A.A. works

It seems that a perennial media topic and a frequent behavioral health research topic, the former often reflecting the latter,  is whether A.A. “works.”  In A.A. the question of “Does A.A. work?” brings the repetitive and humor tinged answer, “Sure it works, just as long as you keep working the program.  You can have your misery refunded any time you want.”

The NY Times reported recently on the results of a review by Italian researchers reported in the “prestigious” Cochrane Library, stated,  “No experimental studies unequivocally demonstrated the effectiveness of A.A. or (professional Twelve Step therapy) for reducing alcohol dependence or problems.”  Apparently the researchers further concluded that A.A. and A.A. based therapies are no more and no less effective than alternative approaches.  It should be noted that this review is ten years after the massive U.S. Government study Project MATCH that had already shown that Twelve Step Facilitation Therapy, a pale replica of A.A., was as effective as the two leading alternative therapies Cognitive Behavior Therapy and Motivational Enhancement.  This led to other media reports such as “Review Sees No Advantage to Twelve Step Programs.

A.A. from the outset in 1935 never saw itself as the final word on the treatment of alcohol dependence, just the only game in town as alcoholism had been, and really still is, neglected by health care providers.  Bill Wilson and others always supported efforts to improve treatment.  They knew, as A.A. still teaches, that being resentful can get you drunk.  But when you think that A.A. is free and almost universally available in the developed world you can’t help but compare that to trying to find someone other than A.A. and A.A. members to help an alcoholic on Saturday night or Sunday morning.  The professionals are all sleeping and they would have to schedule something some time later and of course first check insurance coverage.

There is a magic in one alcoholic talking to another.  A.A. may not work for exactly the reasons expressed in the famous chapter from the Big Book “How it works,” but it does work quite well as several million recovering people will attest.  A.A. is a simple but difficult treatment regimen.  It requires a good deal of work on the part of the individual.  Its spiritual in a secular, materialistic culture.  And it would be great if the gifted intellectuals of the world and the more heterogeneously endowed media types could simple support such a beneficent endeavor.