CEFS 691 Week 4 DB Forum 2 (AA) Example

Discussion Board Forum 2 (AA): Thread and Two Replies

CEFS 691 Substance Abuse: Diagnosis, Treatment and Prevention, Discussion Board Forum 2 (thread and two replies)

Thread by [Student Name]

The prompt, the meetings described and the classmates' posts are composites standing in for the course's own forum, with no AA member identifiable; the textbooks, Scripture and published studies are real; the requirements follow Liberty's public course guide for CEFS 691.

Thread

At the first meeting I attended, a man who said it was his first time was handed a small booklet with first names and phone numbers before he left. Three members told him to call anytime. That moment taught me more about referral than anything I had read: what helps a newcomer is not the name of the group but a person who will answer the phone. I had planned, as a future counselor, to hand clients a printed meeting schedule; after that evening, a schedule alone seemed far too little.

The research supports that impression. Kaskutas (2009) reviewed the evidence on AA's effectiveness against the criteria used to establish causation and found that rates of abstinence were about twice as high among those who attend AA, that higher attendance was related to higher abstinence, and that the relationship held across samples and follow-up periods, while noting that experimental evidence for a specific AA effect was less conclusive. Timko et al. (2006) tested how counselors refer. In a randomized trial with 345 outpatients, an intensive referral that connected patients with AA volunteers led to more involvement, such as having a sponsor and doing service, than a standard referral, and to more attendance among patients with little prior experience of meetings.

A referral, then, is a relationship, not a phone number. I would make it using the skills in Miller and Rollnick (2013): ask what the client already knows about AA, elicit their concerns, offer information with permission, and, if they agree, arrange for a member to meet them before their first meeting. Because fellowships offer support at hours no counselor keeps, as Capuzzi and Stauffer (2016) point out, a careful referral may be among a counselor's most useful acts.

The Preacher pities the person who falls with no companion to help him up (English Standard Version Bible, 2001/2016, Ecclesiastes 4:9-10). The phone list I saw handed out was that verse in practice, a fellowship making sure no newcomer walks out alone.

Classmates: what would you say to a client who agrees to try AA but has no one to go with?

Reply to Megan

Megan, you wrote honestly that the references to God and a higher power at your meeting made you uneasy, and you wondered how you would refer a client who is not religious. That is a fair concern, and research suggests a way to address it. Kelly (2017), reviewing 25 years of studies on how AA produces change, found that while AA's founding literature describes recovery as a spiritual awakening, most members benefit through social, cognitive and affective changes, such as building sober friendships, gaining confidence in handling high-risk situations and reducing craving. Spiritual change seemed central mainly for members with the most severe addiction.

That suggests a counselor can present AA honestly to a nonreligious client: the program uses spiritual language, members interpret it in many ways, and much of its benefit comes from the people and practices of the fellowship. A client who remains uncomfortable could also be offered secular mutual-help options, while the counselor respects the client's choice.

As a Christian, I also find it meaningful that the program leaves room for faith without requiring it, which allows clients to approach God, or not, in their own time.

Would you feel comfortable explaining AA's spiritual language to a client who asked you directly what you believe?

Reply to Darius

Darius, you noticed several people at your meeting who never spoke and wondered whether they were getting anything from it. I noticed the same at both meetings I attended, and I think the readings suggest they may be getting more than it appears. Miller and Rollnick (2013) describe change as a process in which ambivalence is normal, and a person sitting silently at the back of a meeting may be in the middle of resolving it. Simply hearing others describe the same struggles can make change feel possible.

The research on attendance supports patience. Kaskutas (2009) reported that higher levels of attendance were related to higher rates of abstinence, and that earlier attendance predicted later abstinence, which suggests that showing up has value even before a person participates actively. For a counselor, the implication is to affirm a client's attendance and explore what they are noticing, rather than pressing them to share before they are ready. A question such as "What did you hear tonight that stayed with you?" invites reflection without asking the client to perform.

Did any of the quiet members you saw seem to be newcomers, or were some of them long-time attenders who simply preferred to listen and greet people afterward?

References

Capuzzi, D., & Stauffer, M. D. (2016). Foundations of addictions counseling (3rd ed.). Pearson.

English Standard Version Bible. (2016). Crossway. (Original work published 2001)

Kaskutas, L. A. (2009). Alcoholics Anonymous effectiveness: Faith meets science. Journal of Addictive Diseases, 28(2), 145-157. https://doi.org/10.1080/10550880902772464

Kelly, J. F. (2017). Is Alcoholics Anonymous religious, spiritual, neither? Findings from 25 years of mechanisms of behavior change research. Addiction, 112(6), 929-936. https://doi.org/10.1111/add.13590

Miller, W. R., & Rollnick, S. (2013). Motivational interviewing: Helping people change (3rd ed.). Guilford Press.

Timko, C., DeBenedetti, A., & Billow, R. (2006). Intensive referral to 12-step self-help groups and 6-month substance use disorder outcomes. Addiction, 101(5), 678-688. https://doi.org/10.1111/j.1360-0443.2006.01391.x