By A. Tom Horvath, Ph.D.

The primary myth about AA is that it is the only thing that works. Of course, like other myths, there is some truth in this one. Many people assert that AA saved them or others they know well from alcohol problems. They may be correct. In fact, however, no one knows. From a scientific perspective, the effectiveness of AA is unknown. Furthermore, what is known to be effective alcohol treatment, from a scientific perspective, is not very similar to AA.

Therefore, what should be said about AA is that it might workmany people claim based on personal experience that it doesbut other approaches are actually known to work, and they are rather different than AA.

An introduction to the complex scientific literature on AA can be found here:

http://en.wikipedia.org/wiki/Effectiveness_of_Alcoholics_Anonymous

To summarize this literature: attending AA, if freely chosen, is correlated with improvement. Correlated means AA attendance and improvement go together, not that AA necessarily caused the improvement. There is also evidence that being forced to attend AA may be worse than doing nothing! Assuming that research someday verifies that AA attendance is actually effective for some types of individuals, many questions would remain. What might the effective components of AA be: Attending groups (regardless of what happens there)? Meeting one-on-one with sponsors? Believing in a higher power? Other factors not yet identified? Some combination of these factors? Unfortunately, AA has not been supportive of scientific research. Getting the data to answer these questions may not happen. Until then the safest prescription about AA would appear to be that if you find the meetings helpful, attend them; if you dont find them helpful, dont attend!

As to the other approaches for alcohol treatment, a summary is here:

http://www.behaviortherapy.com/whatworks.htm

None of these approaches requires attending AA meetings, believing in a higher power, or believing alcohol problems are diseases. Some of them do not necessarily aim at abstinence.

Even if AA were known to be effective, most individuals who are referred to it wont attend. Most who start attending dont keep attending. Therefore there is room for alternative approaches. Alternatives increase the chances that those who wont attend or follow through with AA may find helpful ideas from other sources.

The primary purpose of this article is to support the individual who has doubts about AA, but can only find professionals who repeat the myth about AA. If you have had drinking problems, you are probably not feeling very good about yourself. It could be hard to stand firm with your thought that the AA program doesnt seem like a good fit for me. There is actually an AA slogan, your best thinking got you here. The slogan suggests that if you werent smart enough to avoid drinking problems, how would you be smart enough to end them? The slogan suggests that you should shut up and listen to people who know better. Actually, however, most people will do better if they find their own way in recovery (getting and sifting through input and support from a variety of sources).

It will be easier to keep listening to your doubts about AA if you realize that AAs effectiveness is unproven, that forced attendance may be harmful, and that alternative approaches exist. Staying out of AA wont in itself solve your drinking problems. However, by not pursuing a path that is wrong for you, you will hopefully find sooner the path that is right for you. If it turns out later that you misjudged AA, and return to it, at least you will be ready to pursue it wholeheartedly.

Although this article is written to support you if you are being railroaded into AA when you dont want to go, dont lose sight of the primary issue: resolving your alcohol problems. You can stop making the point that AA isnt for everyone. Its time to start making the point (and demonstrating) that alcohol problems are in your past, not your present!

About the Author: Adapted with permission from an article originally published in the SMART Recovery newsletter. A. Tom Horvath, Ph.D., ABPP, is a board certified clinical psychologist and president of Practical Recovery (

addiction treatment

), an addiction treatment facility in La Jolla (San Diego), CA, focusing on collaborative care and self-empowerment.

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