Longitudinal engagement and drinking outcomes associated with mode of 12-step attendance

12-step programs have demonstrated efficacy, and evidence suggests that online 12-step meeting attendance has become an established pathway to the 12-step program, both as a sole point of access and in combination with in-person attendance. Because the relative effectiveness of these two modes of 12-step attendance have yet to be compared clinicians have little empirical guidance in making referrals to either in-person or online 12-step meetings. This study contrasts online versus both online and in-person attendance and experiences among early 12-step affiliates. Three domains central to the 12-step program were compared: engagement in prescribed behaviors, impressions of 12-step group dynamics, and drinking outcome.

This was an observational longitudinal study (N = 192) examining the change trajectories of early 12-step members. Participants were recruited via online platforms and selection criteria restricted enrollment to individuals with limited AA histories. Assessments for the entire sample included online interviews at baseline, 3, and 6-months and a subset of the sample also completed twice daily EMA online surveys for 6-months (n = 133). The EMA sample constituted the sample for this study and, of the 133 EMA participants, 110 were classified by 12-step attendance mode.

Demographic profiles did not differ between adults attending only online meetings (n = 40) versus attending both online and in-person meetings (n = 70), with the exception that attending both 12-step modes was associated with pre-baseline treatment episodes. Rates of 12-step attendance were equivalent over 3-months between 12-step modes although online only participants reported less engagement in prescribed activities, and they reported significantly lower agreement on the tasks and objectives of the 12-step program. Rates of abstinence (baseline to 3-months) were significantly higher when attending both 12-step modes (94.51%; SD = 17.24) relative to only online meetings (81.44%; SD = 17.38). No between-group differences were found on measures of drinking intensity and negative consequences.

Online 12-step meeting attendance is a popular method to access the 12-step program. While online meetings offer enhanced accessibility the exclusive use of online meetings was associated with less engagement in prescribed 12-step activities and lower rates of abstinence relative to attending both online and in-person meetings. Awaiting replication, findings suggest that clinicians should recommend attending both 12-step meeting modes during early recovery.