For Whom Is Alcoholics Anonymous Appropriate?

Based on the 12 traditions adopted by AA’s organisational body, the only requirement for membership of AA is a desire to stop drinking. Members are able to attend as many meetings as they wish, at no cost. Individuals who demonstrate a higher level of symptom severity are more likely to affiliate with AA. It is probable that AA’s adherence to the disease model of alcoholism enables an individual with alcohol dependence to relinquish the belief that controlled drinking is possible in their situation.  

AA also provides a new social network supportive of abstinence; for the patient who lacks such support in their home environment, this aspect of AA involvement plays an important role in relapse prevention. 

A common misconception concerning AA is that members need to be religious to benefit from the program. In a review of the mechanisms by which AA is thought to aid recovery, there was little evidence to suggest that AA’s specific practices or spiritual mechanisms play a significant role. Instead, recovery has been linked to common therapeutic elements that serve to improve coping skills, motivation, and perceptions of self-efficacy.  

Clinicians should explain that AA is not a religion and a belief in ‘god’ is not a requirement to attend or receive support through the fellowship. This may be particularly important for people of non-Christian faiths and atheists.  

The efficacy of AA for patients with mental health comorbidities depends on the nature and severity of the mental health problem, although there is evidence that attendance improves abstinence rates among these individuals. It is a common misconception that members of AA must not be using any psychoactive substances: as such, AA is suitable for patients taking prescribed medications for mental health disorders. 

A longer duration of AA attendance in the first year of treatment and sustained involvement across 2 to 8 years has been linked to better long-term outcomes, so continued AA participation should form part of any extended care plan. This will ensure the patient maintains a social network supportive of abstinence once formal treatment is over, and is particularly important for patients who have severe symptoms or low levels of social support outside of the therapeutic environment.