title: Prior Alcoholics Anonymous (AA) affiliation and the acceptability of the Twelve Steps to patients entering UK statutory addiction treatment.
abstract: OBJECTIVE
  The study investigates levels of affiliation with AA and beliefs about the organization and its philosophy among a cohort of alcoholics entering a UK (non-AA) alcohol treatment service.
  
  
  METHODS
  A total of 150 consecutive admissions (75% men) were interviewed by an independent researcher within 5 days of their entry into a residential alcohol treatment unit.
  
  
  RESULTS
  Although about three quarters 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 alcohol treatment at a younger age. Roughly equal groups expressed "positive," "neutral" and "negative" current attitudes towards AA (38%, 36% 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 worthwhile, with attitudes spread across the continuum of opinion. As AA remains one of the most widely sought forms of help for alcohol problems, 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.
authors.affiliation: National Addiction Centre/Institute of Psychiatry, South London and Maudsley NHS Trust, Denmark Hill, London, England.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Harris
authors.forename: David
authors.initials: D
authors.lastname: Best
authors.forename: Michael
authors.initials: M
authors.lastname: Gossop
authors.forename: Jane
authors.initials: J
authors.lastname: Marshall
authors.forename: Lan-Ho
authors.initials: LH
authors.lastname: Man
authors.forename: Victoria
authors.initials: V
authors.lastname: Manning
authors.forename: John
authors.initials: J
authors.lastname: Strang
mesh_terms: D000328:Adult; D000436:Alcoholics Anonymous; D000437:Alcoholism / Q000453:epidemiology* / Q000534:rehabilitation*; D001290:Attitude; D005260:Female; D006801:Humans; D008297:Male; D037141:Mandatory Programs / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data*; D008605:Mental Health Services / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data*; D015397:Program Evaluation; D013997:Time Factors; D006113:United Kingdom / Q000453:epidemiology