Search results

The purpose of this paper is to provide a better understanding of how hidden organizations like Alcoholics Anonymous (AA) manages the dialectical tension between concealment and revelation. Despite research on AA’s successes and failures across disciplines, scholars have not thoroughly uncovered how AA communicates internally and externally to maintain the desired level of the organizational visibility. AA’s visibility management is critical in terms of achieving the organizational goals of AA.

To capture how AA communicatively manages the visibility of the organization, the author attended and observed the World Meeting of AA. As a participant-observer, the author did ethnographic fieldwork at the World Meeting.

During the convention, various types of communication strategies AA used to maintain the dialectical tension of concealment/revelation as well as celebrate its international convention became apparent. In particular, AA responded the tension strategically by choosing segmentation, denial and education at the World Meeting.

The author’s observation was suitable to describe AA’s anonymous communication practices. Its empirical finding was valuable for future research.

This paper explores some of the historical tensions between Alcoholics Anonymous (AA) or fellowship groups and the professional world and advocates the need for partnership and healthy dialogue between ideas from different traditions. A case example is presented combining psychotherapy and AA, leading to an elaboration of the concept of narrative and the importance of spiritual or value‐change.

Attendance at alcoholics anonymous (AA) or narcotics anonymous (NA) meetings and affiliation with the fellowship has potential benefits for people with alcohol or drug use disorders. This effect is present whether or not the individual attends professional treatment services, but the two process can have a synergistic effect. Limited information exists about the extent to which people attending UK specialist treatment services also attend AA/NA and their views about such attendance. The paper aims to discuss these issues.

A cross-sectional survey of 200 consecutive attendees at the specialist treatment service in an English region was conducted between January and April 2018. A measure of past attendance and affiliation with AA/NA (AAAS) and a scale designed to quantify future readiness to attend (Survey of Readiness for Alcoholics Anonymous Participation) were administered and anonymously linked to data supplied to the National Drug Treatment Monitoring Service (NDTMS).

A minority of the sample had ever attended an AA meeting (31 per cent, n=59) or an NA meeting (41 per cent, n=79), and only 14 per cent (n=27) and 24 per cent (n=45) had attended an AA or NA meeting, respectively, in the past year. Only two variables significantly predicted level of readiness to attend AA or NA in a regression model: attended more AA/NA meetings in the past (ß=0.149, p=0.036) and previous level of participation (AAAS score) (ß=0.409, p < 0.001).

A significant proportion of attendees of a specialist drug and alcohol treatment service had never attended AA/NA, despite many positive views about their potential benefits. Given the established benefits of attending AA/NA meetings and participating in the AA or NA fellowship, these results suggest that professional treatment services should do more to explain the process and challenge preconceived ideas about how they operate.

The authors are not aware of any published research that captures the rates of attendance of and participation in both AA and NA groups in a UK-based community treatment sample. These results may therefore provide a baseline for evaluating the impact of interventions to increase attendance/participation, and also provide some insight into the potential barriers to attendance in this population.

This is a study of how members of Alcoholics Anonymous (AA) produce their talk, using the principles of ethnomethodological conversation analysis. The focus is on two interralated phenomena of the openings of turns. Recurrently, the first words of the turns, i.e., greetings and self‐identification, are followed with a resonse space during which members display their orientation to coparticipants through allusions to prior speakers. Positive references to prior speakers are stated directly and addressed explicitly, typically through a phrase such as: “I identified with X and what X said,” wheras critical remarks are stated implicitly and without any address. Through this procedure, members establish their individual position in each meeting without posing challenges to other members. The allusions occasions initiation of a subsequent topic of the turn that characteristically is biographically relevant for the speaker. This procedure of organization of talk permits AA meetings to handle delicate issues in a sociable, nonconfrontive way.

Using strikingly different managerial techniques from conventional organizations, 12 Step Fellowships, most prominently Alcoholics Anonymous, provide useful clues to producing more effective, functional and humane organizations in contrast with our many dysfunctional firms which abuse their employees, behave unethically towards their customers, damage their social and ecological habitat and find it difficult to complete in a turbulent global environment. The founding Fellowship, Alcoholics Anonymous (AA), extends to 131 countries with 1,550,000 members while the second largest, Al‐Anon/Alateen, has 414,000 members in 84 countries. Without advertising, government support or experts, AA is widely considered the most effective method for treating alcoholism. This success story was produced by members who, prior to AA, were themselves severely dysfunctional and often unemployable. Examines facets of the Fellowships (organizational structure, culture, communication and problem solving techniques) to demonstrate a powerful, little studied model for organizational learning and transformation.

Purpose – To reconsider the historical relationship between addiction and obesity, which current literature tends to treat as unrelated until the late twentieth century.

Approach – We describe the forms of sociality and therapeutic discourses manifested in the emerging weight loss group movement from the 1940s until 1970 in cultural and intellectual context, drawing mainly on popular media and medical literature. The histories of these ‘Fatties Anonymous’ groups serve as valuable lens for studying the mutable cultural linkage between drug addiction and obesity that was first forged in the golden age of psychoanalysis.

Findings – We show that medicine began interpreting obesity as addiction around 1940 and that this view achieved dominance in both medical and popular discourse by 1950. The theoretical framing of a psychoanalytical interpretation of obesity in the 1940s, combined with the simultaneous rise to prominence of obesity-related problems in public health and popular stigma around fatness, was translated in the Cold War United States into a popular mutual-aid weight loss movement modelled on Alcoholics Anonymous.

Originality value – Our account challenges the present received view that the stigmatised health conditions of obesity and addiction only came to be related in the late twentieth century. There is notable similarity between the 1950s ‘Fatties Anonymous’ type group and present public health campaigns in fostering the individual's sense of self-control and encouraging self-enterprising improvement. Neither historical and contemporary similarities nor differences should be elided. Further research in this area would be of value to current and future developments in public health.

The purpose of this paper is to investigate how clients – five years after completing treatment interventions endorsing abstinence – view abstinence and the role of Alcoholics Anonymous (AA) in their recovery process.

Interviews with 40 clients were conducted shortly after them finishing treatment and five years later. All the interviewees had attended treatment programmes based on the 12-step philosophy, and they all described abstinence as crucial to their recovery process in an initial interview.

At follow-up, the majority remained abstinent. For many, attending AA meetings was still important – some described attending as a routine, whereas others stressed that the meetings were crucial for remaining abstinent. For those who reported controlled drinking (CD), this was described either as a natural step in their recovery process or as associated with worries and self-doubts.

The results suggest the importance of offering interventions with various treatment goals and that clients choosing CD as part of their sustained recovery would benefit from support in this process, both from peers and professionals.

There are heterogeneous views on the possibilities of CD after recovery from substance use disorder both in research and in treatment systems. This study on client views on abstinence versus CD after treatment advocating total abstinence can contribute with perspectives on this ongoing discussion.

This paper introduces narrative theory and therapy, showing its relevance to addiction and recovery. A variety of techniques and clinical sensitivities are illustrated, the purpose of which is to enable clients to change.