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AA and Other Twelve Step Groups - Cults

Total Posts:  62
Joined  01-10-2006
26 December 2006 13:06

Well, does it matter if AA is a religion or not? For people outside AA it might, but not for people inside it. As to the “recovery rate,” even if it is only 2%, that is still better than 0%. The next thing is, AA has been working since 1935, much longer than any other treatment for any physical/psychological malady has. The fact that it has been effective for millions, for decades, must mean that it has something going for it.

Finally, the Traditions state that AA is “not affiliated with any sect, denomination, politics, organization, or religion.” While you may still argue that this means that AA is a religion unto itself, apart from all others, the meaning and practice clearly shows otherwise. AA will stand or fall despite what any of us here say, but my point is that if it works, it works. If a person drowning in Hurricane Katrina last year were pulled out of the raging water by someone on shore, do you really think that that person would first stop to ask the “religion” of the rescuer? 

Total Posts:  540
Joined  22-11-2005
26 December 2006 23:03

Thank you Pete.  I too have attended many AA meetings but only to get my mother interested in sobriety.  I never did drink as I saw what it did to my mother and all 4 of her brothers.  It was amazing that the entire family was strickened with this terrible disease.  UCLA did a history of the family back in the early 50s.  I was told at the age of 20 that it could be an interited weakness and I should watch out for it.

I did some social drinking until my mother finally died trying to light a cigarette and lit her gown on fire.  She had been drinking for several days and at 72 could not function at all.  It also hit me that my father had been drinking at a party and drove off Sunset Boulevard to his death at the age of 39.  How much more did I need? 

My mother had married two alcoholics after that and there was a lot of violence in our home.  I finally moved in with my grandmother for my own sanity.  I went to a boarding school and never again spent a night under my mother’s roof.  I married and had some kids and although we tried to get my mother involved in our lives, she seldom had a sober day.  I made it clear to my own kids that unless they were very careful they too could end up like their grandmother.  By that time all her brothers were dead of alcoholism.  My cousins went from alcoholism to drug addiction, which was carried down to their children.  It is worse than cancer due to the fact that it is often spread through social activities.

It is sad that alcohol is involved in all celebrations and is used to ease one through disasters.  When the kids went off to college, and my mother died, I moved out of the city where we all were born.  I was the third generation to be born in Santa Monica and I could not wait to get out of the area.  I have never forgiven my mother for leaving my 3 kids with the impression that she was nothing but a drunk; either coming off a drunk or heading into one.  Raising kids to become proud of being humans with superior brains over the animal world is tough enough without seeing members of the family passed out somewhere.  Yes, I am bitter as hell!  I approached the problem and told them the choices would always be theirs to make.  So far, so good.

Total Posts:  10
Joined  23-11-2006
27 December 2006 03:55

[quote author=“Ellecram”]Whim - Have you read any of the AA Horror stories that Ken Ragge and Rebecca Fransway have published?

If not - here is a link to the website that allows you to read them free.


This website also has an interesting article on the cult aspects of AA written by Devin Sexon -

Mind Control Tactics Of Alcoholics Anonymous
by Devin Sexson
June 2002                     http://www.morerevealed.com/dev_art.jsp

I’ve not read the Ragee/Fransway publications as yet.  However,  I am aware of the many controversies concerning AA and the cult issue(s). 

I’ve long followed Steven Hassan’s research and information, as well as the BITE Model for mind control and Mr. Hassan’s resource page contains balanced information and links to secular alternatives to twelve step programs for those facing alcoholism:

The cult aspect of AA was not the issue I was addressing:  Ralphcox’s posed the question “does AA work?”  To which he incorrectly answered no.  He then further supported his erroneous answer with data he twisted.

The AA 12-step method does indeed work for a great many people, and to falsely claim it doesn’t is simply irresponsible.

Total Posts:  10
Joined  23-11-2006
27 December 2006 04:43

For clarity; I want to add one more thing regarding the percentages that have been quoted off & on in this thread.  This is from the March 2006 Cochrane Database regarding AA’s effectiveness: 

Source: http://www.cochrane.org/reviews/en/ab005032.html

The Cochrane Database of Systematic Reviews 2006 Issue 4
Copyright © 2006 The Cochrane Collaboration. Published by John Wiley and Sons, Ltd.

Date of last Subtantial Update: March 20. 2006

Plain language summary:

Alcoholics Anonymous (AA) is self-help group, organised through an international organization of recovering alcoholics, that offers emotional support and a model of abstinence for people recovering from alcohol dependence using a 12-step approach.

As well as AA, there are also alternative interventions based on 12-step type programmes, some self-help and some professionally-led. AA and other 12-step approaches are typically based on the assumption that substance dependence is a spiritual and a medical disease. The available experimental studies did not demonstrate the effectiveness of AA or other 12-step approaches in reducing alcohol use and achieving abstinence compared with other treatments, but there were some limitations with these studies. Furthermore, many different interventions were often compared in the same study and too many hypotheses were tested at the same time to identify factors which determine treatment success.

Even the Cochrane report states there has been numerous limitations within the studies that have made them indeterminate. 

At this point, know one really knows how effective or uneffective AA’s 12-step program actually are because no clear studies of effectiveness having been preformed.  Thus it’s irresponsible to conclusively state current percentages of effectiveness as indisputable facts;  at best they should be stated as limited results and not reflecting the true effectiveness of any particular program.

Total Posts:  1284
Joined  21-12-2004
27 December 2006 08:40

At this point, know one really knows how effective or uneffective AA’s 12-step program actually are because no clear studies of effectiveness having been preformed. Thus it’s irresponsible to conclusively state current percentages of effectiveness as indisputable facts; at best they should be stated as limited results and not reflecting the true effectiveness of any particular program.

Oh boy, I couldn’t agree more!  The reason behind this is actually quite simple, although the underlying causes are quite complex.  There is no group of people on the planet, I believe, more capable of lying to themselves and believing it then the addicted.

I believe that deep in the heart of even the most committed creationist is a small little voice that says:  “Yea, but what about all them bones?”  Not within an addict though, at least not ‘till all the tumblers click into place and they become willing to do something different for a change.

I know you could have put me on a polygraph a couple of days before I stumbled into AA, asked me about my drinking, and I would have beaten the machine.  I had two or three lives going, and a whole network of lies, and even lies about the lies.  Trouble is, I believed all of it!

That’s why the studies mean absolutely nothing.  Alcoholics lie!  Do you believe it?  The trick is to stay sober long enough (length varies from person to person) to see through the bullshit.  For me it was almost nine months ‘till I realized (quite suddenly and somewhat dramatically) that I was an alcoholic and could not drink successfully.

If a person reaches that point, almost anything will work, in my opinion, as long as one does not pick up a drink or drug.

There are some aspects of addiction that have parallels in religiosity, especially to ability to ignore mountains of objective evidence in order to maintain an absurd belief system.

How can you reduce such complex human processes to percentages?  I don’t think you can.  The physiological aspects of addiction, receptors, dopamine and all the rest, have been if not understood for some time, at least heavily researched and quantifiable results obtained.

What goes on in the mind of an addict, however, may be understood at some point, but is far more difficult to quantify.  Perhaps we will find some “magic bullet,” a one-size-fits-all recovery program, or perhaps a one-shot cure for religion, but we don’t have them yet.

Total Posts:  540
Joined  22-11-2005
27 December 2006 08:53

Good for you Pete.  I envy your family who saw you through your being able to heal yourself.  I tried hard for 50 years to try to cut through that devil that had my mother under control.  She would come out of the rehab hospital, I would drive her home and she would treat me as if nothing had happened.  Christmas, Thanksgiving, birthdays, Easter all were lost to her.  She ruined all my holidays and then tried to ruin my kids’ too.  I learned always to make alternative plans so they wouldn’[t be too disappointed.

Sounds as if you have your life under control.  I am giving you a standing ovation.

Total Posts:  10
Joined  23-11-2006
28 December 2006 12:14

FYI -  excerpts from on going research…

Source:  Eureka Alert Science News
Addiction, Parenting, Mental Health Section

Alcoholics Anonymous membership may decrease alcohol-related homicides

  * There is a strong association between alcohol use and violence.
  * New findings confirm a strong relationship between alcohol consumption and homicide rates, particularly among males who consume beer and spirits.
  * Conversely, as Alcoholics Anonymous membership increased, homicide levels decreased.

Studies consistently show a strong link between alcohol use and violence, such as homicide. New research that looks at the relationship among drinking, Alcoholics Anonymous (AA) membership, and homicide mortality has found that AA can have a beneficial effect on alcohol-related homicide mortality rates, particularly among males who consume beer and spirits.

Results are published in the October issue of Alcoholism: Clinical & Experimental Research.
—end excerpt

Alcoholism: Clinical & Experimental Research (ACER) is the official journal of the Research Society on Alcoholism and the International Society for Biomedical Research on Alcoholism. Co-authors of the ACER paper, “Alcohol Consumption, Alcoholics Anonymous Membership and Homicide Mortality Rates in Ontario 1968-1991,” were: Rosely Flam Zalcman, Reginald G. Smart, and Helen Suurvali of the Centre for Addiction and Mental Health; and Brian R. Rush of the Centre for Addiction and Mental Health as well as the Departments of Psychiatry and Public Health at the University of Toronto. The study was funded by the Centre for Addiction and Mental Health.


Alcoholics Anonymous and treatment seem to work best together

  * People with alcohol-use disorders who want to change their drinking habits tend to choose self-help groups, such as Alcoholics Anonymous (AA), or treatment.
  * New findings indicate that individuals who participate in professional treatment and AA together are most likely to achieve remission.

Most clinical studies examine individuals either during or immediately following treatment. A study in the October issue of Alcoholism: Clinical & Experimental Research tracks individuals for 16 years who have first acknowledged their alcohol-use problems and then chosen Alcoholics Anonymous (AA), treatment, or both. Findings indicate that people who become involved in both AA and treatment fare better than those who obtain only treatment.

“We know that self-help groups, such as AA, contribute to better alcohol-related and psychosocial outcomes,” said Rudolf H. Moos, senior research career scientist for the Department of Veterans Affairs Health Care System in Palo Alto, California, and corresponding author for the study. “For example, patients with alcohol use-disorders who participate in AA, and those who attend more meetings and/or participate for a longer time, are more likely to be abstinent and to maintain remission up to five years after an episode of professional treatment than patients who are not involved or less involved in such groups. Affiliation with AA also is associated with more self-efficacy and problem-solving coping skills, and better social functioning, which are linked to better alcohol-related outcomes.”
—end excerpt

Alcoholism: Clinical & Experimental Research (ACER) is the official journal of the Research Society on Alcoholism and the International Society for Biomedical Research on Alcoholism. The co-author of the ACER paper, “Paths of Entry into Alcoholics Anonymous: Consequences for Participation and Remission,” is Bernice S. Moos of the Center for Health Care Evaluation at the Department of Veterans Affairs, and Stanford University, in Palo Alto, California. The study was funded by the National Institute on Alcohol Abuse and Alcoholism, and the Department of Veterans Affairs Health Services Research and Development Service.


AA helps alcoholics stay abstinent over the long term

Individuals who were encouraged to cut down on their drinking by fellow Alcoholics Anonymous members were three times more likely to be abstinent a year after their first treatment for alcoholism, compared to individuals who received no support, a new study reports.

Individuals who received similar support from non-AA members, however, had nearly the same chance of being abstinent as if they had received no support at all, according to Lee Ann Kaskutas, P.D., of the Alcohol Research Group in Berkeley, Calif., and colleagues.

“This suggests that AA members offer types of social support that differ from those typically offered by nonmembers,” Kaskutas says.
—end excerpt

Health Behavior News Service: 202-387-2829 or http://www.hbns.org.
Interviews: Contact Lee Ann Kaskutas at 510-642-1751 or .(JavaScript must be enabled to view this email address).
Alcoholism: Clinical and Experimental Research: Contact Mary Newcomb at 317-278-4765 or .(JavaScript must be enabled to view this email address), or visit http://www.alcoholism-cer.com.


Finding sobriety, and saving money, through spirituality

  * Skepticism abounds regarding the role of “faith-based” groups in achieving and maintaining sobriety.
  * Yet treatment programs - both spiritual and cognitive-behavioral in approach - have the same inpatient costs and clinical outcomes.
  * One study found that spiritually oriented programs have lower post-discharge costs and a higher rate of abstinence.
  * Fellowship provided by faith-based groups may be the key.

Addiction treatment, like many other aspects of health care, does not entail a standard, paint-by-number approach. There exists a wide spectrum of treatment options. On one end lies the medical approach, such as cognitive-behavioral treatment. On the opposite end are “faith-based” initiatives such as Alcoholics Anonymous (AA) and Narcotics Anonymous (NA). A study in the May issue of Alcoholism: Clinical & Experimental Research evaluates the post-discharge health-care utilization and associated costs of these two very different types of approaches.
—end excerpt

The co-author of the Alcoholism: Clinical & Experimental Research paper was Rudolf Moos of the Center for Health Care Evaluation and Program Evaluation and Resource Center at the Veterans Affairs Palo Alto Health Care system, and the Department of Psychiatry and Behavioral Sciences at Stanford University School of Medicine.

The study was funded by the Department of Veterans Affairs Mental Health Strategic Health Group, and the Department of Veterans Affairs Health Services Research and Development Service.


Total Posts:  540
Joined  22-11-2005
29 December 2006 01:18

Very interesting information.  With the cooperation of parents who do not drink in front of their children and instead give the warnings of alcohol being addictive, we might have more success with all alcoholics. 

I’ve lived in the years of parental alcoholism and it did a ton of problems for me to be able to trust anyone.  I heard millions of promises that the drinking was over.  Anxiety was the downfall for my mother.  That feeling of looking forward to any celebration got her drinking and it was many years before I realized Mother’s Day was on a Sunday; it was Wednesday in our home when my mother got out of the drunk tank. 

Her anxiety made me afraid of holidays and birthdays.  I spent all my time at home in a book.  She was a beautiful and talented woman and when she hit 70 she looked like a bum living on the street.  When I was in boarding school, many of the girls had their mothers and fathers in and out of rehab drunk tanks.  We used to sit around and talk about the waste of their lives.  It was a school where all the movie star’s girls attended and it showed all of us that success, talent and money made no difference to an addict.  I believe the addiction comes from people who never had to use their brains for any reason.  They are usually well educated but not in critical thinking.  Many came from religious families where critical thinking is not encouraged.

I want to beg all of you to stay away from alcohol!  I celebrate with a cup of coffee which suits me just fine!  I do a lot of socializing and find that half the people attending will head for sparkling water or coffee too.

Total Posts:  5
Joined  25-12-2006
30 December 2006 04:22

[quote author=“zAZen”][quote author=“hampsteadpete”]What makes a religion a religion?  What is the minimum requirement?  Does a religion have to have a supreme god-figure, or is a set of dogma enough?


tend to take Alan Watts’ characterization: a religion is defined by the presence of three things: [list]1. The creed (a definitive proclamation of what is believed to be true);
2. The code (a set of rules governing behavior, morals and ethics based on the creed set forth previously); and (of course)
3. The cult (the authoritarian hierarchy of worshipful who enforce the previous two components).[/list:u]

That’s a rather limited explanation.
Here are the elements of religion.

1.Worship of a God Or gods

In AA that would be the higher power

2.System of ritual.

AA meetinggs almost always open with a prayer and close with a prayer.
Select readings are done from the Big Book and members then give testimonials.

3.Charismatic leader.

Christianity had Christ. AA has Bill Wilson

4.Sacred text

The AA bible is The Big Book

And of course loads and loads of dogma.



“On the face of it, this would seem to include TSGs like NA and AA. After all, TSGs do have a definitive proclamation of truth regarding a specific problem, such as addiction and alcoholism. However, this proclamation comes about as a result of collective experiences that have to no small extent been verified by medical science”

This statement is misleading. The disease concept of alcoholism was first proferred by Dr. Benjamin Rush at or about 1806. He declared alcoholism to be a disease without any proper scientific study or investigation. He also declared that criminal behavior was a disease as was being born black.


“(at least in terms of the symptoms and behaviors of the afflicted), NOT divine revelation.

With respect to “the code,” there are the 12 Traditions which govern how members of these groups are to interact with one another and how they interact with non-members. “

The traditions are meaningless in AA. Simply because there is no way to enforce them. And besides that most everyone I ever met in AA pretty much ignored them.


“This is somewhat problematic, as the Traditions are guidelines, not moral dictates. Interestingly, neither NA nor AA require that you stop using or drinking (respectively). Working the steps and living the program is entirely optional. You are not required to do either one if you do not find it necessary.”

I can see you are “a dyed in the wool” stepper from this statement. This is the palty excuse most AAcult members use to lure members into the program. They TELL them that belief is optional but they don’t mean it.
The only way to rise in the AA heirarchy is to adopt the dogma. Otherwise you are considered a second class citizen in the AA group.
And yes! Some are considered more equal than others once the meeting starts.

“Finally, we come to whether or not the members of a TSG constitute a cult.  While I acknowledge the experiences described by others as to the cult-like behavior of one group or another’s members, the fact is that nothing in any of the literature I have read, nor in the experiences I’ve heard recounted by others in these groups, suggests that it is at all appropriate to indoctrinate newcomers or behave toward them in such an aggressive and proselytizing manner.”

You obviously know very little about this subject. Step 12 REQUIRES the individual cult member to proselitize. If they don’t they are told they may drink again. Fear is a motivational force that is used with impunity in AA.

“In other words, these individuals who feel it is their moral duty to preach the gospel of (insert program here) have grossly misunderstood the purpose and intent of TSGs, and it is they, not the fellowships, who are in error. “

That statement is an outright lie. Nuff said

“As you point out, meeting attendance is encouraged, not required. You are not forcibly removed from your family or forced to stop talking to others outside the fellowship.”

Scientologists don’t forcibly remove people from their families. Does this mean they aren’t a cult? Your arguments are very weak and uninformed may I add.

“Furthermore, I seem to recall TSGs being very specific about the problem they address and the problems they do not. Neither NA nor AA pretend to have all the answers to all of life’s problems, and state very specifically and clearly that they do not. I challenge you to find any religion that does as much.”

So now you admit they are a religion?
You need to read the steps again. They are written in a nebulous manner.
They are very unspecific if anything. But God is mentioned more times in the 12 steps than in the Ten Commandments.

AA first tells you that you have a terrible affliction that if left untreated will result in only three possible outcomes: Jail, insanity or death.

The old AA death threat. Heard it many times. It’s simply a cowardly fear inducing method to keep the cult members in line. it isn’t based on fact.

“TSGs relate common experience, they don’t “tell” you anything in the sense of a lecture or sermon. Sharing in meetings (when done appropriately) is of the “This is what happened to me” variety, not the “Let me tell you something, buster” variety. “

They testify just like those in the Baptist Church do. It’s a sneaky way of telling peole what to do. An typical with the dishonesty which which AA is riddled with.
But I thought AA wasn’t a religion? LOL

“I don’t see you denying that alcoholism or addiction are afflictions.”

They are behavioral problems not diseases.

“The AMA lists both as diseases, with particular symptoms and recommended regimens for treatment.”

Marty Mann politicized the disease issue and with the help of her organisation The Ncaad , whic is th political wing of AA,she twisted the arms of the AMA to admit it was a disease. It was voted on. As a matter of fact alcoholism was the only “disease” in the history of the AMA that required a vote. It won by consensus. That could be any figure over 50%.
In other words this argument is not valid.


” Religions, Christianity in particular, often describe these conditions in terms of being moral problems, TSGs do not.”

Another lie.
Steps 4 and 5 specifically deal with sin and AA founder Bill Wilson specifically states in the 12x12 that members should start their inventory process by looking at the 7 deadly sins.
You really need to do some homework here my friend.


“Neither NA nor AA, in my experience, have ever endorsed a viewpoint in which addicts or alcoholics were sinners in need of redemption. “

Wrong again. You have a very limited understanding of the steps.
The steps were primarily created for religious conversion. There is no requirement in any of the steps that one stop using alcohol. It’s the typical AA bait and switch.


“The phrase I’ve heard more often than I care to remember is, “We’re not bad people trying to be good; we’re sick people trying to get well.”“

More dogma and loaded language. Some of us refer to the use of sloagans as the language of non-thought. And they use this prpaganda and brainwashing technique with fervor in AA.
The idea that someone is “sick” forever is what keeps people coming back to meetings forever. They are told they can recover at first and then later told they will never recover. Another AA lie


You are then informed that in order to save yourself you must develop a relationship with a “power greater than yourself,” ‘cause you do not have the power yourself to overcome your affliction.  You are then taught a method that will arrest your affliction, and release you from the “obsession to drink” as long as you follow the steps and “work the program.”  You are encouraged to attend as many meetings as you possibly can, and estrange yourself from any former friends and family who are not supportive of your efforts.

“Actually, I believe the first step mentions only powerlessness and unmanageability, not “higher power.”

More dogma. One is not powerless over alcohol. But that’s simply common sense. Personally I never saw a bottle of booze that had arms and legs growing out of it and forced it’s contents down my throat.

The conclusion as to whether or not one is powerless over and unable to manage or control it is left entirely up to the individual, preferably after a rigorous, and dare I say scientific, investigation into the nature of one’s behavior in relation to this problem: when one used, where, how much, consequences of, efforts already made to stop, etc. You are an addict or an alcoholic if and only if you say you are; no one else can make that decision for you.

“The doctrine of original sin places Christians,”



if they buy into it, in the same position as the alcoholic entering AA for the first time.  Without “salvation,” to save them from this imaginary “affliction,” they will spend eternity in a lake of fire.  But wait, just accept jesus….. and you will be OK.

See previous. TSGs do not—ought not—to frame the problems of addiction and alcoholism as primarily moral problems.


Bill Wilson and Dr. Bob clearly believed that SIN was the main cause of alcoholism. Read the steps!


I guess the biggest difference is, AA addresses a real problem

This is a lie. AA has absolutely nothing to do with curing diseases especially imagined ones. If it does it’s just another pseudo science faith healing cure at best.
AA is all about religigious conversion. There is NO SCIENCE to support their claims.

where Christianity addresses an imaginary one with a solution involving an imaginary being.

Agreed. And I think we can agre that atheists can work the 12 steps and live by the traditions as well as the most die-hard book-thumpering fundie.

This is totally incorrect. You really need to read the steps.
They will not “work” without a belief in God.
But they don’t work anyways so who cares?

In AA’s favor, though, they don’t operate like any religion I know where money and power is concerned.  I think everyone in AA, from top to bottom, is driven by an honest desire to help as many alcoholics as possible, and the normal donation when the hat is passed is still the same as it was when I came in.

GSO claims AA has 60 million dollars in the bank as we speak. They are a powerful cult religion.

Agreed. Just because TSGs have some superficial similarities with religions doesn’t mean that TGS are religions.

welcome to the forum.

Thank you for responding. I enjoy these conversations. Here’s my question to you: do you think it possible for an atheist to work the 12 steps, inasmuch as there are a number of those that DO mention the “G-word?”

Total Posts:  26
Joined  26-12-2006
30 December 2006 13:25

I don’t think that AA is cultish.  For a while I attended a mental illness support group that was set up like AA and even used the same books.  It was a great help to me and the others involved.  A lot of my recovery came from being in that group and the personal reflection it entailed outside of the group.  Nothing lead me to believe that it was cultish.

Total Posts:  540
Joined  22-11-2005
31 December 2006 01:31

MsWitt.  AA worked for you but to many of us it is simply another attempt to alter your brain to follow them.  What ever it takes to make you feel normal or whatever was your problem.  It is very harmful to young people facing addiction as it removes their individual responsibility.  It seems that in America mind control has become a world all its own.  We drug the hell out of kids in school and at home we place our children in front of the most active mind control of all…..the television.

I became aware of this drug of mind control back in 1963 and removed my teleivion from our home and we spent the time reading and discussions of what we read.  We became addicted to Scrabble not Dowdy Doodie.  We worked puzzles (crossword and jig saw) and we never missed the television.  I was highly critized by many for making my kids different.  That was the whole purpose.

Today there are all kinds of drugs used to control the mind and brain.  Whatever works!

Total Posts:  10
Joined  23-11-2006
03 January 2007 07:01

[quote author=“MsWitt”]I don’t think that AA is cultish.  For a while I attended a mental illness support group that was set up like AA and even used the same books.  It was a great help to me and the others involved.  A lot of my recovery came from being in that group and the personal reflection it entailed outside of the group.  Nothing lead me to believe that it was cultish.

You are not alone.  New, ongoing research is showing the effectiveness of the these types of programs.  (Emphasis added by me)

January 2, 2007

American Journal of Preventive Medicine
Interviewing Technique Reduces Risk for Binge Drinking and Unplanned Pregnancies

Charlottesville, Va., Jan. 2, 2007 - A University of Virginia Health System researcher and colleagues have just published findings showing that just a few targeted counseling sessions had a notably positive impact on women at high risk for binge drinking, unplanned pregnancy, and exposure to alcohol during pregnancy. The counseling technique, called motivational interviewing (MI), has proven effective after just four counseling sessions. In addition, Karen Ingersoll, Ph.D., has won a grant for $1.9 million from the National Institutes of Health to study how this effective counseling technique works.

Ingersoll, a lead researcher in the UVa Department of Psychiatry and Neurobehavioral Sciences, and her colleagues found that a few nonjudgmental counseling sessions prompted women both to scale back risky drinking and practice more effective contraception. This study, called Project CHOICES, was designed to reduce the risk of alcohol-exposed pregnancy before conception, and was funded by the Centers for Disease Control and Prevention. The study took place at six sites in Virginia, Texas and Florida and enrolled 830 women from many different backgrounds.

The motivational intervention doubled the odds that binge-drinking women who were at risk for pregnancy would be successful in moving from the category of at-risk to low-risk for alcohol-exposed pregnancy. These findings, published in the American Journal of the Preventive Medicine, are noteworthy because it can be difficult for some women to reduce binge drinking, which can cause harm to their fetuses should they become pregnant.

“We demonstrated that using motivational counseling can have a major impact, even on behaviors that are considered difficult to change, such as binge drinking,” Ingersoll said. “While our main goal was to reduce the risk of alcohol-exposed pregnancy, ours was the first multi-site study to show that motivational counseling can be effective when targeting more than one health behavior, in this case, both drinking and contraception habits, among women who were not seeking help to change.”

The women, who were binge drinkers or frequent drinkers, volunteered to be in the study. All of the women were sexually active but not using reliable means to prevent pregnancy. They came from two high-risk samples in each of three cities, including Richmond, Va. During this randomized, controlled trial, the trained counselors used MI to express empathy with the individuals who come for counseling, manage resistance without confrontation, and support the self-confidence of the individual. They used counseling techniques such as open-ended questioning, reflective listening, summarizing, and affirming. Although the study targeted both behaviors (binge drinking and poor contraception use) associated with alcohol-exposed pregnancy, counselors were allowed to emphasize the target behavior favored by the participant.

Now Dr. Ingersoll and colleagues will use the new grant money to answer the question of why this form of counseling, brief as it is, can be so effective. To date, motivational interviewing research has found few links between the characteristics of the people being counseled (clients) and their outcomes.

Thus, the UVa team will look at other aspects of MI, using Project CHOICES’ audiotapes of therapy sessions and its outcomes dataset. The researchers will rate audiotapes to capture therapist and client behaviors and interpersonal interactions, and merge this process data with the existing dataset. They then will test a number of hypothesized mechanisms of action during motivational interviewing. The team plans to examine therapist behaviors, client behaviors, and interpersonal interactions; and evaluate their inter-relationships and their relationships to outcomes to unlock the secrets of MI.

“Our hope is to identify which aspects of this effective counseling style are most important and linked to the positive outcomes, so that we can create even more effective therapies to help people make healthy changes in problematic habits,” Ingersoll said.

This project could have an impact on public health if the researchers do uncover the components of MI that will have the best impact on clinical practice.  Once these components are identified, new, scientifically sound interventions could be developed for a range of health-threatening behaviors for people with chronic illnesses, including addictive disorders.

Total Posts:  12
Joined  05-10-2006
03 January 2007 08:40

Motivational interviewing and 12 step groups are two totally different treatment modalities.

Total Posts:  5
Joined  25-12-2006
07 January 2007 10:25

There has never been a properly run CONTROLLED scientific study that has shown AA to be any more effective than just quitting drinking on ones own..



Total Posts:  1284
Joined  21-12-2004
07 January 2007 14:18

There has never been a properly run CONTROLLED scientific study that has shown AA to be any more effective than just quitting drinking on ones own..

It’s even worse than that, Ralph.  As far as I know there has never even been an improperly run, uncontrolled, unscientific study run.

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