF. 2007. Rates and correlates of relapse among individuals in remission from DSM-IV alcohol dependence: a 3-year follow-up. Alcohol Clin Exp Res. 2007 Dec;31(12):2036-45.
  61. ^ Vaillant GE. A 60-year follow-up of alcoholic men. Addiction. 2003 98, 1043-51. PMID: 12873238
  62. ^ Wright, K (1997) "Shared Ideology in Alcoholics Anonymous: A Grounded Theory Approach". Journal of Health Communication, Volume 2, pp. 83–99
  63. ^ Levinson, D. (1983). Galanter, Marc (ed.). "Current status of the field: An anthropological perspective on the behavior modification treatment of alcoholism". Recent Developments in Alcoholism. 1. New York: Plenum Press: 255–261. ISSN 0738-422X. PMID 6680227.
  64. ^ Wilcox, D.M. (1998). "Chapter 7: Language, Culture, and Belief". Alcoholic thinking: Language, culture, and belief in Alcoholics Anonymous. Westport, CT: Greenwood Publishing Group. pp. 109–124. ISBN 0275960498.
  65. ^ The A.A. Tradition
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  67. ^ Coleman, Phyllis (2005). "Privilege and Confidentiality in 12-Step Self-Help Programs: Believing The Promises Could Be Hazardous to an Addict's Freedom". The Journal of Legal Medicine. 26 (4): 435–474. doi:10.1080/01947640500364713. ISSN 0194-7648. OCLC 4997813. {{cite journal}}: Unknown parameter |month= ignored (help)
  68. ^ New York Times, Jan Hoffman June 15, 1994 ["Faith in Confidentiality of Therapy Is Shaken" http://query.nytimes.com/gst/fullpage.html?res=9F0CE4D81F3AF936A25755C0A962958260&sec=&spon=&pagewanted=all]
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  73. ^ http://www.smartrecovery.org/resources/faq.htm#Q.%20How%20is%20SMART%20Recovery%AE%20different%20from%20traditional%20Twelve%20Step%20programs
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External links

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