Twelve-step programs have millions of recovering members worldwide, yet they’re often dismissed by academics. Why?
Many social scientists appear to be biased against the 12-step approach.12-step recovery should be acknowledged for its scale, reach, and effectiveness for millions of people. According to recent estimates, over two million people are currently in recovery in Alcoholics Anonymous worldwide.
This includes about 1.5 million people in the U.S. and over 500,000 abroad, with over 120,000 meetings per week. Narcotics Anonymous also has hundreds of thousands of members, and 12-step programs have been extended to various other mental and physical health conditions, such as gambling, obesity, compulsiveNevertheless, AA and NA are often criticized by social scientists, some of whom flatly reject the 12-step approach. In his 2014 book,, for example, Dr. Lance Dodes states bluntly that AA “simply doesn’t work,” citing a 5-10 percent success rate. Dodes goes on to claim that AA harms more people than it helps. Other critiques of 12-step programs abound, including their emphasis on powerlessness, their religious-spiritual focus, and their limited research base. AA members have even been described by academics as authoritarian, presumably because of their tightly structured program. Several critiques, including some written in the last five years, are impressionistic—something scientists are typically trained to avoid. In my 25 years as an academic psychologist, I witnessed these negative attitudes toward 12-step programs many times. During informal conversations, at scientific conferences, and in published research, AA was often viewed skeptically, for reasons I elaborate below. These views—now distributed widely across the internet—can lead people who need help to decide 12-step programs aren’t worth trying. After all, shouldn’t social scientists know best?—using the same methods, rules, and standards to address all scientific questions. Without internal consistency, one cannot be objective, something scientists pride themselves on and seek to apply in their work. Since one can always find conflicting results in social science, our task is to seek out and objectively interpret the most rigorous studies—those that use careful measurement, incorporate thorough follow-ups, and enroll large numbers of people.and Alcoholism launched Project Match—the largest, most rigorous treatment study of alcohol use disorder ever conducted. Over 1,700 patients were enrolled in either a 12-step-focused,were most likely to be sober a year later, at a rate similar to treatments for other psychological disorders and at least five times higher than Dodes claimed in 2014. Since then, several studies have confirmed better success rates for people with alcohol use disorder who attend AA versus those who don’t. Yet negative attitudes toward AA linger. Are social scientists biased against AA? Do some hold 12-step programs to higher standards than other treatments? Is their objectivity somehow compromised?Among academics’ chief criticisms of AA is its religious-spiritual orientation, which doesn’t appeal to some people. Scientists themselves aren’t a religious bunch. Over 90 percent of members of the National Academy of Sciences reject the notion of God, which begs the question of whether their personal beliefs impinge on their views of 12-step programs.There is, of course, nothing wrong with secularity, unless it supplants objectivity. A wealth of research from health psychologists shows that religious support, faith, andbolster recovery from illnesses of all kinds. Over 80 percent of Americans believe in God, and even non-believers can attend AA groups founded specifically for atheists and agnostics, which can be found in any sizable city and online.Yet most 12-step members have tried, usually again and again, to control their addictive behavior, with little success. In this context, working a 12-step programagentic. By relinquishing control over their addictive behaviors, members avoid those behaviors, gaining control over much broader swaths of life. Finally, social scientists are sometimes put off by the 12-step anonymity dictate, which makes studying the programs difficult. In their desire to be thoroughly objective, clinical scientists value unfettered access, observation, and data collection. Yet this isruns deep in our culture, and some members find anonymity essential, avoiding any meetings that are open to the public.Change is likely on the way. Influential social scientists like John Kelly at Harvard have championed 12-step programs based on objective comparisons to other approaches. Moreover, the emerging generation of psychological scientists, many of whom are just entering the job market, is highly committed to interventions that “scale up” and are readily delivered in community settings rather than in therapy offices. Few interventions can be delivered at anywhere near the scale and reach of 12-step recovery. Even so, there will always be critics of 12-step programs. After all, criticism is essential to progress, and neither 12-step recovery nor other approaches to treating substance use disorders help everyone. That said, such criticisms should avoid dismissing programs that work for millions of people. Far too many lives are at stake.Glassman, H. S., Moensted, M. L., Rhodes, P. et al. . Obvious benefits but hidden costs: A critical exploration of the impact of adopting the"master narrative" in Alcoholics Anonymous.Moos, R. H., & Moos, B. S. . Participation in treatment and Alcoholics Anonymous: A 16-year follow-up of initially untreated individuals.Kelly, J. F., Pagano, M. E., Stout, R. L., et al. . Influence of religiosity on 12-step participation and treatment response among substance-dependent adolescents.is a former professor of psychology at Ohio State University and Notre Dame. He’s now in clinical practice at Radically Open Connections and works with homeless residents of Columbus, Ohio, fighting addiction.Self Tests are all about you. Are you outgoing or introverted? Are you a narcissist? Does perfectionism hold you back? Find out the answers to these questions and more with Psychology Today.
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