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The AA pioneers (the first people to use a twelve step approach) were consistently well educated middle class or upper class men (in 1930s, most people seemed not to be considering the possibility that women might be alcoholic). The two founders, known as Dr. Bob and Bill W, were both devoted members of the Oxford Group, as were a very large number of the others who came into AA in the first three or four years.
These were men who had tried to stop drinking but felt powerless to do so. In many cases they were far from powerless in other situations. Once AA was available as a resource, they were not too powerless to turn up at an AA meeting, but for them “powerless over alcohol” resonated. The concept of being "powerless" as it relates to alcoholism or addiction is discussed extensively on another page.
Some other things that the earliest AA pioneers had in common were that they were almost all middle class or upper middle class Caucasian protestant male Christians whose only known addiction is alcohol. Almost every one of the AA pioneers was desperate for a way to stop drinking and quickly and strongly identified with the concept of powerlessness. Yes, AA and other twelve step groups have shown success with other addictions and other demographic groups (AA members would object to our comment that AA has success with other addictions; they would remind us that they are only about alcohol). The fact that AA had seemed to be a very effective resource to gain sobriety among people who had tried and failed repeatedly, but only people in this demographic, does not ensure that they will be just as effective in other demographics.
Understanding what is really at issue is made more complicated by the fact that rigorous outcome studies cannot be done on twelve step effectiveness because of the anonymity of the program. Some studies have been done but they are not the kinds of blind studies or studies with control groups needed to establish the level of scientific rigor usually required in health care, including mental health care, in order to establish validity. Our impression, based upon what we have experienced, what we have observed, and what we have read is that twelve step effectiveness does span many demographics, but not all. We do not understand it to be effective for Europeans in cultures such as France and Italy where moderate use of alcohol is universally accepted. AA groups do exist, but primarily for people from other cultures, such as Americans. We believe that twelve step resources are very useful within most other demographics, although sometimes not with everyone in that demographic.
We perceive greatest effectiveness with people who have actively struggled with trying to become sober on their own and have been frustrated by lack of success, and with people for whom the fellowship and expectations of a twelve step group are quite comfortable.
Practical application in selecting a treatment venue:
- Experience with the demographic
- Flexibility in method
More to come!!
Links to Twelve Step References on Other Websites:
- Alcoholics Anonymous -- Official Website
- Alcoholics Anonymous -- Wikipedia Listing
- Frank Buchman -- Founder of Oxford Group
- Oxford Group -- Wikipedia
- Sam Shoemaker -- Wikipedia
- Twelve Steps -- Simple List -- Official AA -- PDF
- Twelve Steps and Traditions -- With explanation, Official AA
- Twelve Steps (for people with no prior knowledge) -- Wikipedia
- Twelve Traditions -- Simple List -- Official AA -- PDF
Navigation Links Related to Substance Abuse and Addiction on this website:
- Back to Top
- Return to Introduction to this article.
- Return to Substance Abuse and Addiction (MSN)
- See Related article on Twelve Step Alternatives
- See Related article on The Destructive Battle over Recovery Methods
- See Related article on The History of Differences over Addiction Treatment
- See Related article on The Seven Challenges.
- See Related article on Motivational Interviewing, Stages of Change, Transtheoretical Model
- See Related article on Harm Reduction Model
Last Update December 5, 2017