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by thedufer 3942 days ago
I have no axe to grind, other than a disdain for supporting emotional ties with poor statistics. I've never brushed with AA or alcoholism in any capacity. That said:

In Project MATCH [1] we learn that "twelve-step" (AA), cognitive behavioral therapy, and motivational enhancement therapy all have very similar results across a large number of measures.

We also find that CBT performs equivalently to "brief opportunistic intervention" (which goes under a variety of names, but takes a single 5-minute meeting), which is the minimum amount of treatment that we're ethically allowed to give alcoholics.

So it may work better than nothing (can't really study that), but there are much lower-touch methods that give equivalent results.

[1] https://en.wikipedia.org/wiki/Project_MATCH

[2] http://robinsteed.pbworks.com/w/file/fetch/52176344/Treatmen..., study by "Chick et al. (1988)"

1 comments

So which is it - is it a treatment with no benefits other than that which is attributable to selection bias, as you first claimed, or is it a high-touch treatment that performs similarly to CBT or other forms of therapy? You're moving the goalposts. The latter statement is perfectly valid, as AA is really just CBT dressed up with additional social support and a charitable aspect.

Why the focus on high-touch/low-touch? It doesn't cost anyone anything except for those who attend, and even those who do aren't obligated to spend anything. It does take up some time, but it is time that I enjoy spending.

I have undergone both CBT and yes, have attended AA. The former did not do much for me, the latter did. AA as practiced in my area is strongly remniscent of CBT, only with additional social support, which is helpful for recovering alcoholics who have likely either alienated most people or who have built social networks focused around substance abuse.

If you were to say that addiction is complicated and the right course of treatment is difficult to determine and efficacy is hard to measure, I certainly would agree.

> So which is it - is it a treatment with no benefits other than that which is attributable to selection bias, as you first claimed, or is it a high-touch treatment that performs similarly to CBT or other forms of therapy?

It is a high-touch treatment that performs as well as a 5 minute intervention, despite constant claims that it is better. In the post I originally replied to, you implied that you were comparing it to other methods rather than nothing, although it wasn't terribly clear.

> It doesn't cost anyone anything except for those who attend

The oft-claimed improvement of AA over other methods messes up our views on addiction, as well as the justice system for addicts. Our refusal to use drugs to fight addiction even though the science is quite clear stems from full-abstinence organizations, largely led by AA.