Galanter said that AA uses many of the psychosocial features that operate in any charismatic membership group: social cohesion through attendance at regular meetings; a belief system embodied in the book Alcoholics Anonymous; a behavioral program of action requiring an individual to practice the 12 steps; and an emphasis on cognitive change by altering habits and avoiding “people, places, and things” that serve as triggers for alcohol or drug use.
Galanter said that a feeling of “belonging” is essential to success in AA. “When joining a charismatic group, an individual experiences relief in distress in direct relation to how closely affiliated he or she feels with the group,” he noted.
He outlined seminal studies looking at variables associated with successful long-term sobriety. In one 2006 study of 628 alcoholics in the VA system, successful abstinence at 16 years was related to AA attendance but not to the quantity of medical treatment.
Two 2003 studies found that engagement in AA was not associated with prior motivation or religiosity. But interestingly, while spiritual beliefs at baseline did not predict abstinence at three-year follow-up, a “spiritual awakening” by three years was associated with three-times higher abstinence rates.
Wait. There’s evidence for the effectiveness of AA and twelve step facilitation? You mean it’s not just a cult bent on evangelizing others into magical group-think?
It begs the question, “Why is there so much professional hostility to the suggestion that twelve step facilitation is an important and evidence-based treatment strategy?”