CHAPTER 35
Support Groups to Promote and Sustain Recovery
LEARNING OBJECTIVES
After studying this chapter, students should be able to:
•
35.1: Understand the history of support groups for recovery
•
35.3: Understand the purpose of the various support groups identified
•
35.5: Consider the effectiveness and challenges of 12-step and other
support groups
CHAPTER OUTLINE
The History of Alcoholics Anonymous
Elements of AA
A Breakdown of the 12 Steps
The Relationship Between Alcoholics Anonymous and Religion
One “A” Is for Anonymous
Alcoholics Anonymous and Outside Organizations
The Primary Purpose of Alcoholics Anonymous
Outcome Studies: The Effectiveness of Alcoholics Anonymous
Narcotics Anonymous
Other 12-Step Groups
Al-Anon
Alateen
Support Groups Other Than 12-Step Groups
Rational Recovery
Self-Management and Recovery Training (SMART)
Secular Organizations for Sobriety (SOS)
Women for Sobriety (WFS)
Moderation Management (MM)
LifeRing
Faith-Based Recovery Initiatives
Minority Group-Oriented Recovery Programs
Challenges to the Traditional 12-Step Movement
CHAPTER OVERVIEW
Self-help groups have, for better or worse, become part of the social environment in this
country. For every problem, there is probably a self-help group for those individuals who have
that condition. In this chapter, the self-help groups most commonly encountered in the
rehabilitation of individuals with SUDs will be discussed. We will also look at the major
challenges that have been raised about the use of such groups, and at the alternative groups
that have emerged.
DISCUSSION QUESTIONS
Break-Out Discussion #1:
Can you measure the effectiveness of 12-step groups? This question raises some interesting
issues, including the very definition of effectiveness. Consider the following hypothetical case: a
person who drank to the point of intoxication daily before joining AA, now only drinks to the
point of intoxication once a week after being a member of AA for 3 years. Contrast this person
Next, different AA groups are autonomous. If members of a certain AA group were to agree to
allow a researcher to ask for volunteers at a meeting for a research study and 50 people were to
volunteer to participate in the study, they may not be representative of all members of AA in
other parts of the country. Likewise, members of Narcotics Anonymous (NA) in Oregon may not
be the same as members of Narcotics Anonymous in Florida.
Questions
1. Of the two cases presented in the first paragraph, which (if either) would you consider to be a
success story for AA? How would you measure the effectiveness of AA?
2. Would a research study conducted on volunteers from an NA group in Florida be applicable to
members of NA groups in Oregon? How many differences between members of these
hypothetical groups might exist?
3. What differences exist between those who attend AA or NA voluntarily, and those who are
forced to attend? Does having both types of members in one group necessarily make the group
less effective? Could it make the group more effective?
4. What differences might exist between those who attend AA meetings online and those who
physically attend traditional 12-step groups?
5. Consider a hypothetical research study in which 50 members of a 12-step group volunteered
to be in the study. Would the fact that 30 of the volunteers were voluntary attendees while the
remainder were court-mandated attendees change the results of the study?
6. What do you think—Is AA effective? Can you defend your answer?
Break-Out Discussion #2:
Should AA and NA remain separate? The organization Alcoholics Anonymous was founded with
the intention of assisting those persons who were alcohol-dependent to stop drinking. However,
in the time since its inception, the world of substance misuse has changed. It is rare to find a
Questions
1. Has the world of substance misuse changed enough to make this differentiation meaningless?
Could you defend your answer?
2. Might a person who misused only alcohol require a different type of treatment from a person
who misused only narcotics? If so, is this distinction enough to warrant separate treatment
groups?
KEY CONCEPTS AND TERMS
LO/STANDARDS CORRELATION CHART
A-head
LO
Standard—CACREP
The History of Alcoholics
Anonymous
35.1:
Understand
the history of
support
groups for
recovery
1a: history and philosophy of the
counseling profession and its specialty
areas
Elements of AA
Narcotics Anonymous
Other 12-Step Groups
Support Groups Other
Than 12-Step Groups
35.2: Identify
the most
commonly
encountered
support
groups for
recovery
6f: types of groups and other
considerations that affect conducting
groups in varied settings
The Relationship Between
Alcoholics Anonymous and
Religion
One “A” Is for Anonymous
Alcoholics Anonymous and
35.3:
Understand
the purpose
of the various
support
groups
6f: types of groups and other
considerations that affect conducting
groups in varied settings
Outside Organizations
The Primary Purpose of
Alcoholics Anonymous
identified
Elements of AA
35.4: Review
the 12 steps
of AA
6f: types of groups and other
considerations that affect conducting
groups in varied settings
Outcome Studies: The
Effectiveness of Alcoholics
Anonymous
Challenges to the
Traditional 12-Step
Movement
35.5:
Consider the
effectiveness
and
challenges of
12-step and
other
support
groups
8a: the importance of research in
advancing the counseling profession,
including how to critique research to
inform counseling practice