Session number: 1111
Abstract title: Alcoholics Anonymous and Positive Treatment Outcomes: Cause or Effect
Author(s):
John McKellar, Ph.D. - Veterans Affairs and Stanford University Medical Centers
Palo Alto, CA
Eric Stewart, Ph.D. - Veterans Affairs and Stanford University Medical Centers
Palo Alto, CA
Keith Humphreys, Ph.D. - Veterans Affairs and Stanford University Medical Centers
Palo Alto, CA
Objectives: Alcoholics Anonymous (AA) self help groups are the most commonly sought form of alcohol treatment. However, few studies provide strong causal evidence for their effectiveness. The present study evaluated whether the association of AA involvement with reduced alcohol problems is causal or merely an epiphenomenon.
Methods: A group of 2319 alcohol dependent men were administered measures of motivation, alcohol use and negative consequences, and level of participation in AA at intake into inpatient substance abuse treatment units. These patients were successfullly located at 1-year and 2-year follow-up and administered all intake measures except those measuring motivation.
Results: An initial structural equation model indicated that 1-year post treatment levels of AA affiliation predicted alcohol impairment at 2-year follow-up while level of alcohol impairment at 1-year did not predict AA affiliation at 2-year follow-up. Additional structural equation models found that these effects were not due to the third variable effects of motivation or psychopathology.
Conclusions: The findings are consistent with the hypothesis that AA has a genuine causal effect on alcohol-related outcomes.
Impact statement: Findings of the current study provide strong evidence of a causal relationship between AA and positive alcohol treatment outcomes. It seems appropriate, then, to now focus research and clinical efforts on answering important questions such as why AA seems to work and how to facilitate the involvement of more alcohol-dependent patients into this organization or other self-help organizations.