COUC 691 Week 3 Experiential Paper 1: AA Example

Experiential Paper 1: A Big Book Study and a Step Meeting in West Texas, and What Alcoholics Anonymous Showed a Counselor in Training

Introduction

Before this assignment, I had referred more than a dozen residents of the recovery home where I work to Alcoholics Anonymous, yet I had never sat in a meeting myself. I knew AA mostly through what residents told me, which ranged from gratitude to resentment. For this paper I attended two open meetings in Lubbock, Texas: a Saturday morning Big Book study held in a community center, and a Tuesday evening step meeting held in a veterans' hall. I chose open meetings because they welcome visitors who do not have a drinking problem, and I chose two different formats so I could compare them.

I went in with a simple plan. I would arrive early, sit toward the back, introduce myself only as a counseling student and visitor if asked, and decline to share. I took no notes during either meeting and wrote my observations in the car afterward. To protect the anonymity that AA treats as a spiritual foundation of the program, this paper describes no member by name, appearance or personal detail, and the moments I report are combined and altered so no one could be recognized (Alcoholics Anonymous, 2001).

Meeting One: An Open Big Book Study

About twenty people sat around folding tables pushed into a long rectangle, with coffee at one end and a stack of blue books at the other. The chair opened with a moment of silence and a reading of the AA preamble, which describes a fellowship of people who share experience, strength and hope so that they can solve their common problem and help others recover. A member read a short passage on anonymity, and the chair asked whether anyone was new. A woman who said she was on her second day raised her hand, and the room applauded her, warmly and without fuss.

The study itself was simple. Members took turns reading paragraphs aloud from the chapter called "There Is a Solution," stopping after each page so that anyone who wished could comment. One man said the chapter described his drinking better than he could. Another said she used to read it as an argument and now reads it as a letter from people who had been where she was. A third disagreed gently with the chapter's language about spirituality and said the group itself had been his higher power for years. No one corrected him.

The meeting closed with the Serenity Prayer, members standing in a circle holding hands. Two people approached the newcomer afterward, gave her a meeting list and wrote their phone numbers on it.

Meeting Two: An Open Step Meeting

The Tuesday meeting was larger, perhaps forty people, and louder. The chair announced that the month's topic was the fourth step, the moral inventory, and asked a member with long sobriety to open the discussion. He spoke for about ten minutes about how afraid he had been to write his inventory, and how his sponsor had helped him see that it was not a list of crimes but an honest look at patterns, including resentments and fears. Then the floor opened, and members raised their hands to share for three or four minutes each.

The most striking part of the evening was the coin ceremony, in which the chair called out lengths of sobriety, from twenty-four hours to thirty years, and members came forward to receive a medallion and a hug. A young man took a thirty-day coin and could barely speak. A woman took a twenty-year coin and said she had relapsed after her first eleven years, so she counted every year as a gift. The room cheered both equally. Later in the sharing, several members spoke about their sponsors, the members with longer sobriety who guide them through the steps, and one said that calling a sponsor before taking a drink had saved him more than once. Another described doing service, such as making coffee or setting up chairs, as the thing that kept her coming back during her first year, when she did not yet believe the program would work for her. A basket passed for the seventh tradition, which keeps groups self-supporting through members' own contributions, and the meeting closed with the Lord's Prayer.

What the Meetings Showed: Integrating the Research

Three themes stood out across both meetings: shared reading, time and belonging.

Shared reading. In the Big Book study, members used a common text to describe their own experience, and that text gave even quiet members a way into the conversation. The book's own opening chapters present shared experience as the core of the program (Alcoholics Anonymous, 2001), and the course text places mutual-help groups within a continuum of care rather than outside it (Capuzzi & Stauffer, 2016). It also helps explain why a structured counseling approach built on the steps can work. In Project MATCH, the largest alcohol treatment trial of its time, more than 1,700 clients in outpatient and aftercare settings were randomly assigned to twelve weeks of one of three manual-guided treatments: coping skills training based on cognitive behavioral principles, a motivational enhancement approach or twelve-step facilitation, and clients in all three conditions made significant and sustained improvements over the following year (Project MATCH Research Group, 1997). A treatment designed to connect clients with AA performed as well as two well-established professional therapies.

Time. The coin ceremony made visible something the research has measured. Moos and Moos (2006) followed adults with alcohol use disorders who had not been treated when they first sought help, surveying them at intervals over 16 years. People who took part in AA for 27 weeks or more during the first year had better 16-year alcohol outcomes than those who did not, and continued AA involvement in later years was also linked with better results, while later professional treatment was not. Part of the benefit of treatment itself appeared to come through AA participation. The thirty-day coin and the twenty-year coin, side by side, illustrated the study's lesson: the dose of involvement over time seems to matter.

Belonging. Members' welcome of the newcomer, the phone numbers on her list and the hand-holding circle suggested that AA works in part as a new social network. Yet my visits also showed variety: one meeting was quiet and textual, the other loud and personal, and one member openly rejected the spiritual language. Tonigan et al. (1996) combined the findings of 74 studies of AA affiliation and outcome and concluded that AA experiences and outcomes are heterogeneous; the relationship between participation and drinking outcomes was stronger in outpatient samples, and better designed studies were more likely to find psychosocial benefits. Their conclusion that there is no single profile of an AA member matched what I saw in two rooms only three days apart.

Implications for My Counseling Practice

These visits changed how I will refer clients. First, I plan to give clients a concrete picture of meetings, including formats and rituals such as the newcomer welcome, so that the first visit is less frightening. Second, I will encourage clients to try several meetings, since the difference between my two meetings was large and a client who dislikes one may feel at home in another. Third, I will treat referral as part of treatment rather than an afterthought. Walitzer et al. (2009) randomly assigned 169 outpatients to treatment as usual or to one of two ways of encouraging AA involvement within skills-focused therapy. A directive twelve-step approach produced more meeting attendance, more active involvement and more days abstinent, while a motivational approach to encouraging AA had no effect on outcomes.

That last finding raises a question for a counselor trained in motivational interviewing. Miller and Rollnick (2013) emphasize engaging the client and listening for the client's own goals, and nothing in the study suggests abandoning that stance. What it does suggest is that once a client has chosen abstinence, specific encouragement, such as identifying a meeting, discussing a sponsor and reviewing attendance each week, adds something. A counselor can be collaborative about the goal and directive about the steps. In practice, I expect to ask a client which meeting they attended, what it was like and what they might try next week, the same way I would review homework in cognitive behavioral therapy.

Finally, the visits showed me how much I did not know. Residents who complained about AA were sometimes describing one meeting, one sponsor or one bad night. Having now seen two very different rooms, I can ask better questions about what went wrong and help a client look for a better fit instead of giving up on mutual help altogether.

A Christian Perspective

James 5:16 urges believers to admit their sins to each other and to pray for each other, with healing as the promised result (English Standard Version Bible, 2001/2016). The step meeting looked to me like a version of that verse in practice: people telling the truth about themselves in front of others and finding acceptance instead of rejection. As a Christian counselor, I do not need AA to share all of my beliefs to respect what it offers. Its emphasis on honesty, humility and service is consistent with Scripture, and members who reject its spiritual language still found a place in the room. My task is to help each client find the support that fits, without imposing my faith or dismissing theirs.

Conclusion

Two open meetings, one built around a book and one around a step, showed me what I had been referring residents to for years: a community with rituals that mark time, welcome newcomers and invite honesty. The research on twelve-step facilitation, long-term participation and the variety of AA experiences helped me understand why those rituals matter. I will refer clients differently now, with more detail, more encouragement and more respect for the people who sit in those rooms.

References

Alcoholics Anonymous. (2001). Alcoholics Anonymous: The story of how many thousands of men and women have recovered from alcoholism (4th ed.). Alcoholics Anonymous World Services.

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

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

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

Moos, R. H., & Moos, B. S. (2006). Participation in treatment and Alcoholics Anonymous: A 16-year follow-up of initially untreated individuals. Journal of Clinical Psychology, 62(6), 735-750. https://doi.org/10.1002/jclp.20259

Project MATCH Research Group. (1997). Matching alcoholism treatments to client heterogeneity: Project MATCH posttreatment drinking outcomes. Journal of Studies on Alcohol, 58(1), 7-29. https://doi.org/10.15288/jsa.1997.58.7

Tonigan, J. S., Toscova, R., & Miller, W. R. (1996). Meta-analysis of the literature on Alcoholics Anonymous: Sample and study characteristics moderate findings. Journal of Studies on Alcohol, 57(1), 65-72. https://doi.org/10.15288/jsa.1996.57.65

Walitzer, K. S., Dermen, K. H., & Barrick, C. (2009). Facilitating involvement in Alcoholics Anonymous during out-patient treatment: A randomized clinical trial. Addiction, 104(3), 391-401. https://doi.org/10.1111/j.1360-0443.2008.02467.x