HARRIS ET AL.
257
Prior Alcoholics Anonymous (AA) Affiliation and the
Acceptability of the Twelve Steps to Patients Entering
UK Statutory Addiction Treatment*
JENNIFER HARRIS, M.SC., DAVID BEST, PH.D.,† MICHAEL GOSSOP, PH.D., JANE MARSHALL, MRC.PSYCH.,
LAN-HO MAN, B.A. (HONS), VICTORIA MANNING, M.SC., AND JOHN STRANG, M.D.
National Addiction Centre/Institute of Psychiatry, South London and Maudsley NHS Trust, Denmark Hill, London, England
ABSTRACT. Objective: The study investigates levels of affiliation with
AA and beliefs about the organization and its philosophy among a co-
hort of alcoholics entering a UK (non-AA) alcohol treatment service.
Method: A total of 150 consecutive admissions (75% men) were inter-
viewed by an independent researcher within 5 days of their entry into a
residential alcohol treatment unit. Results: Although about three quar-
ters of these patients had previously attended AA meetings, levels of
affiliation were low, with only 16% having worked any of the Twelve
Steps. Previous AA attenders were more likely to be older, drinking
greater daily quantities prior to treatment and to have first sought alco-
hol treatment at a younger age. Roughly equal groups expressed “posi-
tive,” “neutral” and “negative” current attitudes towards AA (38%, 36%
T HERE ARE MORE THAN 3,000 AA meetings each
week in the UK, approximately 500 in London (per-
sonal communication with the AA General Service Board).
AA is built around a program to recovery, the Twelve Steps,
and is based on mutual help, group affiliation and identifi-
cation (Spickard, 1990). It is widely believed that the
Twelve-Step model contributes to recovery (Miller and
McCrady, 1993) and many treatment programs incorporate
Twelve-Step principles and recommend AA attendance as
an aftercare resource.
AA meetings differ in terms of their membership, social
structure, group dynamics (Montgomery et al., 1993) and
program implementation (Tonigan et al., 1995), and AA
therefore advocates that new members attend different
groups until they find one that suits their needs. Early re-
search (Leach, 1973; Ogbourne and Glaser, 1981; Trice
and Roman, 1970) suggested that AA affiliates were not
representative of alcoholics receiving treatment (Emrick,
1987). The AA affiliates were characterized as older, single,
Received: June 14, 2001. Revision: April 23, 2002.
*Funding was provided by the Eva and Hans Rausing Trust through the
charity Action on Addiction.
†Correspondence should be sent to Dr. David Best, Police Complaints
Authority, 10 Great George Street, London SW1P 3AE, England, or via
email to: bestd@pca.gov.uk.
257
and 26%, respectively). Each of these three AA-attitude groups expressed
greater endorsement of “Personal Responsibility” steps than of “Higher
Power mediated” steps. Conclusions: Few participants were universally
negative to AA or the Twelve Steps—most regarded some of the steps
as positive, but many rejected those referring to a Higher Power. Most
also regarded some aspects of the organization and its philosophy worth-
while, with attitudes spread across the continuum of opinion. As AA
remains one of the most widely sought forms of help for alcohol prob-
lems, a clearer understanding is needed of its impact on patients and
the appropriateness of its integration within substance misuse programs
which are not explicitly Twelve Step in orientation. (J. Stud. Alcohol 64:
257-261, 2003)
middle class men and more chronically and severely alco-
holic (Emrick, 1987; Galaif and Sussman, 1995). More
recent research (Humphreys et al., 1995; Room and
Greenfield, 1993), however, has failed to identify clear de-
mographic or alcohol-related characteristics associated with
AA attendance. AA membership surveys have also observed
an increase in the percentage of women, people under 30
and polydrug users attending meetings (Chappel, 1993;
Emrick, 1987).
Alcoholics Anonymous is the most common form of
help for those wit∞ alcohol problems (McCrady and Miller,
1993) and most U.S. treatments operate within this broad
context (Wallace, 1996). However, there is little research
on AA in the UK, and there are concerns about generaliz-
ing from American evidence. Little is known about AA’s
acceptability and effectiveness in the UK and even less
about its relationship with “statutory” treatment providers.
While many drug and alcohol treatment services have links
with AA groups, their integration and role vary. Some may
incorporate Twelve-Step principles, others recommend AA
attendance as an aftercare resource. The current article ex-
plores the AA experiences and attitudes of a cohort of Na-
tional Health Service alcohol treatment seekers. Levels of
prior AA attendance and affiliation are described and dif-
ferences between AA attenders and nonattenders examined.
Attitudes towards AA and the Twelve Steps and potential
barriers to AA engagement are also explored.
258 JOURNAL OF STUDIES ON ALCOHOL / MARCH 2003
Method
A total of 150 consecutive admissions to an inpatient
alcohol treatment service in South London were interviewed
by an independent researcher. Data were collected on de-
mographic profile, drinking and treatment history by means
of the Maudsley Addiction Profile (Marsden et al., 1998),
Severity of Alcohol Dependence Questionnaire (SADQ;
Stockwell et al., 1979) and the Alcohol Problems Ques-
tionnaire (Drummond, 1990).
Previous AA attendance and affiliation were measured
using the AA Involvement Scale (Tonigan et al., 1996a),
and a new instrument was used to measure current views
towards AA and the Twelve Steps. Participants were asked
to read through the Twelve Steps and indicate their level of
endorsement of each step. Positive endorsements refer to
unequivocal acceptance of the step; that is, acceptance with-
out reservation about either content or language (Best et
al., in press). A modified measure of spiritual orientation,
religious faith and involvement was used (Religious Be-
liefs and Behaviour Scale; Connors et al., 1996).
Sample characteristics
The sample consisted of 112 (74.7%) men and 38
(25.3%) women, with a mean age of 42.2 years. The ma-
jority (132, 90.4%) were white; 57 (39.0%) were single, 53
(36.3%), divorced, separated or widowed and 36 (24.7%)
living with a partner (valid demographic data n = 146).
Most (112, 77.2%) had not been employed in the past
month, although 23 (15.8%) had worked and 6 (4.1%) were
retired (valid n = 141).
When asked to describe current religious beliefs, 49
(32.9%) endorsed “I believe in God, but I am not reli-
gious”; 40 (26.8%) endorsed “I do not believe in God”; 28
(18.8%) endorsed “I believe in God and practice religion”;
19 (12.8%) endorsed “I don’t know what to believe about
God”; and y3 (8.7%) endorsed “I believe we can’t really
know about God” (valid n = 149).
The sample had been drinking for an average of 22.4
years and had an average age of 37.4 years when first seek-
ing alcohol treatment. Of the sample, 99% self-reported
drinking 34.1 units on a mean of 28.8 days; 128 (86.5%)
drank on a daily basis. They had a mean Severity of Alco-
hol Dependence score of 34.4, and 92 (63.0%) reported a
score of 30 or more, denoting severe dependence. A major-
ity of the total sample (116, 78.4%) agreed with the goal of
abstinence.
Results
Previous attendance at Alcoholics Anonymous
Nearly three quarters of the sample had previously at-
tended an AA meeting (110, 73.3%) with a mean atten-
dance of 45.3 meetings (range of 1-500); 40 (26.7%) re-
ported that they had never attended AA; 49 (32.7%) had
attended AA but not in the last year; and 26 (17.3%) had
first attended in the last year. Those attending in the last
year (61, 55.5%) had attended a mean of 17.8 meetings. The
most common route into AA was through treatment services
(50, 46.3%) (i.e., via statutory NHS treatment services, gen-
eral practitioners or specialist addiction services), followed
by family and friends (31, 28.7%); the remainder (27, 25.0%)
had first attended of their own accord (valid n = 108).
Affiliation with Alcoholics Anonymous
Of patients with AA experience, 22 (20.0%) had “ever
considered [themselves] to be a member of AA”; 17 (15.6%)
had worked any steps; 7 (6.4%) had attended 90 meetings
in 90 days; 19 (17.4%) had ever had a sponsor; 8 (7.3%)
had celebrated a sobriety birthday and 3 (2.8%) had experi-
enced a spiritual awakening.
Profile of AA attenders
A backwards elimination logistic regression analysis
found that previous AA attendance was associated with be-
ing older (p < .01), drinking greater daily quantities prior
to treatment entry (p < .05) and having first sought alcohol
treatment at a younger age (p < .01) (χ2 = 30.2, p < .001).
All other demographic and alcohol-related measures, in-
cluding religious involvement, were not found to be sig-
nificant predictors of previous AA attendance. Similar
proportions of men (77%) and women (63%) had ever at-
tended AA and had attended in the last year (57% and
46%, respectively). Although there were no significant dif-
ferences in levels of lifetime attendance (men: mean of 47.7;
women: mean of 36.6; t = 0.5, p = .6), men reported sig-
nificantly higher meeting attendance over the previous year
(means of 11.8 and 1.4, respectively; t = 3.6, p < .001).
Positive endorsement of the Twelve Steps
After reading through the Twelve Steps, patients endorsed
a mean total of 5.4 steps. A clear and consistent pattern of
endorsement was evident (Best et al., in press), with the
majority agreeing with steps that do not explicitly mention
God or a Higher Power but encourage acceptance, self-
examination and reparation (grouped as “Personal Respon-
sibility” steps, see Table 1). A considerable proportion
reported the references to God (80, 54.4%) and the Higher
Power (88, 62.4%) were “off-putting” (the term most com-
monly used in pilot interviews for adverse views).
Although the measures of Twelve Step endorsement are
closely correlated, each is predicted to different degrees
and by different variables in stepwise regression analyses
using drinking, demographic and AA-related predictor vari-
ables. “Higher Power” endorsement (R2 = 0.25; F = 22.1,
 HARRIS ET AL. 259

p < .001) was predicted by religious involvement (t = 5.8,
p < .001) and lifetime number of AA meetings attended (t
= 2.6, p < .05). A smaller proportion of “Personal Respon-
sibility” endorsement was explained (R2 = 0.13; F = 9.5, p
< .001) by current AA-attitude (t = 3.1, p < .01) and agree-
ment with the goal of abstinence (t = 2.3, p < .05).
Current attitude to Alcoholics Anonymous as an organization
Patients’ attitudes to AA were categorized in three
groups: 57 (38.3%) were “negative,” 53 (35.6%) “neutral”
and 39 (26.2%) “positive” (valid n = 149). Demographic
characteristics, alcohol problem severity, religious involve-
ment, meeting attendance, step endorsement and knowledge
were entered into a stepwise multiple regression analysis to
predict current attitude. Endorsement of “Personal Respon-
sibility” steps (t = 3.3, p < .01) and knowledge of the Twelve
Steps (t = 5.9, p < .001) were significant predictors (R2 =
0.28; F = 25.7, p < .001).
As shown in Table 2, the three AA-attitude groups dif-
fered significantly with regard to meeting attendance (both
lifetime and in the last year), Twelve Step knowledge and

TABLE 1. Positive endorsement of the Twelve Steps by the total sample (N = 150), AA attenders (n = 110) and non-AA attenders
(n = 40)
Total AA Non-AA Difference
sample attenders attenders between AA
Frequency Frequency Frequency vs non-AA
(%) (%) (%) attenders
Endorsement of “Personal
Responsibility” steps
Step 1: We admitted that we were
powerless over alcohol—that our
lives had become unmanageable 127 (84.7) 97 (76.4) 30 (23.6) χ2 = 3.90, p < .05
Step 4: Made a searching and fearless
moral inventory of ourselves 93 (62.0) 69 (74.2) 24 (25.8) χ2 = 0.09, p = .76
Step 8: Made a list of all persons we
had harmed, and became willing to
make amends to them all 96 (64.0) 73 (76.0) 23 (24.0) χ2 = 1.00, p = .32
Step 9: Made direct amends to such
people wherever possible, except
when to do so would injure them or
others 93 (62.0) 68 (73.1) 25 (26.9) χ2 = 1.01, p = .94
Step 10: Continued to take personal
inventory and when we were wrong
promptly admitted it 116 (77.3) 86 (74.1) 30 (25.9) χ2 = 0.17, p = .68
Step 12: 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 54 (36.0) 35 (64.8) 19 (35.2) χ2 = 3.13, p = .08

Mean number (SD) (range = 0-6) 3.9 (1.8) 3.9 (1.7) 3.8 (1.9) t = 0.36, p = .72

Endorsement of “Higher Power

mediated” steps
Step 2: Came to believe that a power
greater than ourselves could restore
us to sanity 47 (31.3) 36 (76.6) 11 (23.4) χ2 = 0.37, p = .54
Step 3: Made a decision to turn our will
and our lives over to the care of God
as we understood Him 32 (21.3) 22 (68.8) 10 (31.3) χ2 = 0.44, p = .51
Step 5: Admitted to God, to ourselves,
and to another human being the exact
nature of our wrongs 49 (32.7) 35 (71.4) 14 (28.6) χ2 = 0.14, p = .71
Step 6: Were entirely ready to have God
remove all these defects of character 27 (18.0) 20 (74.1) 7 (25.9) χ2 = 0.01, p = .92
Step 7: Humbly asked Him to remove
our shortcomings 41 (27.3) 30 (73.2) 11 (26.8) χ2 = 0.001, p = .98
Step 11: We 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 41 (27.3) 31 (75.6) 10 (24.4) χ2 = 0.15, p = .70

Mean number (SD) (range = 0-6) 1.6 (2.1) 1.6 (2.1) 1.6 (2.1) t = 0.02, p = .99

Source: Alcoholics Anonymous, 1976, pp. 59-60 (italics in original).

260 JOURNAL OF STUDIES ON ALCOHOL / MARCH 2003
TABLE 2. Step endorsement, meeting attendance and religious involvement reported by the three AA-attitude groups
Negative
AA attitude
Mean (SD)
Knowledge of the Twelve Steps (0-12) 0.09 (0.4)a
Overall endorsement of the Twelve
Steps (0-12) 4.2 (3.0)a,b
Endorsement of “Higher Power
mediated” steps (0-6) 0.9 (1.6)a,b
Endorsement of “Personal
Responsibility” steps (0-6) 3.3 (1.9)a
Lifetime meeting attendance 10.8 (21.7)a
Meeting attendance in the last year 0.9 (1.8)a
Religious involvement (0-30) 4.5 (4.5)
Note: Means on the same row having the same subscript letter differ significantly at the p < .05 significance level (Bonferroni
post hoc significance test).
endorsement but not religious involvement. All three groups
found the “Higher Power mediated” steps less acceptable
than the “Personal Responsibility” steps. Endorsement of
the “Higher Power mediated” steps was lowest among the
“negative” group (“neutral” and “positive” groups reported
similar levels of endorsement).
Discussion
Nearly three quarters of the sample had previous experi-
ence of AA. For many, however, this had been only a fleet-
ing engagement as most of the sample reported low levels
of affiliation (exposure was infrequently translated into en-
during membership). The current research investigates
whether there is a distinctive profile for AA attenders. While
AA attenders were older than non-AA attenders (as sum-
marized by Galaif and Sussman, 1995), other demographics
failed to distinguish attenders from nonattenders (support-
ing Emrick, 1989, and Tonigan et al.’s inpatient finding,
1996b).
Furthermore, AA attenders did not differ in religious
involvement as previously found by Laundergan and
Kammeier (1978). However, there was a mixed picture with
regard to alcohol problem severity. Ogbourne and Glaser
(1981) and Vaillant’s (1983) findings of a positive rela-
tionship between AA affiliation and severity are not sup-
ported in the current sample. Those who had previously
attended AA, however, were more likely to report first seek-
ing alcohol treatment at an earlier age and drinking larger
daily amounts prior to treatment. This suggests likelihood
of attendance might be less predicted by “static” character-
istics, such as gender, and more by historical factors, such
as age and duration of problem drinking.
The observed lack of AA affiliation was not reflected in
overall AA attitudes. The largest group (38%) expressed
“negative” attitudes; however, more than a quarter were
“positive” and just over a third “neutral.” The presence of
a sizeable nonpolarized group challenges the preconception
Neutral Positive
AA attitude AA attitude Significance
Mean (SD) Mean (SD) test
0.3 (0.9)b 1.7 (2.0)a,b F = 24.9, p < .001
5.9 (3.4)a 6.7 (3.1)b F = 8.2, p < .001
2.0 (2.2)a 2.1 (2.2)b F = 5.8, p < .01
3.9 (1.7) 4.6 (1.4)a F = 7.3, p < .01
21.8 (70.7)b 81.4 (117.6)a,b F = 11.2, p < .001
2.0 (6.9)b 22.9 (35.3)a.b F = 19.5, p < .001
7.3 (7.2) 6.1 (6.2) F = 2.9, p = .06
that drinkers are heavily polarized in AA attitudes. All three
AA-attitude groups expressed greater endorsement of “Per-
sonal Responsibility” than of “Higher Power mediated”
steps. The groups were differentiated only in the strength
of their approval of “Personal Responsibility” steps and the
strength of their rejection of “Higher Power mediated” steps.
Those with a negative attitude towards AA may still be
receptive to some steps, particularly to “Personal Responsi-
bility” steps. Conversely, even those generally positive about
AA may have some reservations, especially about steps that
evoke a “Higher Power.”
Over half the sample found references to God off-put-
ting, consistent with Room (1998) and Galaif and Sussman
(1995), who suggest the spiritual emphasis of the Twelve
Steps might be a barrier to engagement. The “Higher Power”
concept may be a barrier that can be overcome in personal
terms, perhaps by its representation as a quality within the
individual or group. Clinical staff may be able to facilitate
a reconceptualization of the “Higher Power,” so that it may
be tailored to personal beliefs. This problem has been ad-
dressed by adapting the Twelve Steps to downplay refer-
ences to a Higher Power in the Seven Points of Links
(Kurube, 1992), and, in temperance-based groups in Italy
and Croatia, the Twelve Steps play a limited role (Room,
1998). Increased understanding of the impact these changes
have on affiliation and abstinence rates, and their pancultural
generalizability, would be valuable.
It is important to bear in mind the sampling frame when
considering implications. This is a group of self-identified
problem drinkers entering treatment in a generic unit with
no commitment to AA. As a consequence, the sample is
not representative of the general drinking population, nor
does it represent “typical” AA recruits. Nonetheless, it is
important to consider the policy and practice issue of
whether the appropriate place for AA is within generic al-
cohol treatment services. It is too restrictive to assume that
all barriers to attendance relate to the Twelve Steps, as
previous experiences and expectations of AA attendance
 HARRIS ET AL.
are likely to color overall beliefs and acceptance. Analysis
of the qualitative components of the current body of re-
search will examine this issue in greater detail.
Current AA involvement within statutory alcohol treat-
ment programs appears largely arbitrary in the UK. If the
efficacy of AA is to be optimized, its involvement in treat-
ment should be implemented in such a way that clients
who choose to attend are empowered (Sanchez-Craig, 1990)
to develop the personal and social skills that are prerequi-
site for benefiting from AA meetings (Caldwell and Cutter,
1998). Although AA might not benefit all problem drink-
ers, consideration of the barriers to attendance and engage-
ment may facilitate integration and implementation so that
benefits may be extended to a broader group. Thus, those
who fail to engage as a result of references to God and the
Higher Power may still derive some advantage from an
amended version that excludes or reduces the salience of
these components. As with other components of treatment,
clinicians may benefit from working with a range of “AA-
style” approaches that seek to match aspects of meetings to
the beliefs and perceptions of the patient.
Acknowledgments
The authors would like to thank the staff and patients of the alcohol
unit included in the study. They are also grateful to the Eva and Hans
Rausing Trust for funding the study and to Action on Addiction for its
support.
References
ALCOHOLICS ANONYMOUS. Alcoholics Anonymous: The Story of How Many
Thousands of Men and Women Have Recovered from Alcoholism,
3rd Edition, New York: Alcoholics Anonymous World Services, 1976.
BEST, D.W., HARRIS, J.C., GOSSOP, M., MANNING, V.C., MAN, L.H.,
MARSHALL, E.J., BEARN, J. AND STRANG, J. Are the twelve steps more
acceptable to drug users than to drinkers? Europ. Addict. Res., in
press.
CALDWELL, P.E. AND CUTTER, H.S.G. Alcoholics Anonymous affiliation
during early recovery. J. Subst. Abuse Treat. 15: 221-228, 1998.
CHAPPEL, J.R. Long-term recovery from alcoholism. Psychiat. Clin. No.
Amer. 16: 177-187, 1993.
CONNORS, G.J., TONIGAN, J.S. AND MILLER, W.R. A measure of religious
background and behavior for use in behavior changes research. Psychol.
Addict. Behav. 10: 90-96, 1996.
DRUMMOND, D.C. The relationship between alcohol dependence and alco-
hol-related problems in a clinical population. Brit. J. Addict. 85: 357-
366, 1990.
EMRICK, C.D. Alcoholics Anonymous: Affiliation processes and effective-
ness as treatment. Alcsm Clin. Exp. Res. 11: 416-423, 1987.
EMRICK, C.D. Alcoholics Anonymous: Membership characteristics and ef-
fectiveness as treatment. In: GALANTER, M. (Ed.) Recent Developments
in Alcoholism, Vol. 7: Treatment Research, 1989, pp. 37-53.
261
GALAIF, E.R. AND SUSSMAN, S. For whom does Alcoholics Anonymous
work? Int. J. Addict. 30: 161-184, 1995.
HUMPHREYS, K., MOOS, R.H. AND FINNEY, J.W. Two pathways out of drink-
ing problems without professional treatment. Addict. Behav. 20: 427-
441, 1995.
KURUBE, N. The ideological and organizational development of the Swed-
ish Links movement. Contemp. Drug Probl. 19: 649-676, 1992.
LAUNDERGAN, J.C. AND KAMMEIER, M.L. Posttreatment Alcoholics Anony-
mous Attendance and Treatment Outcome, Center City, MN: Hazelden,
1978.
LEACH, B. Does Alcoholics Anonymous really work? In: BOURNE, P.G.
AND FOX, R. (Eds.) Alcoholism: Progress in Research and Treatment,
San Diego, CA: Academic Press, 1973, pp. 245-284.
MCCRADY, B.S. AND MILLER, W.R. (Eds.) Research on Alcoholics Anony-
mous: Opportunities and Alternatives, New Brunswick, NJ: Rutgers
Center of Alcohol Studies, 1993.
MARSDEN, J., GOSSOP, M., STEWART, D., BEST, D., FARRELL, M., LEHMANN,
P., EDWARDS, C. AND STRANG, J. The Maudsley Addiction Profile (MAP):
A brief instrument for assessing treatment outcome. Addiction 93:
1857-1868, 1998.
MILLER, W.R. AND MCCRADY, B.S. The importance of research on Alco-
holics Anonymous. In: MCCRADY, B.S. AND MILLER, W.R. (Eds.) Re-
search on Alcoholics Anonymous: Opportunities and Alternatives, New
Brunswick, NJ: Rutgers Center of Alcohol Studies, 1993, pp. 3-11.
MONTGOMERY, H.A., MILLER, W.R. AND TONIGAN, J.S. Differences among
AA groups: Implications for research. J. Stud. Alcohol 54: 502-504,
1993.
OGBOURNE, A.C. AND GLASER, F.B. Characteristics of affiliates of Alcohol-
ics Anonymous: A review of the literature. J. Stud. Alcohol 42: 661-
675, 1981.
ROOM, R. Mutual help movements for alcohol problems in an interna-
tional perspective. Addict. Res. 6: 131-145, 1998.
ROOM. R. AND GREENFIELD, T. Alcoholics Anonymous, other 12-step move-
ments and psychotherapy in the U.S. population, 1990. Addiction 88:
555-562, 1993.
SANCHEZ-CRAIG, M. Brief didactic treatment for alcohol and drug-related
problems: An approach based on client choice. Brit. J. Addict. 85:
169-177, 1990.
SPICKARD, A., JR. The utilization of self-help groups. In: LERNER, W.D.
AND BARR, M.A. (Eds.) Handbook of Hospital Based Substance Abuse
Treatment, New York: Pergamon Press, 1990, pp. 169-183.
STOCKWELL, T., HODGSON, R., EDWARDS, G., TAYLOR, C. AND RANKIN, H.
The development of a questionnaire to measure severity of alcohol
dependence. Brit. J. Addict. 74: 79-87, 1979.
TONIGAN, J.S., ASHCROFT, F. AND MILLER, W.R. AA group dynamics and
12-step activity. J. Stud. Alcohol 56: 616-621, 1995.
TONIGAN, J.S., CONNORS, G.J. AND MILLER, W.R. Alcoholics Anonymous
Involvement (AAI) Scale: Reliability and norms. Psychol. Addict.
Behav. 10: 75-80, 1996a
TONIGAN, J.S., TOSCOVA, R. AND MILLER, W.R. Meta-analysis of the litera-
ture on Alcoholics Anonymous: Sample and study characteristics mod-
erate findings. J. Stud. Alcohol 57: 65-72, 1996b.
TRICE, H.M. AND ROMAN, P.M. Sociopsychological predictors of affiliation
with Alcoholics Anonymous: A longitudinal study of “treatment suc-
cess.” Social Psychiat. 5: 51-59, 1970.
WALLACE, J. Theory of 12-step oriented treatment. In: ROTGERS, F., KELLER,
D.S. AND MORGENSTERN, J. (Eds.) Treating Substance Abusers: Theory
and Techniques, New York: Guilford Press, 1996, pp. 13-36.
VAILLANT, G.E. The Natural History of Alcoholism, Cambridge, MA:
Harvard Univ. Press, 1983.