Home

Monday, January 4, 2010

An Anti-AA Standard Line Cut To Shreds

Here is an exchange with one of the world's leading opponents of the AA movement.

He has challenged anyone who can refute anything on the Orange site to do so.

So I did.
Orange
repeatedly circles his links to some page(s) where he claims an old AA triennial study shows AA has a 5% success rate. This analysis is completely false, but most of his anti-AA cultee's don't have the ability to think for themselves or do basic math and lap it up.



(Just so you know.....the population of 100% is represented after month 12 on the graph but the anti-AA's claim and probably really think it is represented before month 1. )

So here it is :










mikeblamedenial, on January 3rd, 2010 at 2:28 pm Said:
The five percent retention rate is valid. AA’s triennials in the US have always indicated it, and the Australian AA study from 1994 said the same thing. Dismissing it as made-up garbage is a dodge, as is your assertion that anything he says can’t be relied upon because

Five percent retention rates have always been the norm in AA. Lots of sources indicate that. Dismissing it as made-up garbage is just a dodge, despite your adamance and vitriole. Nowhere has it been accurately demonstrated as wrong. It has been explained away, poorly, but never convincingly shown to be incorrect. Doubt, mischaracterize and dismiss all you like, you disprove nothing.



Tony J, on January 3rd, 2010 at 3:33 pm Said:
AA triennial surveys have never indicated a 5% success rate.

Why do you claim it does ?
Are you just repeating what orange taught you ?

Like I said, that claim is enough to discredit your whole movement.




mikeblamedenial, on January 3rd, 2010 at 7:55 pm Said:

There is no “movement”, as far as I know. Deny it all you want, or rationalize it all you want. Cherry-pick it. Make up some new facts. It still won’t go away. AA has single-digit one year retention rates, and most likely, always has.


Tony J, on January 3rd, 2010 at 9:57 pm Said:

You have no proof of that.

It’s all just random numbers to suit your cause.

When there are actual studies (probably never) then we can talk retention rate and success rate statistics.

Since we don’t have any, anyone claiming statistics is either ignorant or dishonest…..or both.



mikeblamedenial, on January 3rd, 2010 at 10:15 pm Said:

No, we can talk about it for as long as you care to keep denying it. You are well-aware of the studies which have been cited repeatedly. Since you have no evidence to contradict AA’s own assertions, I will assume that you are either easily misled or blatantly dishonest.


Tony J, on January 3rd, 2010 at 11:32 pm Said:

AA doesn’t make any assertions through a controlled study.

It is not I who is easily misled or dishonest.

You’re analysis of the triennial study has been soundly refuted. And all it takes is common sense and basic math ability to see why your claims are wrong.

As I said, orange shows that he is either ignorant or dishonest by citing that 5% number. The fact that you follow him blindly doesn’t say much for your own reasoning skill.

BTW, repeatedly citing the wrong conclusion from the wrong studies is not proof of anything.

If you care to show me how the AA triennial studies show that there is a 5% retention rate and/or success rate, please do.

Otherwise your just showing me how eager you are to please your cult master
Orange.

I hoped to engage someone with the ability to think for themselves. So far, no dice here.


mikeblamedenial, on January 4th, 2010 at 1:24 am Said:

Common sense and basic math show exactly the opposite. For example, with bigbook sales at about one million copies/year for the last fifteen years or so, and a flat-lining membership during that same period, what other sensible conclusion is possible? Lots of people come into AA year after year, yet AA’s growth ended years ago. Most come in, look around, listen to folks like you and your pals for a minute, then hit the deck running as soon as they get their slips signed.
Here is a vid we did on the numbers awhile ago. BTW, exactly how are the numbers refuted, other than as shown in the vid? http://www.youtube.com/watch?v=n-IH07-BVxg


Tony J, on January 4th, 2010 at 1:58 am Said:

The AA triennial survey shows that 26% of people that were present in the first month are still there at the end of month 12.

That’s what the math shows.

You claim the retention rate is 5% because that is the number on month 12. Like I said, you can’t do basic math and have no reasoning skills.

Any educated person can show you where you’re wrong. Go ahead and take that graph to anyone who understands statistics and see what they tell you.

Go ahead, I dare you.

As far as Big Book sales, how does that indicate retention or success ? That’s just a measure of how many people are buying Big Books. If sales are down it might indicate that new membership is down, but what does that have to do with anything ?

mikeblamedenial, on January 4th, 2010 at 3:52 am Said:

We seem to have run out of room on your last post. Your assertion that 26% of those remaining after the first month will still be there at the end of one year is absolutely correct. What you failed to mention in your fun with numbers exercise is that the surveys indicate that 81% of the original pool have already left AA by the end of that first month. 26% of the remaining 19% once again yields slightly less than a 5% annual retention rate.

{{{Note Mike admits that my 26% is correct but erroneously claims that 81% have left by the end of month 1. He has no clue what the numbers actually represent. }}}


mikeblamedenial, on January 4th, 2010 at 12:53 pm Said:

If you have any complaints regarding its content, conclusions, and validity, or the qualifications of the authors, World Services in NY would be the ones to talk to.


{{{Mike is now passing the buck telling me World Services is responsible for his assertion. WTF ?? }}}

Tony J, on January 4th, 2010 at 9:31 pm Said:
Nope. 81 % have certainly not left AA by the end of the first month.

Only 19% have been represented at that point.

Tell me how 81 people can leave a room when there were onlyl ever 19 there to start with ?

Riddle me that Batman ??

Like I said, take the chart to someone you know understands statistics and ask them to explain it to you. You honestly don’t have a clue about what you are saying.

Reply
Tony J, on January 4th, 2010 at 9:39 pm Said:
BTW, World Services in NY is not misrepresenting the data. You are.

Hence I am asking you to defend what ‘you’ are saying.

Passing the buck will not get you off the hook.

You asked me to demonstrate something wrong on orange's site and I just have.

You loose. You aren’t smart enough to know it, but you do anyway. Sorry.

mikeblamedenial, on January 4th, 2010 at 9:42 pm Said:

One more time. The survey report indicates that fully 81% of all attendees leave within their first month. Deny it, justify it, malign it, impugn it, you still present nothing valid. You need to re-watch the video I so thoughtfully linked.

{{{Mike repeats the lie and claims I have not presented evidence to refute it.....WTF ? }}}

Tony J, on January 4th, 2010 at 10:00 pm Said:

No Mike. Just saying it over and over will not make it true.

The AA triennial survey does, in no way, indicate that 81% of attendee’s have left after the first month.

Do you care to explain why you think it does ?

26 comments:

  1. So the upshot is;

    75% success rate for those who really try, bitches!

    ReplyDelete
  2. Does creating and anti-AA website and posting youtube videos count as trying......does it....really ??

    ReplyDelete
  3. Sick people like to remain sick and they want followers.

    I'll admit, I've spent a bit of time on the internet over the last 9 months observing what people think about A.A.

    Since 1994, I've been able to differentiate MOTR from the actual Program, but I didn't really know where it all came from... other than treatment centers. Now I'm starting to think that maybe it was sabotage from the get go.

    The program of Alcoholics Anonymous say we have to concede to our inner most self that we are alcoholic. We cannot concede to ANYTHING if we don't know what it is. Most people don't. Sadly, most people don't know in many meetings I've been to. They think they are alcoholic because they hit a bottom, or got a D.U.I., or got divorced, or lost a job, or are lonely and depressed, or or or...

    They never talk about their current experience on lack of power being their dilemna or that our problem centers in the mind and is rooted in self, and we need Power to live.

    Be an Atheist if you want. Just shut your fucking mouth and get on with it. You can go play Pickup Sticks with your butt-cheeks while we meditate, but don't talk to us about it. We've moved on... so should you.

    My bro says that "Atheism must be the new Gay". Come out the closet. But just shut up about it. If it serves you, great! We're happy for you. Really.

    ReplyDelete
  4. Dangit! I can't post over there so I'll post it here and save it for later.
    The U.S. Secretary of Health and Human Services sends a report to Congress entitled Alcohol and Health.
    It can be found here!
    http://pubs.niaaa.nih.gov/publications/10report/intro.pdf
    It says this.
    “Participation in AA or professional treatment
    programs based on the 12 steps of AA is the
    dominant approach to alcoholism treatment in
    the United States. Higher levels of AA attendance
    during and following professional treatment are
    consistently associated with better outcomes,

    Right there on Pg 445 and 446



    I also found this.
    http://www.articlesbase.com/medicine-articles/are-non12step-recovery-approaches-effective-643197.html
    It says this.
    " Every three years the U.S. Secretary of Health and Human Services sends a report to Congress entitled Alcohol and Health.
    "The effectiveness of AA has not been scientifically documented, and methodological problems make such an evaluation difficult" In the United States there is no higher authority on such applications. This report states: "AA is considered by many lay persons and professionals to be the most successful treatment for persons with alcohol problems, despite the lack of well-designed and well-executed studies. Nearly 20 years later AA remains relatively unstudied from a scientific perspective".

    ReplyDelete
  5. Nice job TJ. So it looks like you and Karl are going to go through Orange's false and mythical claims with a pair of pliers and a blow torch. He's going to have to go get a job working at the mall putting toothpicks through pieces of chicken teriyaki and handing them out to passers by. These guys at hindsfoot here cite some info about this little myth.

    I'm gonna break this down a bit and try to get to the essence of it. If I'm not mistaken, A.A. has a 75% recovery rate for those who really try.

    ReplyDelete
  6. Introduction

    This paper is written for AA members and is intended for internal and public circulation as an item of AA historical and archival research.

    It is offered to help inform the AA membership and academic researchers of a widely circulated misinterpretation and mischaracterization of AA recovery outcomes.


    The fellowship of Alcoholics Anonymous, as a matter of long established principle, policy and practice, does not engage in public debate and seeks to avoid public controversy. The authors of this paper must emphasize that we do not speak for AA. We have a personal interest in the history of AA and consider it imperative to correct historical inaccuracies and propagation of myth.

    Arthur S, Arlington, TX

    Tom E, Wappingers Falls, NY

    Glenn C, South Bend, IN

    The publication of this paper does not imply affiliation with, approval by, or endorsement from, Alcoholics Anonymous or any part of its worldwide organization and service structure. The views expressed in this paper are solely those of the authors.

    AA, Alcoholics Anonymous, The Big Book, Box 4-5-9, The Grapevine, GV, Box 1980 and La Viña are registered trademarks of Alcoholics Anonymous World Service (AAWS), Inc and AA Grapevine Inc.

    Single-use excerpts from AAWS and AA Grapevine publications are cited in this paper under the good faith and fair use provisions of US copyright statutes for purposes of criticism, comment, scholarship and research.

    AA Recovery Outcome Rates - Contemporary Myth and Misinterpretation
    Version 1.10 Updated 2 10/11/2008

    ReplyDelete
  7. Foreword

    “Nothing is more responsible for the good old days than a bad memory” - Franklin P Adams

    (1881-1960) This paper addresses an erroneous myth that AA is experiencing a 5% (or less) “success rate” today as opposed to either a 50%, 70%, 75%, 80% or 93% (take your pick) “success rate” it once reputedly enjoyed in the 1940s and 1950s.

    The term “myth” is used to emphasize that the low “success rates” promulgated are a product of imagination, invention and inattention to detail rather than fact-based research.

    Also noteworthy in the derivation of the mythical percentages, is the absence of fundamental academic disciplines of methodical research, corroborating verification and factual citation of sources.

    Regrettably, some of the advocates who are propagating the myth are AA members who purport to be “AA Historians” and appear to be advocating agendas that portray fiction as fact and hearsay as history.

    The AA Fellowship has a robust verbal tradition. Much information is passed on by word of mouth. This has both its good and difficult sides. How does one know what is fact versus myth? AA members can sincerely state something they believe is true but is inaccurate - this is the difference between myth and fact. Consequently, much effort has been taken to ensure that the contents of this paper are independently confirmed in reliable written reference sources. Those sources are identified in footnotes or in the body of the narrative.

    References have been made on the internet, in publications, in individual AA talks and on TV, that depict AA’s early to mid years, as having had a typical successful recovery rate outcome of 50-75%. These high-end numbers are often followed by a second depiction that contemporary AA has deteriorated to a 10% or 5% or less recovery rate outcome. The two sets of numbers (high versus low percentage) are then cast in an idyllic portrayal of past AA contrasted to a dismal scenario of AA today.

    ? Claims of a 10%, 5% or less success rate for contemporary AA are erroneous and rest largely and misguidedly on the misinterpretation of data in a 1989-1990 internal AA General Service Office 1 report on “AA Triennial Membership Surveys.”

    ? The assertion of a 50-75% success rate in AA is derived from various AA literature sources and other written sources, but is not explicitly demonstrated except in one instance. That instance pertains to the AA members who had their personal stories printed in the first edition “Big Book.”

    2 The 50-75% success rate number has been cited, without change or challenge, since it first publicly appeared in 1941 and it persists to this date.

    In 1989-1990, an internal General Service Office (GSO) report, analyzing 5 prior AA membership surveys, contained a hand-written graph that has been persistently misconstrued to attempt to portray AA’s “success rate” as 5% or less (or AA’s “failure rate” as some cast it, of 95% or more).

    3 The graph has been cited as representing “retention” or “success” rates when in fact it simply illustrates the distribution of the length of time the population participating in the survey sample have been attending AA. Other survey questions asked about sobriety. This was only about attendance in the first year after someone’s first meeting. It is astonishing that negative projections of AA of such magnitude are casually issued with presumed “certainty” but contain no demonstration of where or when the “certainty” had been established. Extant citations have become so careless and perfunctory that in many cases they merely refer to other erroneous citations in other publications to lend credence to the reference. Erroneous citations are used to support other erroneous citations.

    ReplyDelete
  8. 1 The General Service Office (GSO) of the United States and Canada located in New York City (also noted as AAWS/GSO in this paper).

    2 The term “Big Book” is used for AA’s basic recovery text in lieu of its title “Alcoholics Anonymous” (both terms © AAWS, Inc).

    3 1990 report titled “Comments on AA’s Triennial Surveys” on five membership surveys from 1977-1989.

    AA Recovery Outcome Rates - Contemporary Myth and Misinterpretation

    Version 1.10 Updated 3 10/11/2008

    Even more unfortunate, concerning statistical confidence and accuracy of the citations, is that none of the authors (or self-proclaimed “AA Historians”) has apparently independently performed a critical, unbiased investigation of the original data or attempted to duplicate the calculations of AA’s reputed “failure statistics” from the basic source data listed in the membership surveys. That basic data, and an explanation of what it signifies, follows this section.

    Over the years, the internet has provided an international forum for anyone who can access it. A number of so-called “recovery” or “AA history” or “AA archives” web sites have proliferated. Many teem with personal grievances, screeds, and widely varying (and revisionist) interpretations of AA history and the AA program of recovery. An abundance of academic and medical special interest web sites have materialized as well.

    The erroneous 10%, 5% or less success rate myth for contemporary AA has proliferated without as much as a token challenge to its veracity or investigation of its origin. The topic of AA success or failure outcomes suffers from a great deal of anecdotal misinformation, misinterpretation and editorializing. Discussion, examination and analysis of the topic of AA recovery outcome rates are divided in this paper into two categories of investigation and reporting:

    The first category concerns the examination of the contemporary (and quite erroneous) assertion that AA is only achieving a 5% or less success rate. The appalling success rate assertion is false but a segment of AA members not only readily believes it but also attempts to exploit it to support personal agendas. They propagate revisionist AA history and manufacture exaggerated claims of a superior early AA recovery program. The second category concerns the examination of a popular and much repeated notion in AA of a 50% immediate success rate with about half (or 25%) of the “slippers” returning to successful recovery to produce an overall 75% success rate.

    This has been the prevailing “best estimate” of AA’s recovery outcomes since the late 1930s. It is denoted in this paper as a “50% + 25%” success rate (for a 75% total success rate). Based on research discoveries to date, it is believed that the 50% + 25% success rate is in all probability a very reasonable “best estimate” of AA’s success (both early and contemporary).

    ? The sole qualification (it is vitally important and often disregarded) is that the 50% + 25% success outcome rates apply only to those prospects who attempt to give AA a serious try (i.e. you get out of AA what you put into it). This rests on the simple, obvious, premise that a remedy cannot be construed as either a “success” or “failure” until it is at least tried and tested.

    ? Also of contextual importance, is that the subset of the past and present prospect population falling into this category is estimated to be 20% to 40% (1 or 2 out of 5) of the total prospect population.
    The remainder of this paper identifies information sources for the derivation of AA success or failure outcomes and highlights relevant information that has been omitted, invented or misconstrued. The main and initial item of interest and analysis is the grossly misinterpreted 1989-1990 internal GSO report on AA Triennial Membership Surveys.

    AA Recovery Outcome Rates - Contemporary Myth and Misinterpretation
    Version 1.10 Updated 4 10/11/2008

    ReplyDelete
  9. a) Triennial Surveys of AA Membership
    In 1968, Alcoholics Anonymous took an inventory of its membership in the form of a survey. Recognizing the need to know more about the Fellowship, a small trial survey was conducted in a few groups by the Regional Trustees to see how members would respond to a voluntary anonymous questionnaire. It went so well that a committee was set up to conduct a survey of 5% of the registered groups in the United States and Canada. A later pamphlet “The Alcoholics Anonymous Survey” (previously numbered P-38) explained: It was Dr. John L Norris, nonalcoholic chairman of AA?s Board of Trustees, who first stated the need for more accurate information about AA and its members. In dealing with the medical and scientific community on the question of alcoholism and its treatment, Dr. Norris found that he could cite numerous examples of how AA works, but that he lacked facts and figures. He posed his problem at a meeting of the Policy Committee of the Board of Trustees and requested that the Fellowship explore ways and means of providing more accurate information. Dr. Norris stated that “There were two major reasons for undertaking the survey:”
    To enable AA to furnish more accurate data about the Fellowship and its effectiveness to the growing number of professionals - doctors, psychiatrists, social workers, law enforcement officials and others who are working today in the field of alcoholism.

    2. To provide AA with more information about itself so that members can work more effectively in helping the many millions of alcoholics who still suffer throughout the world.
    That first survey in 1968 sampled 11,355 AA members in the United States and Canada. It was so well received and useful that the General Service Conference of Alcoholics Anonymous has continued the practice on a regular basis. The “Triennial Survey” has been conducted by AA every three years since the first survey in 1968. The 1996 survey was delayed by one year while the General Service Conference discussed its content. In general, a new edition of AA pamphlet number P-48 has been published the year after each survey to report the results:

    AA Membership Survey Pamphlets (P-48) Published
    1971 Profile of an AA Meeting
    Alcoholics Anonymous 1989 Membership Survey
    1974 Profile of an AA Meeting
    Alcoholics Anonymous 1992 Membership Survey
    1977 The AA Member
    Alcoholics Anonymous 1996 Membership Survey
    1980 The AA Member
    Alcoholics Anonymous 1998 Membership Survey
    1983 The AA Member
    Alcoholics Anonymous 2001 Membership Survey
    1986 AA Membership Survey
    Alcoholics Anonymous 2004 Membership Survey
    Alcoholics Anonymous 2007 Membership Survey
    The 2004 AA Triennial Membership Survey occurred during the period August 1-14, 2004. Seven hundred AA groups were previously selected at random. As in prior years, survey questionnaires were distributed to the General Service Representatives (GSRs) or group contacts of the selected groups with the assistance of the Area Delegates. The most recent survey was conducted in the summer of 2007.

    The results were published in 2008 and are included in this “Updated” paper. The survey was conducted at regularly scheduled AA meetings. The selected groups were specifically asked not to call a special meeting for conducting the membership survey. All members attending the regular scheduled meeting were asked to complete a questionnaire unless they had previously done so at another meeting. The forms were anonymous and confidential. Completed questionnaires were returned to the Public Information (PI) service desk of the AA General Service Office (GSO).

    ReplyDelete
  10. AA Recovery Outcome Rates - Contemporary Myth and Misinterpretation
    Version 1.10 Updated 5 10/11/2008
    Using Length of Sobriety as a Measurement of “Success”
    For it to be possible to compare recovery outcome "success" rates, it is necessary to understand that the meaning of the word “success” is inconsistent among various observers and critics. If a member has not had any alcohol for the last 5 years, most observers would agree that is a measure of success. It does not matter if the sobriety began the day of the first meeting or some time substantially later. The member has been sober for 5 years and that is what matters.

    Now that AA is easy to find almost anywhere, many people visit AA long before entering the worst of the downward spiral of alcoholism. They already know where AA is when they finally need and want it years later. This was discussed in an AA pamphlet (P-38) published in 1970 titled “The Alcoholics Anonymous Survey.” It reported on the first AA Membership Survey in 1968 (note: the tables “3 and 4” referenced below are not in this paper): LENGTH OF SOBRIETY TABLE 3 Time Reported Since Last Drink For most people who come to AA there is a point after which they just don't drink. This point may be at their first AA meeting. It may be a week, month or years after their first meeting. But once having achieved this point, experience has shown that the great majority do not resume drinking. (emphasis added) While AA has no measure of the number of alcoholics who have gotten sober, returned to normal life without ever drinking and died without having taken a drink, we can assume that this is a normal pattern for those who accept the AA program. Thus, AA views success as continuous sobriety - that is, the alcoholic lives a normal life without ever drinking. However, the medical and scientific community often has a less demanding criterion for success. This criterion is frequently one year of total abstinence. Using that standard, there is apt to be a lot of successful sobriety in any AA meeting anywhere in the United States or Canada. Of the 11,355 members who filled out questionnaires at AA meetings, 60% reported that they had not had a drink of alcohol for one year or more (emphasis added). This is one indication that AA works. According to the data which follows, it can be assumed that many of the remaining 40% are newcomers who have either not had a drink or who stopped drinking shortly after attending their first meeting. ... HOW LONG FOR AA TO TAKE TABLE 4 Length of Time from First Visit to AA to Time of Last Drink Another indication that AA works well is shown by the fact that a total of 64% of the respondents in the survey reported that they had stopped drinking either immediately after their first meeting (41%) or within the first year (23%). (emphasis added) A total of 68% of the women in the survey reported that they had stopped drinking within a year of their first meeting as compared with only 63% of the men. At the same time, 74% of those under thirty reported they had stopped drinking within a year of attending their first AA meeting, compared with 63% of those over thirty. Here it should be noted that, while a number of those surveyed have not yet attained successful sobriety, few AA members would be apt to refer to them as hopeless. Most AA's know at least one member who attended AA meetings year after year with little or no success, but then finally sobered up. Unless the alcoholic dies, the most that the majority of AA members will say is that it hasn't worked so far.

    ReplyDelete
  11. AA Recovery Outcome Rates - Contemporary Myth and Misinterpretation
    Version 1.10 Updated 6 10/11/2008
    b) First Year Retention
    Figure C-1 from the 1990 Summary Report of 1977-89 AA Triennial Membership Surveys
    The tendency of some observers to offer a pessimistic view of AA today is based on a misreading of the graph shown above. It has been extracted from a summary in a 1990 internal GSO report on AA Triennial Membership Surveys. The misreading of the summary report has been circulated widely. The title of the misquoted graph is "% of those coming to AA within the first year that have remained the indicated number of months.” Identified as Figure C-1, the graph is page 12 of the 1990 internal GSO report. This hand-written graph is at the center of erroneous assertions that contemporary AA has a 5% success rate outcome. The sequence of percentages at the bottom ends in 5% above month 12 of the x-axis of the graph. This 5% value has been erroneously interpreted as the percentage of candidates who stayed a full year and it is a completely inaccurate interpretation of what the 5% value actually represents. This paper presents considerations and discussion regarding the graph, its source data, composition, and most importantly, how it should be interpreted. The data plotted in Figure C-1 represent a subset of the overall survey sample populations. The population subset reported a year or less since their first-time-ever attendance in AA. The x-axis of the graph shows intervals of time for the first through 12th month of attendance in AA. The points plotted for the five surveys represent the percentage distribution of the population subset in each of those intervals.

    ReplyDelete
  12. AA Recovery Outcome Rates - Contemporary Myth and Misinterpretation
    Version 1.10 Updated 7 10/11/2008
    Following are citations and notes of how the narrative in Appendix C of the internal GSO report describes the graph: APPENDIX C: THE FIRST YEAR “It is possible to calculate from completed questionnaires, by month, the number of members that have “been around” a given number of months. This relies on the question that determines the month and year that the respondent first came to AA. The calculation has been performed for the twelve months of the first year for the five surveys, and the results are plotted in Figure C-1. Such results can be interpreted to show the probability that a member will remain in the fellowship a given number of months. To be more explicit: if all the members who report they have been in the Fellowship for less than a month were present a month later, then the number who report being in AA between one and two months should equal the number that report being in less than a month, subject of course, to month-to-month fluctuations and to any possible seasonal effects. The same should apply to succeeding months. However, it is observed that there is a steady decline (subject to inevitable fluctuations).” Note that it states, “Such results can be interpreted to show the probability that a member will remain in the fellowship a given number of months.” That type of probability is not shown in the way the graph in Figure C-1 is presented: APPENDIX C continued: “This has been the case for each of the five surveys we are reporting on, and the remarkable similarity of results for the surveys is shown in Figure C-1, where all five are plotted on a single scale by taking into account the size of each survey. That figure also tabulates the average over the five surveys and that average strongly suggests that about half those who come to AA are gone within three months. Unfortunately, there seems to be no way in which the reason for departure can be determined.” For the 1997 survey, the number of respondents who were in each month number of their first-time-ever AA attendance was divided by the total that was in their first year and plotted as a dash-dot line. The same type of data was plotted as a plus-plus line for the 1980 survey. The 1983 survey was plotted as a dot-dot line. The 1986 survey was plotted as a dash-dash line. Lastly, the 1989 survey was plotted as a solid line. The vertical axis is the distribution percentage in that month interval for each of the five surveys.
    Figure C-1 Average of 5 Surveys
    Distribution %
    19%
    13%
    10%
    9%
    8%
    7%
    7%
    6%
    6%
    6%
    6%
    5%
    Month
    1
    2
    3
    4
    5
    6
    7
    8
    9
    10
    11

    ReplyDelete
  13. The “Average of 5 Surveys” is tabulated along the bottom of the chart (and shown in the table above). It shows that 19% of the first-year respondents were in their first month. The third and fourth month numbers are about half of that which is how the report author interprets “that about half those who come to AA are gone within three months. Chart 1 of this paper (which follows below) is titled “1st Year Retention per Summary of 1977-89 Surveys.” It plots the same information at a scale where the shape of the retention (or attrition) curve is easier to understand. APPENDIX C continued: “It seems impossible that such a systematic effect could be achieved by any mechanism other than a slow attrition of newcomers during the first year. It is little comfort to suggest that many who leave return later, because those who have done that are already counted in the numbers shown here.” Many prospects that stop coming after their first few meetings do return to AA later and achieve successful sobriety. A car dealership (or any other retail business) looks at the number of cars they sold. They do not bemoan the many window-shoppers that looked but did not buy anything.
    AA Recovery Outcome Rates - Contemporary Myth and Misinterpretation
    Version 1.10 Updated 8 10/11/2008
    AA co-founder, Bill Wilson, wrote in a 1939 letter, “Here in New York, it was the same story. I went along six months talking to a lot of them before any permanent results were obtained, and at that time, I was laboring under the delusion that I was divinely appointed to save all the rummies in the world!” 4 APPENDIX C continued: “After the first year, survey results show that attrition continues, but at a much slower rate. During such years, it is likely that many whose activity in AA diminishes remain sober but are no longer adequately represented in the sample.” Section b) of this paper, titled “First Year Retention” and section c) titled “Growth of Long Term Sobriety” address what all the triennial membership surveys to date show about long-term sobriety and continued AA participation after the first year. APPENDIX C continued: “It is not part of the survey to attempt to determine the causes of this phenomenon beyond noting that suggestions would include individuals sent against their will, individuals who are not convinced of their alcoholism, individuals who are unable to accept one or another characteristic of the AA program, etc. But it does appear that this result and its implied challenge to AA should be widely understood in the Fellowship.” Alcoholics Anonymous teaches that it is easier to stay sober by drinking absolutely no alcohol at all. That is pretty much a deal-breaker for a visitor who hoped AA would teach him how to control his drinking. When an alcoholic’s reasons for coming to AA exceed his/her excuses for not coming, then he/she has a chance to recover. APPENDIX C continued: “Individuals may rebel against this result as contradicting our time-honored statement that “half get sober right away, another 25% eventually make it,” etc. That statement applies to observations made at an earlier time, and there is no reason to doubt that changes in society and in AA since that time could create a different circumstance today. Like other findings of the survey, this may be a challenge to the membership to “change the things we can.”” Section d) of this paper, titled “Timeline of Sources and Citations of AA’s 50% + 25% “Success Rates,” explores the history and important qualifications associated with the 50% + 25% success rate to provide a proper context for its interpretation.

    ReplyDelete
  14. The time-honored 50% + 25% success rate assertion is in the Foreword to the second edition Big Book and states, “Of alcoholics who came to AA and really tried, 50% got sober at once and remained that way; 25% sobered up after some relapses…” 5 The first year retention data in the surveys does not contradict the 50% + 25” success rate. In the first few weeks or months, the prospective member typically answers two questions: (1) am I an alcoholic and (2) am I really trying? Many people come to AA to find out if they are alcoholics. For some the answer is obvious and easy. Others need to explore the question for a while. Some AA members try to impress newcomers with rhetoric like, “You wouldn’t be here if you weren’t an alcoholic.” However, in AA each individual makes his or her own diagnosis. It is hoped that they stay long enough to understand what it means to be an alcoholic and make an informed decision. Meeting attendance is not an absolute requirement for recovery in AA but it certainly helps. Some in isolated places have gotten by with only the Big Book and other literature. Some may work one-on-one with another alcoholic if there are no groups with meetings nearby. But that is rare enough that, for the sake of understanding the survey data, a person who stops coming to meetings in the first few months is not assumed to be “really trying.”
    4 “Pass It On” page 226 © AAWS, Inc. 5 Roman numeral page xx in the 3rd and 4th edition Big Book
    AA Recovery Outcome Rates - Contemporary Myth and Misinterpretation
    Version 1.10 Updated 9 10/11/2008
    The “Average of 5 Surveys” noted in Figure C-1 of the 1990 internal GSO report is shown in Table 1 below as the columns “Month” and “Distribution %.” The data are plotted in Chart 1 at a normalized scale where the shape of the retention (or attrition) curve is easier to understand. Chart 1: 1st Year Retention per Summary of 1977-89 Surveys

    Table 1: 1st Year Retention Percentages
    Month #
    Distribution %
    Starting 1st month
    Starting 2nd month
    Starting 3rd month
    Starting 4th month
    Chart info...

    ReplyDelete
  15. Notes:
    ? The "Distribution %" column of Table 1 is taken from the original “Figure C-1” graph.

    ? Total Distribution % would add up to 100% (instead of 103%) if the percentages had not been rounded off.

    ? Distribution % values are “normalized” to give various starting months.

    ? The resulting curves show retention after various “orientation periods.”
    Chart 1: 1st Year Retention per Summary of 1977-89 Surveys"Distribution" is % of first year newcomers in AA some number of monthsThe other curves show retention after some number of monthsEg.: 50% of those in their 3rd month stay the rest of the year

    chart info

    Month # of First Time First Year NewcomersPercent4th month3rd month2nd month1st monthDistribution
    AA Recovery Outcome Rates - Contemporary Myth and Misinterpretation
    Version 1.10 Updated 10 10/11/2008

    The original Figure C-1 graph data were NOT retention percentages as has been frequently misinterpreted and erroneously reported. The reasoning is as follows:

    ? Each Triennial Survey is a cross-sectional study - a snapshot at one point in time. Assume that the same number of new people have been attending their first meetings every month. That is how many will be in their first month when the observation is made.

    ? The ratio of the second month people in the survey to the first month people is the retention rate between the first and second months. In that same way, it is possible to find the retention between any two sampled months. If there were perfect retention for all twelve months, then 8.3% of the first year people would be found in each of the twelve months. That is not the case but it shows how a retention calculation can be done.
    In the actual data presented: Month1 = 19 does NOT mean that "81% (i.e. 100% - 19%) dropped out in a month as some sources claim. Month3 = 10 does NOT mean that "90% (i.e. 100% - 10%) leave within 3 months and Month12 = 5 does NOT mean that "95% (i.e. 100% - 5%) stop active participation in AA inside of a year. Instead, what the data does show is that for every 100 people surveyed with under a year since first attendance: 19% of that population were in their first month 13% were in their 2nd month 9% were in their 4th month 7% were in their 6th month 6% were in their 8th month, etc By multiplying everything by a normalizing factor (5.25 in this case) such that it starts at 100%, then a reasonable approximation of retention can be derived. The "Starting 1st month" column in Table 1 is scaled to show retention of a first-time newcomer. The "Starting 4th month” column is scaled to show retention after a recommended 90-day introductory period.

    ? What is actually shown in Table 1 is that 56% of those who stay beyond three months are still active in AA at the end of a year. Other Survey results show even better retention rates after the first year.

    ReplyDelete
  16. ? Another important consideration for data interpretation and context is that not everyone who attends an AA meeting is an alcoholic.
    Some come to a few meetings because of pressure from home, work, the legal system, treatment facilities, friends and even AA members. Some are not “alcoholic enough” to believe they need help. Moreover, drug addicts with no drinking history are relatively common in contemporary AA. Those people were counted if they were at the meeting on the day of the survey. It is not surprising that some of them do not stay at the time of their first exposure to Alcoholics Anonymous. The important characteristic of randomization is of question in the sample selection method in early AA membership surveys. The Area Delegate determined the groups within the area to be sampled in those early years. This presented an opportunity for sample populations to be skewed in the selection of groups. On the other hand, there are enough US and Canadian delegate areas that the net results would not be significantly affected. In later years, the groups to be sampled were randomly selected from the AAWS/GSO list of registered groups. This too would have some opportunity for inadvertent sample bias if there were some consistent characteristic of those attending unregistered groups. Thousands of AA groups in the US and Canada do not register. The graphs and tables that follow reflect AA membership survey data from 1968 through 2007. The accompanying analysis and commentary offers further accurate and appropriate interpretation and projection of the survey data.

    AA Recovery Outcome Rates - Contemporary Myth and Misinterpretation

    Version 1.10 Updated 11 10/11/2008

    c) Growth of Long-Term Sobriety
    How long have members of AA been sober? That is one of the questions the Triennial Surveys can help to answer. Each survey is a snapshot or cross-section of AA membership by sampling those attending meetings in randomly selected groups at about the same time. Comparing a series of surveys reveals changes in the makeup of the Fellowship. It is not necessary to track individual results for this to be a “longitudinal” study. To the extent that all surveys sample the same population, the comparisons are reasonable. Each survey pamphlet reported member sobriety in ranges of 0-1 year, 1-5 years and over 5 years. Those were converted to 0-1 year, over 1 year and over 5 years for Chart 2 and Table 2 below. That made the graph easier to read and understand. Each survey pamphlet also reported the average length of sobriety of members sampled. When the pamphlet said, “Over 4 years,” it was necessary to graph a more specific number. Trend data for the increased length of sobriety is shown below in Chart 2 “Growth of Long-term Sobriety Ranges” and Table 2 “Long Term Sobriety Ranges Percentages:” The curve in Chart 3 “Growth of Long Term Sobriety Averages” and Table 3 “Long Term Sobriety Averages” which also follow below give a “best fit” to the statistics as reported.

    ? The 2004 Survey showed an increase in the length of sobriety over the 2001 Survey, as has every triennial survey since 1983.

    ? As of the 2004 Survey, long-term sobriety was so prevalent that the "Greater Than Five Years" range of previous surveys was subdivided into 2 parts as follows (5-10 Years = 14%) + (>10 Years = 36%) == (> 5 Years = 50%).

    AA Recovery Outcome Rates - Contemporary Myth and Misinterpretation
    Version 1.10 Updated 12 10/11/2008
    Chart 1: Growth of Long-Term Sobriety Ranges
    1983 Survey found 25% of AA members sober over 5 years
    2004 Survey found 50% of AA members sober over 5 years
    chart info

    ReplyDelete
  17. Survey Year
    Percent of AA Members
    >10yr
    >5yr
    >1yr
    0-1yr
    Trend data for the progressive increased length of sobriety reflected in AA membership surveys:

    Chart 2: Growth of Long Term Sobriety Ranges
    Notes:

    ? Published pamphlet data are used for most years but a few of those only gave ranges.

    ? When only a range was given, a number in that range was chosen for a smooth curve fit.

    ? Values for 1977-1983 are from a 1990 internal AA paper analyzing the 1977-1989 Surveys.

    ? 1968 and 1971 pamphlets only say that 40% were sober less than 1 year and 60% were sober 1 year or more.

    The 2004 Survey subdivided the “Over 5 years” category into “5 to 10 years” and “Over 10 years.

    Table 2: Long Term Sobriety Ranges Percentages
    Year 0-1 1-5 > 5 Pamphlet Pamphlet Pamphlet Source 0-1yr >1 yr >5 yr >10yr

    1968 40 only this "<1yr>1yr = 60%" pamphlet 40 60

    1971 40 only this "<1yr>1yr = 60%" pamphlet 40 60

    1974 40 35 25 pamphlet 40 60 25

    1977 37 39 24 "35-40%" "35-40%" "20-30%" paper 37 63 24

    1980 36 37 27 "35-40%" "35-40%" "20-30%" paper 36 64 27

    1983 38 37 25 "35-40%" "35-40%" "20-30%" paper 38 62 25

    1986 33 38 29 pamphlet 33 67 29
    1989 34 37 29 pamphlet 34 66 29
    1992 31 34 35 pamphlet 31 69 35
    1996 27 28 45 pamphlet 27 73 45
    1998 27 26 47 pamphlet 27 73 47
    2001 30 22 48 pamphlet 30 70 48
    2004 26 24 50 “>5yr” includes "5-10yr = 14%" ">10yr = 36%" pamphlet 26 74 50 36
    2007 31 24 45 “>5yr” includes "5-10yr = 12%" ">10yr = 33%" pamphlet 31 69 45 33
    AA Recovery Outcome Rates - Contemporary Myth and Misinterpretation
    Version 1.10 Updated 13 10/11/2008
    Chart 2: Growth of Long-Term Sobriety Averages
    1983 Survey found average AA member sober 4 years
    2004 Survey found average AA member sober more than 8 years
    (Fraction for "more than" is adjusted for smooth curve fit)
    graph info

    '77 '80 '83 '86 '89 '92 '96 '98 '01 '04 '07
    Survey Year
    Years Sober
    Average

    Chart 3 and Table 3 below, offer additional supporting data showing the trend of the average length of sobriety
    among the population sampled. The table data represent only those who are still attending meetings. Someone who
    got sober in AA and who is staying sober by some other means, and not attending meetings, would not appear in the
    survey, nor would someone who died sober. AA does not track individual case histories.
    It is very important to keep in mind the reality that attending a few AA meetings does not mean that someone is
    interested in staying sober. Likewise, not attending AA meetings does not mean that someone is drinking again.

    ReplyDelete
  18. Chart 3: Growth of Long Term Sobriety Averages
    Notes:

    ? Values for 1977-1989 are from the 1990 internal AA paper analyzing the 1977-1989 Surveys.

    ? Published pamphlet data are used for 1992-2007.

    ? The fractions for “more than” in the pamphlets are chosen to give a smooth curve fit for the graph.
    Table 3: Long Term Sobriety Averages
    Year Average Pamphlet Source Used

    1968 * not given *

    1971 * not given *

    1974 * not given *

    1977 4 not given paper

    1980 4 not given paper


    1983 4 not given paper

    1986 4.3 "52 months" paper

    1989 4.7 "more than 4 years" paper

    1992 5.5 "more than 5 years" curve fit of pamphlet

    1996 6.4 "more than 6 years" curve fit of pamphlet

    1998 7.1 "more than 7 years" curve fit of pamphlet

    2001 7.6 "more than 7 years" curve fit of pamphlet

    2004 8.1 "more than 8 years" curve fit of pamphlet

    2007 8.1 "more than 8 years" curve fit of pamphlet

    AA Recovery Outcome Rates - Contemporary Myth and Misinterpretation

    Version 1.10 Updated 14 10/11/2008

    d) Timeline of Sources and Citations of AA’s 50% + 25% “Success Rates”

    The notion of an overall 75% successful recovery outcome rate in AA owes its durability to anecdotal repetition rather than consistent statistical demonstration. There is very little consistent, verifiable data and record keeping either validating or refuting the claim of any recovery outcome rates for AA.
    The only specific population sample identified by AA co-founder Bill W, as achieving a 50% + 25% (or overall 75%) success rate, were the pioneering members who had their personal
    stories printed in the first edition Big Book.

    6 Beyond that, the origin or validation of the percentages is neither explained nor demonstrated. The information that follows presents a chronological series of references and citations of written works in which recovery outcome rates, and factors influencing the rates, are mentioned. July 1938 - The earliest archival reference found to a cited success rate of 50% occurs in a letter from Bill W to Dr Richard C Cabot in which Bill W wrote:

    We have never developed any accurate statistical information (emphasis added) but I should say that we have dealt with about 200 cases in all, about half of whom seem to have recovered. Doctors tell us that, almost without exception, we have been problem drinkers of a class commonly regarded as hopeless.

    7
    August 1938 - The relatively small AA population at the time allowed some measure of tracking success or failure by individual member. In the minutes of the first meeting of the Alcoholic Foundation Board, 8 early New York member Hank P, at the request of Frank Amos, reported a census of the number of alcoholics and prospects in the Fellowship, which then consisted of two groups (Akron, OH, and New York City). The counts Hank P reported were:
    Count
    Reported
    %
    41 6 12 10 25
    Definite on the ball Questionables So difficult practically denied Definite but out of touch Prospects

    44% 6% 13% 11% 27%
    94
    Total

    ReplyDelete
  19. Out of a population of 94 members and prospects, 51 were considered “definite” recoveries, which comprised a 55% successful outcome. Ten of the 51 “definite” were “out of touch” (which is presumed to mean sober but not attending meetings or in contact with other members). The total number of members reported in August 1938 was four less than that stated when the Big Book was published in April 1939. February 1940 - the first public reference to the 50% + 25% success rate by Bill W occurred in his talk to the dinner guests at the historic Rockefeller dinner at the Union League Club in New York City. He stated: By the time the book was published last April there were about one hundred of us, the majority of them in the West. Although we have no exact figures, (emphasis added) in counting heads recently, we think it fair to state that of all the people who have been seriously interested (emphasis added) in this thing since the beginning, one-half have had no relapse at all. About 25% are having some trouble, or have had some trouble, but in our judgment will recover. The other 25% we do not know about.
    Note the qualification “of all the people who have been seriously interested.” It provides an important context to the claimed success rate to indicate that it did not apply to 100% of everyone who showed up in AA. This key context is often overlooked or omitted.

    6 Bill W’s commentary in the introductions to the personal stories, 2nd edition Big Book unnumbered pages 167-169. 7 July 1938 letter from Bill W to Dr Richard C Cabot, GSO Archives ref: 1938-81, Alcoholic Foundation, R 28, Bx 59. 8 The minutes are erroneously dated April 11, 1938, GSO Archives ref: 1938-19, Alcoholic Foundation, R 10, Bx 22.

    AA Recovery Outcome Rates - Contemporary Myth and Misinterpretation

    Version 1.10 Updated 15 10/11/2008
    Consequently, it can fabricate an exaggerated and unrealistic expectation of success. It can also distort the interpretation of past results to yield a false impression that a high percentage level of past AA success was achieved when, in reality, the results achieved were not even close to the percentage level presumed. As will be shown later (circa 1949 in this timeline) it is important to understand that the success rates cited by Bill W applied to a subset of about 1-2 prospects out of five (i.e. 20-40% of the total prospect population). The remaining prospect population (3-4 out of 5, or 60-80%) was described by Bill W to have “quit AA after a brief contact.”

    March 1941 - The first nationally published mention of the 50% + 25% success rate occurred in the historic Saturday Evening Post article written by Jack Alexander in which he stated: One-hundred-per-cent effectiveness with nonpsychotic drinkers who sincerely want to quit (emphasis added) is claimed by the workers of Alcoholics Anonymous. The program will not work, they add, with only those who “want to want to quit” or who want to quit because they are afraid of losing their families or their jobs. The effective desire, they state, must be based upon enlightened self-interest; the applicant must want to get away from liquor to head off incarceration or premature death. He must be fed up with the stark social loneliness which engulfs the uncontrolled drinker and he must want to put some order into his bungled life.
    As it is impossible to disqualify all borderline applicants, the working percentage of recovery falls below the 100 per-cent mark. According to AA estimation, 50% of the alcoholics taken in hand recover almost immediately; 25% get well after suffering a relapse or two, and the rest remain doubtful. This rate of success is exceptionally high. Statistics on traditional medical and religious cures are lacking, but it has been informally estimated that they are no more than 2 or 3 per cent effective on run-of-the-mine cases.

    ReplyDelete
  20. 9
    Note the qualifier of “according to AA estimation.” It does not state “according to AA records.” Early 1941 membership had grown to an estimated 2,000 members and soared to an estimated 8,000 members by the end of 1941 because of the historic article. 10 The assertion of “One-hundred-per-cent effectiveness with non-psychotic drinkers” is obvious hyperbole but it is also qualified as including only those “drinkers who sincerely want to quit.” Some early AA groups did try to track membership counts, sober time and slips. However, these limited records are not an adequate basis for claiming a national or regional recovery outcome rate. From 1941 on, the 50% + 25% success formula became an AA mantra and unvarying fixed rate. The percentages are often cited out of context as if they applied to the total prospect population who encountered AA. This is not so. As noted previously, and as will be seen again later, the percentages were qualified to apply to a much smaller subset of the total prospect population.

    January 1944 - About 3 years after the Jack Alexander article, Dr Harry Tiebout, in a paper for “The American Journal of Psychiatry” stated a similar, but qualified, assertion about recovery rates in AA from 1935 through 1942:

    11 Statistics at the New York office of the organization read as follows: 5 recovered at the end of the first year, 15 recovered at the end of the second year 40 recovered at the end of the third year 100 recovered at the end of the fourth year 400 recovered at the end of the fifth year 2000 recovered at the end of the sixth year 8000 recovered at the end of the seventh year Alcoholics Anonymous claims a recovery rate of 75% of those who really try their methods (emphasis added).”

    Note the qualification “of those who really try their methods” that the recovery outcome rate of 75% applies to a subset of the total population of prospects.

    9 March 1941 Saturday Evening Post; also see AA publication (P-12)

    ReplyDelete
  21. “Jack Alexander Article About AA” © AAWS, Inc. 10 “Alcoholics Anonymous Comes of Age” pages 35, 192, 310 and “Pass It On” page 266 both © AAWS, Inc. 11 See also “Alcoholics Anonymous Comes of Age” pages 309-310 © AAWS, Inc.
    AA Recovery Outcome Rates - Contemporary Myth and Misinterpretation
    Version 1.10 Updated 16 10/11/2008
    May 1944 - Further qualifications (regarding context) appear in a reprint of a talk to the Medical Society of the State of New York, in which Bill W stated: 12 Alcoholics Anonymous is an informal fellowship of about 12,000 former alcoholic men and women who are to be found banded together as groups in about 325 American and Canadian communities, these groups ranging in size from half a dozen to many hundreds in individuals. Our oldest members have been sober eight to nearly ten years. Of those sincerely willing to stop drinking (emphasis added) about 50% of those has done so at once, 25% after a few relapses, and most of the remainder have improved. It is probable that half of our members, had they not been drinkers, would have appeared in ordinary life to be normal people. The other half would have appeared as more or less pronounced neurotics. Once again, note the context “Of those sincerely willing to stop drinking.” In other instances where AA contributed information for professional publications, the same traditional formula appeared. June 1947 - “Survey Midmonthly” magazine contained an article titled “Problem Drinkers” which stated: Now in its thirteenth year, AA has 1,200 chapters including outposts in Canada and Latin America, and is winning about 1,000 new members a month, according to the February issue of Time. Supported by donations from members, it has no offices, no dues, no big funds. Members are pledged to help all other alcoholics, but give assistance only when called upon. Anonymity is an important rule of the organization, in order that new members may be encouraged to join.
    Of its members, some 50 per cent have stopped drinking entirely after joining, 25 per cent have succeeded after one or two slips. By contrast, all but 5 per cent of alcoholics were formerly considered hopeless of cure, according to the Time report.

    13 The success rates cited above are not qualified and give the appearance of applying to the total prospect population.
    April 1949 - An issue of “Survey” contained the following excerpts:

    14 One seed was planted in Akron, Ohio by two habitual drunks. One was a doctor, the other a broker, both of some distinction before alcohol addiction began to ruin their careers and threaten to break up their homes. Intelligent men, they fought hard, but without much success, until they managed to get together in a sober interval. Then they decided that one drunk might help another. Out of this idea grew the now famous Alcoholics Anonymous. In a year's time, these two former inebriates had not only achieved continuous sobriety for themselves, but had helped others to the same goal.

    ReplyDelete
  22. Today the organization they started has some 85,000 members in 2,400 chapters throughout the country. The entire membership is composed of alcoholics fighting desperately to help each other stay away from the substance that is poison to them.

    Many of the members have not touched a drop since they became AA?s. Others have slipped from time to time, but have returned to the organization to keep up the fight. Some former members have sunk back into the mire of perpetual drunkenness.

    But Alcoholics Anonymous, which maintains that 75 percent of its members have achieved sobriety, is generally conceded to present the most widely successful attempt at alcoholic rehabilitation in this country's history.

    Statistics on “success” are unreliable (emphasis added) for a man who is sober today may be drunk tomorrow - even though his sobriety has lasted over a number of years. Nevertheless, doctors, scientists, social workers, clergymen, public health experts, suffering relatives, and others who have had to deal with alcoholics, have watched the AA's achievements with amazement.”


    12 “Medicine Looks at Alcoholics Anonymous” May 1944 Bill W talk to the Medical Society of the State of NY © AAWS, Inc.

    13 Later reprints excluded the paragraphs stating estimated success rates and membership size.

    14 April 1949, “Survey” article titled “Hope for the Alcoholic” by Kathryn Close.

    AA Recovery Outcome Rates - Contemporary Myth and Misinterpretation

    Version 1.10 Updated 17 10/11/2008

    Note the qualification in the Survey article that “Statistics on „success? are unreliable.”

    The success rate figures also are not qualified. However, AA was not the only one claiming remarkable success rates with alcoholics at the time. In the 1949 Survey article, the author also comments on the Yale Plan Clinics: ... Diagnosis was from the first a major concern of the Yale Plan Clinic, but experience soon demonstrated that if diagnosis was to have any meaning it would have to be followed by therapy and guidance in cases needing treatment not provided by other community services. Since its opening, the clinic has received 1,100 alcoholics, 60 per cent of whom have achieved either complete sobriety or markedly lengthened spacing between their drinking bouts. Referrals between the clinic and Alcoholics Anonymous are commonplace, the clinic getting patients from AA and in turn recommending AA to persons who seem able to benefit from the fellowship program.

    ReplyDelete
  23. Many persons are clinic patients and active AA members at the same time. The Survey article also discussed an alternative to AA whose founder claimed an impressive success rate as well: ...

    Edward J McGoldrick Jr, director of New York City's Bureau of Alcoholic Therapy, established within the Department of Welfare in 1943, is an individualist among alcoholic therapists for he also holds out against the theory that alcoholism is a disease. ...

    All therapists at Bridge House are former alcoholics who have been rehabilitated through the McGoldrick method.

    Though the method differs from procedures of Alcoholics Anonymous, the director goes along with them in the theory that persons who have “hit bottom” as alcoholics themselves can more easily help other alcoholics.

    Mr. McGoldrick objects to calling alcoholism a disease on the grounds that it adds to the alcoholic's sense of weakness and helplessness, thus giving him an excuse to go on drinking.

    He opposes compulsory treatment as useless, for it ignores the ingredient of positive willingness, which he feels, is necessary to reform.

    Bridge House, with only twenty beds, serves about 350 alcoholics a year, both on a resident and a non-resident basis. Its record of success, using Mr. McGoldrick's measurement of one year of complete sobriety, is 66 percent - a good record but one not affecting some 200,000 alcoholics in New York City who do not reach Bridge House, nor any of the city's alcoholic women.

    It is, however, a project being watched throughout the country. November 1949 - In an article in “The American Journal of Psychiatry” Bill W wrote: Of alcoholics who stay with us and really try (emphasis added) 50% get sober at once and stay that way, 25% do so after some time and the remainder usually show improvement.

    But many problem drinkers do quit AA after a brief contact, maybe three or four out of five (emphasis added). Some are too psychopathic or damaged. But the majority have powerful rationalizations yet to be broken down. Exactly this does happen provided they get what AA calls “good exposure” on first contact. Alcohol then builds such a hot fire that they are finally driven back to us, often years later. Note the qualification by Bill W that the success rate applied to a subset of about 1-2 prospects out of five and consisted “Of alcoholics who stay with us and really try.” The remainder of the prospects “maybe three or four out of five” [i.e. 60-80%] “quit AA after a brief contact.” July 1955 - The Foreword to the second edition Big Book contains the following excerpt: Of alcoholics who came to AA and really tried (emphasis added) 50% got sober at once and remained that way;

    ReplyDelete
  24. 25% sobered up after some relapses, and among the remainder, those who stayed on with AA showed improvement. Other thousands came to a few AA meetings and at first decided they didn't want the program. But a great number of these-about two out of three-began to return as time passed.

    Bill W wrote this foreword and again, notes the context “Of alcoholics who came to AA and really tried.” A precise demonstration of who came, who stayed and who returned to AA as of 1955 (AA’s 20th Anniversary) is anyone’s guess and that is all it was, “a best estimate.”

    However, put something, anything, in the Big Book, especially if it was written by Bill W, and many AA members will interpret it as infallible revelation and beyond refutation.
    AA Recovery Outcome Rates -

    Contemporary Myth and Misinterpretation
    Version 1.10 Updated 18 10/11/2008

    July 1955 - The introduction to the story section in the second edition Big Book states:
    When first published in 1939, this book carried twenty-nine stories about alcoholics. To secure maximum identification with the greatest number of readers, the new Second Edition (1955) carries a considerably enlarged story section, as above described. Concerning the original twenty-nine case histories, it is a deep satisfaction to record, as of 1955, that twenty-two have apparently made full recovery from their alcoholism. Of these, fifteen have remained completely sober for an average of seventeen years each, according to our best knowledge and belief.

    15 In the introduction to the Pioneers of AA Section stories, it goes on to state:

    16 Dr Bob and the twelve men and women who here tell their stories were among the early members of AA?s first groups. Though three have passed away of natural causes, all have maintained complete sobriety for periods ranging from fifteen to nineteen years as of this date 1955. Today, hundreds of additional AA members can be found who have had no relapse for at least fifteen years. All of these then are the pioneers of AA. They bear witness that release from alcoholism can really be permanent. Twenty-two of the 29 stories in the first edition Big Book were dropped for the second edition. This population has also been the subject of an erroneous myth that the stories were dropped because the members returned to drinking. The reality was quite the opposite. The 22 stories were changed simply to reflect a better cross-section of AA membership population at the time (1955).

    ? According to Bill W’s introduction to the stories in the second edition Big Book, of the 29 early members, whose stories appeared in the first edition Big Book, 76% (22 of 29) were sober as of AA’s 20th anniversary (1955).
    ? Seven of the 29 early members (24%) had returned to drinking but subsequently sobered up again; another seven of the 29 (24%) returned to drinking and did not sober up.
    This data appears to be the only population sample explicitly supporting an assertion of the successful 50% + 25% recovery outcome. Its scope would be confined to three groups (Akron, New York and Cleveland) and its population sample (29) would represent around 30% of the original estimate of 100 AA members as of April1939.

    ReplyDelete
  25. April 1958 - Bill W addressed the New York City Medical Society on Alcoholism 17 on AA’s early history: Our next need was publicity, and it was forthcoming. Fulton Oursler, the noted editor and writer, printed a piece in Liberty magazine about us in 1939. The following year, John D Rockefeller, Jr, gave AA a dinner which was widely publicized. The next year, 1941, there was a feature article in the Saturday Evening Post. This story alone brought us thousands of new people.

    As we gained size, we also gained in effectiveness. The recovery rate went way up. Of all those who really tried AA (emphasis added) a large per cent made it at once, others finally made it; and still others, if they stayed with us, were definitely improved. Our high recovery rate has since held, even with those who first wrote their stories in the original edition of „Alcoholics Anonymous.?

    In fact, 75 per cent of these finally achieved sobriety. Only 25 per cent died or went mad.

    Most of those still alive have now been sober for an average of twenty years. In our early days, and since, we have found that great numbers of alcoholics approach us and then turn away-maybe three out of five, today (emphasis added).

    But we have happily learned that the majority of them later return, provided they are not too psychopathic or too brain-damaged. Once they have learned from the lips of other alcoholics that they are beset by an often fatal malady, their further drinking only turns up the screw.

    Eventually they are forced back into AA; they must do or die. Sometimes this happens years after the first exposure. The ultimate recovery rate in AA is therefore a lot higher than we at first thought it could be.
    15 Second edition Big Book, AA Publishing, Inc. 1955.

    Introduction to Part III “They Nearly Lost All” unnumbered page 167.

    16 Second edition Big Book, AA Publishing, Inc. 1955. Introduction to Part I “Pioneers of AA” unnumbered page 169.

    17 Bill W’s April 1958 talk is preserved in AA pamphlet (P-6) “Three Talks to Medical Societies” © AAWS, Inc.

    ReplyDelete