A 2020 Cochrane Review was recently released evaluating outcomes and cost-effectiveness of Alcoholics Anonymous (AA) and Twelve-Step Facilitation (TSF).  While a prior 2006 Cochrane Review did not provide conclusive evidence of the effectiveness of the AA or TSF approaches, it was limited to eight studies and much has changed since then.

Most important to this current review is the number and quality of studies available for review. The current review includes 27 studies involving 10,565 participants with 21 of those studies being randomized or quasi-randomized controlled trials.  In short, the review demonstrates that AA/TSF increases rates and lengths of abstinence compared with other interventions (such as cognitive behavioral therapy and motivational enhancement therapy) at a much lower cost.

This 2020 Cochrane Review provides the highest scientific rigor. We are encouraged by the findings since they support a recovery process that has benefited so many of us, our participants, friends, family and colleagues. We are also reminded that there is more unknown than known when it comes to addictive illness and that our most strongly held beliefs are the ones we need to be most wary of. Polarized views of what works or doesn’t work usually betray us.  There are no simple solutions to the complex problem of addiction. Humility in the face of the awesome destructive power of this illness urges us to embrace every tool at our disposal.

We are grateful to the study authors for this important contribution.  It validates the experiences of millions who credit their recovery to AA and other 12 Step Programs and may help alleviate skepticism and doubt among others.  We extend special appreciation to Keith Humphreys, PhD, one of the study authors, an leader in the science of mutual help, supporter of the Physician Health Program model, and friend to WPHP.