I find it somewhat ironic that suddenly personal responsibility is so important when talking about addiction. But when talking about why we ended up in programs, it's suddenly somebody else's fault.
If you can't see the difference between an adult being responsible for their own actions and a child being forced into a "rehab", I can't help you.
Suddenly we are on an uncontrollable destiny, not of our own choosing.
That's right. I didn't choose to go to Straight and I certainly didn't choose to be abused there. However, how I choose to deal with it now is up to me.
AA works for a lot of people, I have a hard time understanding why people are so offended by this truth, on fornits.
Because there's no proof, other than anecdotal, that "it" does work and AA's own Dr. George Vaillant's study concluded that it was actually harmful to the alcoholic because it taught them that if they 'relapsed' (even having one drink) or rejected AA's teaching, then they were "certainly signing their own death warrant" (see 12 & 12). The poor souls believed it and went binge drinking.
http://www.orange-papers.org/orange-effectiveness.htmln spite of the scarcity of good, properly run randomized longitudinal controlled studies of the effectiveness of Alcoholics Anonymous, there are still several good tests and studies which were done properly, and give us a good idea of what is happening.
There is experimental evidence that the A.A. doctrine of powerlessness leads to binge drinking. In a sophisticated controlled study of A.A.'s effectiveness (Brandsma et. al.), court-mandated offenders who had been sent to Alcoholics Anonymous for several months were engaging in FIVE TIMES as much binge drinking as another group of alcoholics who got no treatment at all, and the A.A. group was doing NINE TIMES as much binge drinking as another group of alcoholics who got rational behavior therapy.
Those results are almost unbelievable, but are easy to understand — when you are drunk, it's easy to rationalize drinking some more by saying,
"Oh well, A.A. says that I'm powerless over alcohol. I can't control it, so there is no sense in trying. I'm doomed, because I already took a drink. One drink, one drunk. I'm screwed, because I already lost all of my sober time. Might as well just relax and enjoy it now. Pass that bottle over here, buddy."
It's also easy to rationalize taking the first drink with,
"I'm powerless. I can't help it. The Big Book says that I have no defense against those strange mental blank spots when I'll drink again. Bottoms up!"
Dr. Jeffrey Brandsma and his associates Dr. Maxie Maultsby (co-inventor of Rational Behavior Therapy) and Dr. Richard J. Welsh did a study where they took some alcoholics who had been arrested for public drunkenness, and randomly divided them into three groups, which got one of:
1. A.A. treatment
2. Lay RBT (non-professional Rational Behavior Therapy, something invented by Dr. Maxie Maultsby and Dr. Albert Ellis, something very similar to SMART)
3. No treatment at all. This was the control group.
And the results were:
The variables that showed significant differences at outcome could be organized into three categories: treatment holding power, legal difficulties, and drinking behavior. Treatment holding power was indicated by the percentage of dropouts between intake and outcome (p = 0.05), the mean number of treatment sessions attended (p = 0.05), and the mean number of days in treatment. Less than one-third (31.6%) of the clients assigned to the AA group qualified for outcome measures in contrast to almost 60% for the lay-RBT group, and this occurred with equivalent attempts by our social work staff to keep the men in treatment, whatever type it was. Table 32 highlights these differences.
See table at link above.http://cbtrecovery.org/AAefficacyrates.htmSome information about AA's success rate comes from its own membership surveys. In particular, the rather famous 'Comments on AA's Triennial Surveys' document cited by Charles Bufe in Alcoholics Anonymous: Cult or Cure is AA's ID # 5M/12-90/TC, which was produced for internal purposes. It is also summarized in Vince Fox's Addiction, Change, and Choice (1993). The document is not listed in AA's 'Conference Approved Literature' but Fox was able to obtain a copy from AA.
AA's own analysis was that 50% of all those who try AA leave within 90 days, which they describe as cause for 'concern'. Their own data shows that is actually optimistic. In the 12-year period shown, 19% remain after 30 days, 10% remain after 90 days, and 5% remain after a year.
The retention rate of AA is 5% after one year.
So do we define the success rate as the retention rate? You'd have to tell me if you believe that success in AA is measured by whether people are still attending meetings.
Other observations:
60% of those surveyed were getting outside professional help. This means that any success (or failure) rate, however it is defined, can't be attributed entirely to AA.
One way to measure the success of AA would be by comparing 12-step based treatment with other treatments. A 1997 study found that 93% of American drug and alcohol treatment programs follow the 12-step model. So it would be pretty easy to tell, at least, whether 12-step programs work.
An extensive study (Hester and Miller, Handbook of alcoholism treatment approaches) shows that peer-based 12-step alcohol treatment programs do NOT have a higher success rate than no treatment at all. Facilitated 12-step treatment (trained facilitators guiding subjects through the twelve-step process) were marginally better. "The two tests of AA found it inferior to other treatments or even no treatment but were not sufficient to rank AA reliably."
Brief, non-confrontational interventions and motivational interviewing were found most effective.
If you define success as reduced drinking, absence of alcohol dependence, or a reduction in problem drinking, then you see different results. Success in AA is presumed to be total abstinence. But followup to many treatment programs finds people have done some drinking, or drink moderately (defined by the researcher, not the patient!). They would be considered failures in AA--but the behavior has changed. So if one wants to improve the statistical success rates of 12-step treatment, just broaden the definition of 'success' to include moderate drinking!
http://www.psychologytoday.com/blog/add ... le-diseaseGeorge Vaillant is a world renown alcoholism expert who identified this truth, then became a spokesperson for Alcoholics Anonymous and the disease theory. When he determined that his 12-step treatment program did no good, Vaillant intoned, "the best that can be said for our exciting treatment effort at Cambridge Hospital is that we were certainly not interfering with the normal recovery process." Chew on that! But, even this ridiculously modest claim is wrong.......
............In a separate non-clinical sample he studied, Vaillant found that the substantial majority achieved remission without entering AA. Yet Vaillant failed to cite a single case of natural recovery in his book! Every single case is of an AA success, or else of failures like "Tom Reardon," who foolishly "never learned to pick up the telephone" to call AA. The discrepancy between his data and his case studies is not very reassuring about Dr. Vaillant's mission.
Poll