Alcoholics Anonymous (A.A.)

Any person who believes they may have a problem with alcohol. No one is turned away whether they identify as an alcoholic or not.

A.A. Preamble (Revised 2021*)

Alcoholics Anonymous (A.A.) is a fellowship of people who share their experience, strength, and hope with each other that they may solve their common problem and help others to recover from alcoholism. The only requirement for membership is a desire to stop drinking. There are no dues or fees for A.A. membership; we are self-supporting through our own contributions. A.A. is not allied with any sect, denomination, politics, organization, or institution; does not wish to engage in any controversy, neither endorses nor opposes any causes. Our Primary Purpose is to stay sober and help other alcoholics to achieve sobriety.

*The A.A. Preamble was revised in 2021 to replace the words “men and women” with “people” in the first sentence of the Preamble. The revision was approved through advisory action at the 71st General Service Conference annual meeting held online over April 17 to April 25, 2021.

Any A.A. Literature referenced on this Website, is a Copyright of Alcoholics Anonymous World Services, Inc.

Alcoholics Anonymous

• Agency/Affiliation: A. A. World Services, Inc.
• Website: http://www.aa.org
• Phone: (212) 870-3400

The goal of Alcoholics Anonymous is:

• Obtain sobriety, freedom from alcohol

The essential components of Alcoholics Anonymous (A.A.) include:

• The Twelve Steps of Alcoholic Anonymous (A.A.) for the individual:
• We admitted we were powerless over alcohol—that our lives had become unmanageable.
• Came to believe that a Power greater than ourselves could restore us to sanity.
• Made a decision to turn our will and our lives over to the care of God as we understood Him.
• Made a searching and fearless moral inventory of ourselves.
• Admitted to God, to ourselves and to another human being the exact nature of our wrongs.
• Were entirely ready to have God remove all these defects of character.
• Humbly asked Him to remove our shortcomings.
• Made a list of all persons we had harmed, and became willing to make amends to them all.
• Made direct amends to such people wherever possible, except when to do so would injure them or others.
• Continued to take personal inventory and when we were wrong promptly admitted it.
• Sought through prayer and meditation to improve our conscious contact with God, as we understood Him, praying only for knowledge of His will for us and the power to carry that out.
• Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics, and to practice these principles in all our affairs. [Copyright 1952, 1953, 1981 by Alcoholics Anonymous Publishing (now known as Alcoholics Anonymous World Services, Inc.) All rights reserved. Service Material from the General Service Office, New York. The Twelve Steps are explained in the book Alcoholics Anonymous. www.aa.org Rev. 11/21 SM F-121]
• The Twelve Traditions of Alcoholics Anonymous (Short Form) for the group (used at each meeting of A.A.)
• Our common welfare should come first; personal recovery depends upon A.A. unity.
• For our group purpose there is but one ultimate authority—a loving God as He may express Himself in our group conscience. Our leaders are but trusted servants; they do not govern.
• The only requirement for A.A. membership is a desire to stop drinking.
• Each group should be autonomous except in matters affecting other groups or A.A. as a whole.
• Each group has but one primary purpose—to carry its message to the alcoholic who still suffers.
• An A.A. group ought never endorse, finance, or lend the A.A. name to any related facility or outside enterprise, lest problems of money, property, and prestige divert us from our primary purpose.
• Every A.A. group ought to be fully self-supporting, declining outside contributions.
• Alcoholics Anonymous should remain forever nonprofessional, but our service centers may employ special workers.
• A.A., as such, ought never be organized; but we may create service boards or committees directly responsible to those they serve.
• Alcoholics Anonymous has no opinion on outside issues; hence the A.A. name ought never be drawn into public controversy.
• Our public relations policy is based on attraction rather than promotion; we need always maintain personal anonymity at the level of press, radio, and films.
• Anonymity is the spiritual foundation of all our Traditions, ever reminding us to place principles before personalities. [Copyright 1952, 1953, 1981 by A.A. Grapevine, Inc. and Alcoholics Anonymous Publishing (now known as Alcoholics Anonymous World Services, Inc.) All rights reserved. A summary of the Twelve Traditions can be found in the appendices of the book Alcoholics Anonymous. Rev. 11/21 www.aa.org SM F-122 Service Material from the General Service Office]
• Other aspects of meetings:
• Typically, an A.A. group will have a Secretary, a Treasurer (room rental, coffee, donations to General Service Board in New York, A.A. literature, etc.), and maybe a Literature person.
• Groups can be started on their own by following the manual, commonly called the Big Book.
• At "open meetings," speakers tell how they drank, how they discovered A.A., and how its program has helped them. Members may bring relatives or friends, and usually anyone interested in A.A. is also welcome to attend "open meetings."
• "Closed meetings" are for alcoholics only. These are group discussions, and any members who want to may speak up, ask questions, and share their thoughts with fellow members. At "closed meetings," A.A. members can get help with personal problems in staying sober and in everyday living. Some other A.A. members can explain how they have already handled the same problems — often by using one or more of the Twelve Steps.
• For information as to how A.A. operates as a whole, please see the Twelve Concepts for World Service (Long Form).

Adult Services

Alcoholics Anonymous (A.A.) directly provides services to adults (regardless of whether they are parents or caregivers) and addresses the following:

• Problems with alcohol

Recommended Intensity

On average across the board, an hour to an hour and a half – 5-minute coffee break – Fellowship before and after depending on room constraints

Recommended Duration

It is based on one’s own personal journey.

Delivery Settings

This program is typically conducted in a(n):

• Community Daily Living Setting
• Community-based Agency / Organization / Provider
• Group or Residential Care
• Hospital
• Justice Setting (Juvenile Detention, Jail, Prison, Courtroom, etc.)
• Outpatient Clinic
• Shelter (Domestic Violence, Homeless, etc.)
• Virtual (Online, Smartphone, Zoom, Telephone, Video, etc.)

Homework

This program does not include a homework component.

Languages

Alcoholics Anonymous (A.A.) has materials available in the following languages other than English:

• French
• Spanish

For information on which materials are available in this language, please check on the program's website or contact the program representative (contact information is listed in this page).

Local meetings are available around the world and have meeting materials available in local languages.

Resources Needed to Run Program

The typical resources for implementing the program are:

In countless locations, there are A.A. Central/Intergroup offices that provide A.A. literature (books, pamphlets, etc.) and a list of local A.A. meetings. These offices are usually run by one paid employee/manager and supported by volunteer staff.

Prerequisite/Minimum Provider Qualifications

No education requirements – a person does not even have to know how to read to run an A.A. meeting. However, only A.A. fellowship members deliver/discuss the recovery process of Alcoholics Anonymous.

Manual Information

There is a manual that describes how to deliver this program.

Program Manual(s)

Manual details:

• Alcoholics Anonymous World Service. (2001). Alcoholics Anonymous: The story of how many thousands of men and women have recovered from alcoholism (4th ed.). Author.

The manual, often called The Big Book, can be purchased from many sources listed here: https://www.aa.org/the-big-book#purchase-options

Training Information

There is no training available for this program.

Pre-Implementation Materials

There are no pre-implementation materials to measure organizational or provider readiness for Alcoholics Anonymous.

Formal Support for Implementation

A.A. has an upside-down pyramid structure with the members/local groups on the top of the organization and the General Service Board at the bottom of the organization. There is support for the groups at all of the levels below them including the Group General Service Reps, Districts, Area Assemblies, the General Service Conference, and the General Service Board. There is a Group Handbook and other toolkits available on the A.A. website.

Fidelity Measures

There are no fidelity measures for Alcoholics Anonymous.

Established Psychometrics

There are no established psychometrics for Alcoholics Anonymous.

Fidelity Measures Required

No fidelity measures are required for Alcoholics Anonymous.

Implementation Guides or Manuals

There is an A.A. resource called The A.A. Group…where it all begins which is available at https://www.aa.org/sites/default/files/literature/P-16_0624.pdf.

Implementation Cost

There are no studies of the costs of Alcoholics Anonymous.

Research on How to Implement the Program

Research has not been conducted on how to implement Alcoholics Anonymous.

Child Welfare Outcome: Child/Family Well-Being

"What is included in the Relevant Published, Peer-Reviewed Research section?"

Two meta-analyses, see citations following, have also been conducted on Alcoholics Anonymous (A.A.) though these articles are not used for rating and therefore are not summarized:

• Tonigan, J. S., Toscova, R., & Miller, W. R. (1996). Meta-analysis of the Alcoholics Anonymous literature: Sample and study characteristics moderate findings. Journal of Studies on Alcohol, 57(1), 65–72. https://doi.org/10.15288/jsa.1996.57.65
• Kownacki, R. J., & Shadish, W. R. (1999). Does Alcoholics Anonymous work? The results from a meta-analysis of controlled experiments. Substance Use and Misuse, 34(13), 1897–1916. https://doi.org/10.3109/10826089909039431

• Moos, R. H., & Moos, B. S. (2005). Sixteen-year changes and stable remission among treated and untreated individuals with alcohol use disorders. Drug and Alcohol Dependence, 80(3), 337–347. https://doi.org/10.1016/j.drugalcdep.2005.05.001

  Type of Study: Pretest–posttest study with a nonequivalent control group (Quasi-experimental)

  Number of participants: 461

  Population:

  • Age — No Help: Mean=32.6 years; A.A.: Mean=33.3 years; Professional Treatment: Mean=33.9 years
  • Race/Ethnicity — No Help: 79% Caucasian; A.A.: 86% Caucasian; Professional Treatment: 79 % Caucasian
  • Gender — No Help: 39% Female; A.A. Only: 55% Female; Professional Treatment: 53% Female
  • Status — Participants were previously untreated individuals with alcohol-use disorder seeking treatment via and information and referral center or detox program.

  Location/Institution: Not specified

  Summary:

  The purpose of the study was to examine changes over a 16-year interval and predictors of stable remission among previously untreated individuals with alcohol-use disorders who did not obtain help or who entered either Alcoholics Anonymous (A.A.) or professional treatment in the first year after initially seeking help. Participants were divided into three groups: Those who did not enter treatment, those who attended A.A. only, and those who sought professional treatment and attended A.A. Measures utilized include the Situational Confidence Questionnaire, the Life Stressors and Social Resources Inventory, and the Coping Inventory. Results indicate that significantly more individuals in the A.A. and treatment group exhibited stable remission than in the untreated group (42.3% versus 24.2%). However, those who entered A.A. or treatment 1 year after initial referral or detox (delayed treatment group) did not show better remission rates than untreated individuals. Limitations include nonrandomization of participants, reliance on self-reported measures, and lack of data on the process and content of treatment.

  Length of controlled postintervention follow-up: 16 years.

• Moos, R. H., & Moos, B. S. (2006). Participation in treatment and Alcoholics Anonymous: A 16-year follow-up of initially untreated individuals. Journal of Clinical Psychology, 62(6), 735–750. https://doi.org/10.1002/jclp.20259

  Type of Study: Pretest–posttest study with a nonequivalent control group (Quasi-experimental)

  Number of participants: 461

  Population:

  • Age — No Help: Mean=32.6 years; A.A.: Mean=33.3 years; Professional Treatment: Mean=33.9 years
  • Race/Ethnicity — No Help: 79% Caucasian; A.A.: 85% Caucasian; Professional Treatment: 79% Caucasian
  • Gender — Not specified
  • Status — Participants were previously untreated individuals with alcohol-use disorder seeking treatment via an information and referral center or detox program.

  Location/Institution: Not specified

  Summary:

  The study used the same sample as Moos & Moos (2008). The purpose of the study was to examine duration of participation in Alcoholics Anonymous (A.A.) or professional help in previously untreated individuals with alcohol-use disorders. Participants were divided into three groups: Those who did not enter treatment, those who attended A.A. only, and those who sought professional treatment. Measures utilized include the Situational Confidence Questionnaire, the Life Stressors and Social Resources Inventory, and the Coping Inventory. Results indicate that for both the treatment and A.A.-only groups, participating in 27 weeks or more of treatment or A.A. involvement resulted in significantly better outcomes at 16 years in relation to those who remained untreated. Statistical analysis also showed that for the treatment group, additional participation in A.A. resulted in improved outcomes, over and above treatment alone. Limitations include nonrandomization of participants, obtained information only on 6-month windows of alcohol-related outcomes at each follow-up, and lack of data on the content of treatment.

  Length of controlled postintervention follow-up: 16 years.

• Kaskutas, L. A., Bond, J., & Avalos, L. A. (2009). 7-year trajectories of Alcoholics Anonymous attendance and associations with treatment. Addictive Behaviors, 34(12), 1029–1035. https://doi.org/10.1016/j.addbeh.2009.06.015

  Type of Study: Pretest–posttest study with a nonequivalent control group (Quasi-experimental)

  Number of participants: 586

  Population:

  • Age — Mean=34 years
  • Race/Ethnicity — 31% Black, 9% Other, and 6% Hispanic
  • Gender — 33% Female
  • Status — Participants were adults in treatment for alcohol dependency who were recruited from ten public and private programs.

  Location/Institution: Northern California

  Summary:

  The study examined follow-up data after participation in Alcoholics Anonymous (A.A.). The purpose of the study was to determine the relationship between A.A. treatment exposure and attendance. Participants were divided into 4 groups: a low A.A. group (averaging fewer than 5 meetings at most follow-ups), a medium A.A. group (about 50 meetings a year at each follow-up), a descending A.A. group (about 150 meetings year 1, then decreasing steeply), and a high A.A. group (about 200 meetings at 1 year, then decreasing gradually by year 7). Measures utilized include the Diagnostic Interview Schedule for Psychoactive Substance Dependence-DSM-IV, Addiction Severity Index (ASI), AA Affiliation Scale, and the Religious Beliefs and Behaviors Scale. Results indicate that for all four groups, A.A. attendance increased from baseline to the year 1 follow-up, with the increase steepest for the high A.A. and descending A.A. groups. From there, it decreased, except for the medium A.A. group whose attendance levels remained stable. Treatment did not strongly correlate with A.A. meeting trajectories, although the low A.A. group tended to have the lowest treatment rates over time. Limitations include lack of randomization, lack of control group, and missing data on the following: treatment, A.A. attendance, and alcohol consumption during years 2, 4, 6, and 7.

  Length of controlled postintervention follow-up: 7 years.

• Humphreys, K., Blodgett, J. C., & Wagner, T. H. (2014). Estimating the efficacy of Alcoholics Anonymous without self‐selection bias: An instrumental variables re‐analysis of randomized clinical trials. Alcoholism: Clinical and Experimental Research, 38(11), 2688–2694. https://doi.org/10.1111/acer.12557

  Type of Study: Randomized Controlled Trial - Secondary data analyses from 5 existing randomized controlled trials

  Number of participants: 2,356

  Population:

  • Age — 35–55 years
  • Race/Ethnicity — 80% Non-Hispanic White, 13% Black, 6% Hispanic, and 2% Other
  • Gender — Pooled Sample: 72% Male; MATCH Sample: 80% Male
  • Status — Participants who participated in the Alcoholics Anonymous program.

  Location/Institution: Not specified

  Summary:

  The study utilized information from The National Institutes of Health RePORTER interface to employ an innovative statistical technique to derive a selection bias-free estimate of Alcoholics Anonymous (A.A.) impact. Six data sets from 5 randomized trials of A.A. facilitation interventions were analyzed using instrumental variables models (1 with 2 independent parallel arms). Results indicate that for most individuals seeking help for alcohol problems, increasing A.A. attendance leads to short- and long-term decreases in alcohol consumption that cannot be attributed to self-selection. However, for populations with high preexisting A.A. involvement, further increases in A.A. attendance may have little impact. Limitations include trials differed in sample size and inclusion/exclusion criteria

  Length of controlled postintervention follow-up: Varied by study.

• Alcoholics Anonymous World Services, Inc. (1972). A brief guide to Alcoholics Anonymous. Retrieved from http://www.aa.org/pdf/products/p-42_abriefguidetoaa.pdf

• Krentzman, A. (2007). The evidence base for the effectiveness of Alcoholics Anonymous: Implications for social work practice. Journal of Social Work Practice in Addictions, 7(4), 27-48. https://www.tandfonline.com/doi/abs/10.1300/J160v07n04_03