Academic journal article Social Work

Making Meaning of Alcoholics Anonymous for Social Workers: Myths, Metaphors, and Realities

Academic journal article Social Work

Making Meaning of Alcoholics Anonymous for Social Workers: Myths, Metaphors, and Realities

Article excerpt

The meaning of the term "Alcoholics Anonymous (AA) varies, depending on how one sees oneself in relation to this increasingly popular mutual-help program for alcoholics. (The word "alcoholic" is used in this article to refer to someone dependent on alcohol, consistent with its use in the AA program.) Social workers have variously described AA as "a set of principles developed by alcohol-dependent men" (Nelson-Zlupko, Kauffman, & Dore, 1995), "a very successful model for self-help groups" (Borkman, 1989, p. 63), and disempowering to women (Rhodes & Johnson, 1994). Some feminists (Kasl, 1992) have dismissed it as another white, middle-class male organization that enjoins women to depend on "having a High Power, which is usually described as an all-powerful male God" (p. 150) and to follow one specific journey to recovery "as defined by privileged males" (p. 147). For other feminists, the meaning of AA is quite different; Covington (1994) saw it as a "model for mutual-help programs" within which "women can find the most powerful resources for healing" (p. 4). Some researchers have concluded that "without question AA involvement has been associated with vast numbers of alcohol-dependent individuals becoming abstinent for long periods of time" (Emrick, 1987, p. 421), although others have questioned whether it is even possible to assess the effectiveness of this organization in any kind of scientific manner ("Treatment of Alcoholism," 1996). Perhaps the greatest meaning of AA, from the vantage point of the individual sober member, is that "through its program he (she) attained sobriety" (Kurtz, 1979, p. 157).

Social workers may need more information about Alcoholics Anonymous to determine their own meanings and interpretations of the controversies surrounding this program. Although related disciplines have published many articles to inform their members about AA and about ways to use this organization to benefit their clients, a review of the literature reveals little recent information on this topic in social work journals. Sometimes the information that is offered is too limited, such as the statement in the recent NASW News article (Landers, 1996) that "the traditional Alcoholics Anonymous program, well-known as an effective recovery program for men, does not work as well for women, according to experts in the treatment field" (p. 3). This statement, which implies that AA is not very effective for women, does not identify the "experts" and does not take into account the steadily increasing membership of women in AA. In 1992, women under 30 constituted an estimated 43 percent of AA members, and women of all ages constituted an estimated 35 percent of members, compared with 30 percent in 1983 and 22 percent in 1968 (AA World Services, 1993).

This article addresses concerns about women and other criticisms social workers may have of AA by reframing the meaning of AA from an alternative treatment or service delivery model to an understanding of AA based on metaphor, using Rappaport's (1993) concept of "normative narrative communities" (p. 239). The article describes areas of program strength and potential barriers for social workers (and consequently for their clients) and reviews the research findings on the efficacy of this program.

We chose to focus on Alcoholics Anonymous for two reasons. First, it is the prototype for other mutual help groups that have adopted the 12 Steps and Traditions, and second, it offers help for the least exotic and most prevalent (except nicotine) - but very damaging - addiction. We draw from a variety of professional and personal experiences, including work with paraprofessional helpers, refugee women, disenfranchised people, and addicted individuals, and from years of sitting in many hundreds of AA meetings, as well as from an increasing body of literature dedicated to a deeper understanding of Alcoholics Anonymous. It should be understood that the authors do not and cannot speak for AA (AA literature on various topics can be obtained by writing to Alcoholics Anonymous, Box 459, Grand Central Station, New York, NY 10163). …

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