Processes of change in Alcoholics Anonymous: maintenance factors in long-term sobriety

Examination of the change strategies associated with successful long-term sobriety remains an understudied area in addiction research. The following study recruited individuals in various stages of sobriety (range: 1 month to 27 years continuous abstinence). Subjects (N = 191) were surveyed on demographic, problem history, degree of self-help utilization, current process of change use and self-efficacy measures. Subjects were differentiated based on varying experience with AA, including exposure, frequency of meeting attendance and degree of affiliation. Analyses included comparisons on demographic, problem history, process of change and self-efficacy markers (i.e., self-change vs self-help; differing levels of self-help utilization). Few differences were found between groups on demographic or self-efficacy indices, although there was a trend for past or current AA attendees and medium affiliates to report slightly greater alcohol use prior to quitting compared to self-changers or low affiliates. There was a consistent, positive relationship between the use of behaviorally oriented change processes and increased involvement with AA, with current attendees and high affiliates utilizing these particular strategies more frequently than either self-changers, past attendees or the low to medium affiliate groups. The utility of process analyses in helping map the pattern of successful addictive behavior change is discussed.