How Alcoholics Anonymous Works

AA is founded on the assumption that shared experience and mutual support are necessary for recovery from addiction. In particular, AA proposes that sobriety is only possible by first acknowledging one’s inability to control one’s drinking, committing to a comprehensive overhaul of one’s identity and lifestyle, and assisting new members in their recovery.  

AA, as the prototype for many self-help groups, uses a core program based around 12 steps (see Box 11.1) that promote increased self-awareness and heighten a sense of meaning in life. Several studies have also suggested that AA-facilitated abstinence is partly due to an increase in self-efficacy. Another hypothesised mechanism through which AA is believed to work is by facilitating changes in the composition of an individual’s social network, specifically by increasing the number of pro-abstinence peers supportive of recovery.  

AA encourages new members to attend 90 meetings in 90 days, and many long-time members (10 years or more) still attend daily. Such meetings form the core of recovery by providing a non-judgmental environment that facilitates the open discussion of members’ difficulties and vulnerabilities. Generally, after attending several meetings, the new AA member is assigned a sponsor (mentor) who helps them work through the 12 steps. The sponsor has been through the AA recovery program and maintained sobriety for at least one year (usually much longer); the new member is also encouraged to contact their sponsor whenever necessary if additional support is needed between meetings. 

The program itself can be broken down into three main stages, namely: 

• First, the member must recognise that they are unable to control their drinking, and that they require help from a source greater than themselves to overcome the problem (Steps 1 to 3). It is important to note that the concept of God or a ‘higher power’ includes anything of a transpersonal nature that can be drawn on for strength, including the AA group itself.  
• The second phase develops self-awareness by asking the member to conduct an in-depth ‘moral inventory’, which is then used as the basis for ‘making amends’ (Step 8). This helps the member work through situations that could potentially trigger a relapse (Steps 4 to 10). 
• Finally, the member is encouraged to develop a sense of spirituality (Step 11) and purpose by assisting others achieve sobriety (Step 12).