Research has consistently demonstrated a link between participation in 12-step programs and better substance use outcomes, as well as psychological and social functioning. That means that people who are a part of 12-step groups have a better chance of remaining abstinent and functioning better in life than those who aren’t.
The downside is that many people aren’t fond of AA and they drop out over time. Scott Tonigan, PhD, of the University of New Mexico, a leading AA researcher, has concluded that between 55% and 80% of people with serious drinking problems stop attending AA meetings in less than a year. That being said, very few individuals are ever told about alternative support groups.
Some non 12-step recovery groups, also called mutual help groups, like Women for Sobriety, SMART Recovery, and LifeRing Secular Recovery, have been around for decades, but very little research has been done to compare their results with those of AA. A new study by the Alcohol Research Group (ARG), however, has been conducted to look into the efficacy of alternative recovery groups.
The Peer Alternatives in Addiction (PAL) Study
The PAL study is the first to follow people from several mutual help groups and compare aspects of their lives according to their primary recovery group, be it Alcoholics Anonymous, SMART Recovery, Women for Sobriety, or LifeRing Secular Recovery. The study involved over 600 people who had had an alcohol use disorder sometime during their lives. At the beginning and every 6 months after, participants completed surveys which included questions about how involved they were with their primary group, the severity of their drug or alcohol use, the problems they had with alcohol use, and alcohol abstinence.
In short, the study suggested that there are no differences in efficacy between 12-step groups and WFS, LifeRing, or SMART Recovery. There were some differences across the groups, though; when compared with 12-step members, the people who identified SMART as their primary group at the beginning of the study had much lower odds of abstinence and no alcohol problems across their follow-up periods. In the same way, participants affiliated with LifeRing showed much lower odds of complete abstinence across their follow-up periods. The researchers determined that the explanation for these findings could be that both these groups probably had different goals at the start of the study – specifically, compared to the other groups, these two were much less likely to endorse a lifetime goal of complete abstinence. After researchers statistically controlled for beginning recovery goals, the differences between the groups became insignificant.
This means that when beginning recovery goals aren’t accounted for, the outcomes were worse for SMART and LifeRing members, as compared to 12-step members. When accounting for the differences in beginning recovery goals, the outcomes are the same for every group, meaning that people with similar recovery goals had similar outcomes, regardless of what group they were attending.
A Similar Pattern
A lot of people who have overcome their substance abuse issues say that it helped them to make a commitment to themselves that they would abstain from drinking alcohol forever. While not a requisite for staying sober, most participants in the PAL study who swore off alcohol for the rest of their lives fared better than all those who didn’t.
Committing to never again drink alcohol has a stronger effect than promising yourself to only sometimes drink alcohol. However, people with less stringent goals most likely still benefit from participating in mutual help groups. The study suggests that being involved with a mutual help group and attending meetings, having a close friend or sponsor in the group, volunteering, all help with substance use, regardless of group choice.
Tom Horvath, PhD and former president of SMART Recovery, said “SMART allows participants to describe their own goals if they wish to. If they are not committed to abstinence, that’s fine, they are still welcome in the meeting. Participants feel less shame about recurrences and are willing to come to meetings earlier in their using careers.”
Spreading the Word
Although the results of the PAL study are very promising as far as alternatives to AA are concerned, it’s still just one study. More research is needed to confirm and extend what has been found so far. Hopefully, treatment providers will start taking notice of alternative mutual help groups and begin offering options to those who might not be inclined to participate in AA.