What can be confidently said about AA in general and about the role of spirituality in AA in particular?

• First, there is convincing evidence that alcoholism severity predicts later AA attendance.
• Second, atheists are less likely to attend AA, relative to individuals who already hold spiritual and/or religious beliefs. However, belief in God before AA attendance does not offer any advantage in AA-related benefits, and atheists, once involved, are at no apparent disadvantage in deriving AA-related benefits.
• Third, the spiritually-based principles of AA appear to be endorsed in AA meetings regardless of the perceived social dynamics or climate of a particular meeting, eg, highly cohesive or aggressive.
• Fourth, significant increases in spiritual and religious beliefs and practices seem to occur among AA-exposed individuals.
• Fifth, in spite of much discussion to the contrary there is little evidence that spirituality directly accounts for later abstinence.

We are finding, however, that spirituality has an important indirect effect in predicting later drinking reductions. Specifically, in the past 20 years a number of effective methods have been developed to facilitate initial AA attendance. Such as Brief-TSF.

Interventions that lead to initial increases in spirituality appear to lead to sustained AA affiliation, which, in turn, produces sustained recovery over time.

Research; Tonigan JS. Spirituality and alcoholics anonymous. South Med J. 2007 Apr;100(4):437-40.

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• What About This Spiritual Awakening Thing?
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• Bill W.Biography
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Coping Strategies of Female Victims of Child Abuse in Treatment for Substance Abuse Relapse: Their Advice to Other Women and Healthcare Professionals,

Abstract

This study was a part of a larger qualitative descriptive study designed to explore chronic sorrow as a relapse trigger among female victims of child abuse who were currently enrolled in substance abuse treatment for relapse.

The purpose of this study was to identify coping strategies and other factors these women perceived as helpful to their recovery. A purposive sample of twelve women participated in interviews using a semistructured interview schedule.

The advice the participants offered to women in similar situations reflected interpersonal, cognitive and action-focused positive coping strategies.

They encouraged clinicians in primary care facilities to approach persons suspected of substance abuse in a nonjudgmental manner. Healthcare professionals should be more assertive in recommending resources for substance abuse treatment.

Research; Cheryl Slaughter Smith. Coping Strategies of Female Victims of Child Abuse in Treatment for Substance Abuse Relapse: Their Advice to Other Women and Healthcare Professionals, Journal of Addictions Nursing, Volume 18, Issue 2 April 2007 , pages 75 – 80

Spirituality/religiosity promotes acceptance-based responding and 12-step involvement.

BACKGROUND: Previous investigations have observed that spirituality/religiosity (S/R) is associated with enhanced 12-step involvement. However, relatively few studies have attempted to examine the mechanisms for this effect. For the present investigation, we examined whether acceptance-based responding (ABR) – awareness or acknowledgement of internal experiences that allows one to consider and perform potentially adaptive responses – accounted for the effect of S/R on 12-step self-help group involvement 2 years after a treatment episode.

METHODS: Data were collected as part of a multi-site treatment outcome study with 3698 substance-dependent male veterans recruited at baseline. Assessments were conducted at baseline, discharge, 1-year follow-up, and 2-year follow-up. We utilized structural equation modeling to examine the relationships among latent variables of S/R, ABR, and 12-step involvement over time.

RESULTS: In the final model, S/R was not directly related to 12-step involvement at 2-year follow-up. However, S/R predicted enhanced ABR at 1-year follow-up after accounting for discharge levels of ABR. In turn, ABR at 1-year follow-up predicted increased 12-step involvement at 2-year follow-up after accounting for discharge levels of 12-step involvement.

CONCLUSIONS: S/R promotes the use of post-treatment self-regulation skills that, in turn, directly contribute to ongoing 12-step self-help group involvement.

Authors: Carrico AW, Gifford EV, Moos RH. Spirituality/religiosity promotes acceptance-based responding and 12-step involvement. Drug Alcohol Depend. 2007 Jun 15;89(1):66-73

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Prayer as medicine: how much have we learned?

SPIRITUALITY AND HEALTH

Many people use prayer, and some studies have shown a positive association between prayer and improved health outcomes. This article explores four possible mechanisms by which prayer may lead to improved health.

While acknowledging the efficacy of prayer and recognizing the needs of patients, prayer, being a personal spiritual practice, cannot be prescribed, nor should it be used in place of medical care.

The spiritual search for meaning and hope in life is integral to human existence. This is particularly evident during times of personal stress and crisis. Recent census findings indicate that 74% of Australians and 96% of Americans believe in a higher power, and similar percentages claim some form of religious affiliation.1,2 Evidence also suggests that certain spiritual beliefs and the practice of prayer are associated with improved coping and better health outcomes.3-6 Although North Americans have been the predominant participants in most of the research available, the findings are relevant to the Australian experience, as they reflect a basic human desire for supernatural involvement in matters of health and wellbeing.

Research; Marek Jantos and Hosen Kiat. Medical Journal of Australia, 2007; 186: S51-S53

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Patterns of AA involvement five years after treatment entry

BACKGROUND: Most formal treatment programs recommend Alcoholics Anonymous (AA) attendance during treatment and as a form of aftercare, but we know very little about treatment seekers’ patterns of AA involvement over time and how these relate to abstinence.

METHOD: This paper applies latent class growth curve modeling to longitudinal data from 349 dependent drinkers recruited when they were entering treatment and were re-interviewed at one or more follow-up interviews one, three and five years later, and who reported having attended AA at least once.

RESULTS: Four classes of AA "careers" of meeting attendance emerged:

• The low AA group mainly just attended AA during the 12 months following treatment entry.
• The medium and high AA groups were characterized by stable attendance at the second and third follow-ups-at about 60 meetings a year for the medium group and over 200 meetings per year for the high group, followed by slight increases for the medium group and slight decreases for the high group by year five.
• The declining AA group doubled its meeting attendance post-baseline, to almost 200 meetings during the year following treatment entry, but by year five they were only attending about six meetings on average.

Decreases in AA meetings did not necessarily signal disengagement from AA; at the five-year follow-up, a third of the low AA group and over half of the declining AA group said they felt like a member of AA.

Activities other than meeting attendance, such as having a sponsor, otherwise paralleled the meeting careers, but social networks were similar by year five.

Rates of abstinence by year five (for the past 30 days) were

• 43% for the low AA group,
• 73% for the medium group,
• 79% for the high group and
• 61% for the declining group.

Rates of dependence symptoms and social consequences of drinking did not differ between the groups at year five.

CONCLUSIONS: The prototypical AA careers derived empirically are consistent with anecdotal data about AA meetings: some never connect; some connect but briefly; and others maintain stable (and sometimes quite high) rates of AA attendance. However, contrary to AA lore, many who connect only for a while do well afterwards.

Kaskutas LA, Ammon L, Delucchi K, Room R, Bond J, Weisner C. Alcoholics anonymous careers: patterns of AA involvement five years after treatment entry. Alcohol Clin Exp Res. 2005 Nov;29(11):1983-90.

The Process of Reconnecting: Recovery from the Perspective of Addicted Women

This study examined women’s experiences with addiction to drugs and/or alcohol and their process of recovery. The techniques of in-depth interviews and participant observations were employed to elicit the perspectives of the women. The study consisted of 12 participants, 6 who were currently involved in a 90-day community-based drug and alcohol treatment program and 6 who had more than five years of recovery.

Grounded theory method guided data collection and analysis. The women in this study described experiences of connectedness and disconnectedness throughout their lives, their addiction, and their recovery. The researcher constructed a substantive theory and model to explain this process of connectedness and disconnectedness.

The findings support that making connections and establishing healthy relationships play a significant role for women in achieving sobriety and maintaining recovery.

Research; The Process of Reconnecting: Recovery from the Perspective of Addicted Women. Carolynn Masters & Dorothy S. Carlson. Journal of Addictions Nursing, Volume 17, Issue 4 December 2006 , pages 205 – 210

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An Introduction to Medication for Alcohol Dependence

Anti-craving Drugs

Binge Drinking & Brain Damage

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Brief-TSF Description

Brief-TSF Learning Objectives

Characteristics of Children of Alcoholic

Controlled drinking?

Counselling and the 12 Steps of AA

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Depression & 12-Step Programs

Effects of Gambling Addiction

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Families, Mental Health & Alcohol abuse

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Five Alcoholism Subtypes

Free Training Alcoholism Anti-craving Medications

Gender Matching Hypothesis in Alcohol Treatment

Healing through Social and Spiritual Affiliation

How Alcoholics Anonymous is changing

How do alcoholics get to AA?

Humility and Surrender

Nutritional Therapy in Alcoholic Liver Disease

Painkiller abuse

Phases of Recovery from Alcoholism

Readiness to Change Profiles

Recovery through the Twelve Steps

Research Evidence for TSF

Risky Partners and Domestic Violence

Slogans for everyday life in AA

Spiritual Assessment

Spirituality in Alcoholism Recovery

Stages of an Eating Disorder

Strategies for Dealing With Denial

Symptoms of alcoholism

The 12-Steps Promote Acceptance of Addiction

The Personality Traits of Alcoholics

Treating Alcoholism as a Chronic Disease

TSF Description

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Women and the Twelve Steps of AA

World view change in Adult Children of Alcoholics

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Does Prayer Decrease Alcohol Consumption?

Four methodologically diverse studies (N = 1,758) show that prayer frequency and alcohol consumption are negatively related.

In Study 1 (n = 824), we used a cross-sectional design and found that higher prayer frequency was related to lower alcohol consumption and problematic drinking behavior.

Study 2 (n = 702) used a longitudinal design and found that more frequent prayer at Time 1 predicted less alcohol consumption and problematic drinking behavior at Time 2, and this relationship held when controlling for baseline levels of drinking and prayer.

In Study 3 (n = 117), we used an experimental design to test for a causal relationship between prayer frequency and alcohol consumption. Participants assigned to pray every day (either an undirected prayer or a prayer for a relationship partner) for 4 weeks drank about half as much alcohol at the conclusion of the study as control participants.

Study 4 (n = 115) replicated the findings of Study 3, as prayer again reduced drinking by about half.

Research; Nathaniel M. Lambert, Frank D. Fincham, Loren D. Marks and Tyler F. Stillman; Psychology of Addictive Behaviors; Volume 24, Issue 2, June 2010, Pages 209-219; Invocations and Intoxication: Does Prayer Decrease Alcohol Consumption?

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Recovery doesn’t usually change addicts’ core beliefs about God and religion, but measures of spirituality appear to increase along with sobriety, according to researchers from the University of Michigan Addiction Research Center.

Researchers assessed 10 measures of spirituality among 154 adults in an outpatient treatment program for alcohol dependence and abuse. Measures included patients’ views of God, religious practices such as prayer or church attendance, forgiveness, spiritual experiences, using religion or spirituality to cope, and existential meaning.

The study found that half of the measures of spirituality changed over the six-month study period, including daily spiritual experiences, the use of religious practices, forgiveness, positive use of religion for coping, and feeling of purpose in life.

“While people’s actual beliefs don’t seem to change during recovery, the extent they have spiritual experiences, and are open to spirituality in their lives, does change,” said lead researcher Elizabeth A.R. Robinson, Ph.D. “This effect was also independent of their participation in Alcoholics Anonymous which has a strong spiritual aspect.”

Use of alcohol also declined, with 72 percent of participants successfully avoiding heavy drinking for the six-month study period. Participants whose spirituality increased were less likely to drink heavily, researchers found.

Reference:: Robinson, E.A.R., Cranford, J.A., Webb, J.R., Brower, K.J. (2007) Six-Month Changes in Spirituality, Religiousness, and Heavy Drinking in a Treatment-Seeking Sample. J. Stud. Alcohol Drugs, 68(2): 282-290.

Spiritual Connections: How to Find Spirituality Throughout All the Relationships in Your Life by Sylvia Browne Read more about this title…

Slogans for everyday life and the ethical practices of Alcoholics Anonymous

Alcoholics Anonymous has developed an oral tradition for teaching people to alter their relation to their own desires and their own freedom fundamentally, teaching that is done through practice rather than through ideas.

Our study of AA’s innovative organisational tools for building long-lasting mutual-help groups shows that the same tools that build the organisation also exemplify and embody the organisation’s ethical worldview.

To that extent, AA’s group practices are worth studying not only from the point of view of learning about bottom-up, non-expert-led networks but also to shed light on the development of a popular pragmatist ethics in which little techniques – anonymity, the focus on the 24-hour cycle, etc. – deconstruct the Kantian distinction between means and ends.

This study of the everyday ethics of AA members argues that AA’s unique role in the history of popular ethical practices can be traced to several original features.

• First, AA incorporates elements of the disease model of alcoholism while remaining fundamentally a spiritual programme, thus mapping an important hybrid terrain often ignored by students of medicalisation.
• Secondly, AA was able to steer away from the political controversies about temperance, prohibition, and control of alcoholic beverages that had made the old temperance movement founder.
• Thirdly and most importantly, AA uniquely managed to combine the once-in-a-lifetime experience of total transformation that is characteristic of religious conversion with the development of a series of slogans and mental techniques for dealing with the ‘trivial’ details of life.

This paper first outlines the hybrid terrain of AA, between medicine and religion, and then examines a few of the techniques that are at the core of AA’s success, including anonymity, the Higher Power, and the twenty-four hour cycle.

Valverde M. & White-Mair K. (1999), One Day At A Time and other Slogans for Everyday Life the Ethical Practices of Alcoholics Anonymous. Sociology (1999), 33:393-410