Alcoholism is one of the issues that have affected mankind for a long time. Millions of dollars have been spent on alcohol and alcohol related issues. Thousands of families have been adversely affected, not to mention the talents that have been lost or not fully exploited due to taking of too much alcohol.
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We are not in a position to measure all the impacts that indulgence in alcohol has on mankind. The society understands the weight this issue has and different approaches have been taken aiming at helping the people who are struggling to stop taking alcohol. Scientists, theoreticians, philosophers, doctors and counsellors have all come up with suggestions meant to help people struggling to stop taking alcohol.
Many theories have been developed in an attempt to find strategies which can help alcohol users to quite taking alcohol. Motivational theories are widely used to explain how motivation can be used to address the alcoholism issue. Motivational theories have been developed by different psychologists over time and most of the alcohol recovery programs indeed use at least one or a combination of motivational theories to help victims recover from alcoholism.
Alcoholic Anonymous is one of the widely renowned alcoholism recovery programs operating in almost 200 countries and helping millions of alcohol addicts recover from alcoholism. This paper discusses Alcoholics Anonymous (AA) motivational program, motivational theories and then analyses how successful or not the AA program has been basing on the motivational theories.
Alcoholics Anonymous (AA)
The history of AA can be traced from a group called the Oxford Group which was a Christian organisation. Its purpose was to help men struggling to quite taking alcohol possible. It is believed that their concept of dealing with alcoholism was more of a spiritual approach as they believed that surrendering to God would help solve the sinful nature of alcoholism.
AA is said to have been formed in 1939 by Bill Wilson who borrowed most of the ideas from the Oxford Group and broadened the concept to include psychological and physical treatment as well. Since then the membership has increased and the program has increased its boundaries from America and Canada, where it was originally based to different parts of the world (Kurtz, 1979).
How AA works
AA motivational program works on a voluntary basis whereby whoever is willing to quite taking alcohol join the group. In order to encourage alcoholic victims to join the program and at the same time protect them from public ridicule the program calls for anonymity of the members hence the name alcoholics anonymous. The program not only helps alcoholics but also people struggling from other forms of addiction as well.
It is worth noting that the program is self-sustaining with no any external financial help, but works from voluntary contributions from its members and literature sales. There are no employed workers but rather the counselling is carried out by the previously recovered individuals through the mentorship program which is also voluntary. AA believes that the only qualification for membership is the decision and will to quit taking alcohol (Kurtz, 1979).
There are meeting centres distributed over 200 countries and a willing member is expected to join in any of the AA group meetings close to them. Once in the group, one is expected to confess and share personal experiences as an alcoholic with other members within the group and this would thus mark the beginning of the healing process (Kurtz, 1979).
Sponsorship can be seen as a mentorship program whereby members who have undergone much of the recovery program have the responsibility of mentoring and helping new entrants into the 12 principles of AA treatment program. This works both ways, the new members are able to learn from the already experienced members and on the other hand the sponsors are able to improve on their recovery process by helping the new individuals.
The basic principle of AA motivational program is that the victims of alcohol addiction must admit that there is a higher power, that is, God for those that believe in him or just any higher power for those that may not believe in God. By submitting oneself to this higher power instead of working on self-reliance, the high power will somehow give them assistance as they try to recover from their addiction (AA, 2008).
It is worth noting that AA takes the approach of self-involvement whereby there are no organisational structures, no managers neither CEO’s.
There are no documentations or regulatory official requirements but rather the organisation is only accountable to its members. One unique characteristic of AA is the fact that individuals are not assessed by qualified experts but rather every individual does personal diagnosis and checks the progress from the 12 stepwise procedures (Dick, 1998).
The course of treatment at AA is based on giving in to external greater power rather than relying on personal will and strength. In contrast to the mostly used approach of working towards improving on self-esteem, AA takes a different approach of exercising humility and submission to a greater power.
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According to AA, if the alcoholic just follows the simple plan that is suggested then he/she would have more chances of recovering (Galanter and Kaskutas, 2008, p. 10). In addition they believe that there is no free will in alcoholics since the alcoholic has already lost personal control to alcohol. AA, according to Galanter and Kaskutas (2008), defines alcoholism as:
Spiritual, mental, and physical illness and recovery requires healing all aspects of the illness; abstinence from alcohol in and of itself is regarded as “being dry” and is insufficient because alcoholism is but a “symptom” of underlying character defects. (Galanter and Kaskutas, 2008, p. 10)
The success or failure of AA recovery program can arguably be attributed to the strength of an individual to undergo total change in the way of thinking. The expectation of change of thought to surrender to an external powerful authority is expected to help the person quite taking alcohol. Simple suggestions are made to new individuals especially those who want to take drastic changes at a go. AA believes that the simple and few steps will help someone to stabilise before making tougher decisions later.
It is claimed that one of the strengths of AA is its cognitive approach to dealing with alcoholism. “AA meetings provide an atmosphere in which cognitive restructuring can take place” (Galanter and Kaskutas, 2008, p. 10).
In addition the AA’s12 steps, attendance to meetings and being a mentor or sponsor all works positively towards mental restructuring. Self-diagnosis is one of the most important elements of the program as individuals can develop their own alcoholic individuality which, according to psychologists, creates self-recovery on one’s inner self.
Motivational theories are thoughts and assumptions that attempt to explain the nature of a human being in terms of what prompts or triggers actions towards a certain direction.
Huitt (2001) defined motivation as “internal state or condition that activates behavior and gives it direction, or desire or want that energizes and directs goal-oriented behavior, or influence of needs and desires on the intensity and direction of behavior” (Huitt, 2001, p. 1). The AA program uses the ideology of motivation to help alcoholic victims recover from their alcoholic behavior.
Biological motivation is based on the fact that human actions may be driven in such a way to satisfy an internal biological need such as need to satisfy hunger or thirst. It is believed that there are internal subconscious drives that make a human being behave in a certain way (Bernstein & Nash, 2006).
Drive reduction theory explains how human actions are biologically motivated in order to reduce the causative agent inside the human nature.
This theory is based on the fact that inside any organism are physiological or biological needs and requirement such as hunger, thirst, sexual desire, among others which, unless met, will trigger and maintain an unstable state of body which is believed to increase with time if the need is not satisfied in time (Bernstein & Nash, 2006). The process can be viewed as a feedback mechanism (Deci and Ryan, 2008).
When the physiological need is satisfied the organism will go back to the normal or stable state. When the physiological need is met either directly or indirectly then, there is a reduction of the drive. Arousal theory explains that it is in human nature to sustain a definite degree of arousal that makes us feel stable and comfortable. It can mean emotional, rational or even physical activity (Shah & Gardner, 2008).
The AA program certainly uses biological motivation though in a simplistic approach. The program appreciates the fact that total abstinence at once may never give any desirable results. This is because a sudden stop of use of alcohol especially for addicts will definitely trigger one of the strongest biological needs to quench the alcoholic thirst. The biological motivation principle of maintaining the physiological homeostasis will be triggered by sudden cut off of alcohol.
What the program advocates is continual gradual reduction in the amount of alcohol taken which will eventually reduce to manageable level where total cut off can be done. In addition the AA principle of relinquishing oneself to a higher power to take over the alcoholic problem can arguably be seen as a diversion of the alcoholic biological motivation to an external agent and in that way, the biological drive and arousal are somewhat compressed. This is likely to enable the alcoholics recover quickly.
Cognitive/social motivational theory
This theory explains how behavior patterns of individuals are influenced by, among other factors, physical environmental, people and situations. This theory connects between the individual, environment and the behavior. The environment can be seen as a combination of all the external factors that are likely to influence a person’s behavior (Deci and Ryan, 2008).
The person’s perception about the different aspects of the environment is believed to influence the person’s behavior. The behavior can also be influenced by a person’s perception of other people’s behaviors through either watching them or even when interacting with them.
Tolman Purposeful behavior theory
Tolman was one of the social cognitive theorists. Through his numerous experiments with rats and mazes he came up with the theory of purposeful behavior. According to Dalton“ Tolman proposed that learning could occur without reinforcement and without an observable change in behavior.
In addition, Tolman found that behavior is affected by an organism’s expectations, often resulting goal-oriented, purposeful behavior” (Dalton 1). This is arguably one of the most applicable motivational theories in the AA program. The success or failure of any given case in the AA program depends, to a large extent on the expectation of the individual. If the individual has a predetermined mind about recovery his behavior in the AA program will certainly lead him to recovery.
Asch attribution and conformity theory
Solomon Asch presented his theories conformity and attribution. According his attribution theory, individuals attribute actions in life to an agent either external or internal. Alcoholics may attribute their drinking habit to lack of self control. AA program counter attacks the different attributions by offering a supernatural, powerful being in which the drunkards can attribute their weaknesses and hence relinquish their inner self to the power.
In addition his conformity theory which revolves about voluntary yielding to situations despite personal preferences also applies. Being in the presence of a group of similar individuals in the AA meetings creates a favorable condition for conformity to the behavior of the group. This does help in motivating the alcoholics towards recovery.
The physical environment such as the condition of a house or a class may play a significant part in motivating someone. The physical environment may also be a source of materials, opportunities or even societal support; this is one of the motivation strategies employed by the AA program. The fact that members meet in places far away from public ridicule and in the presence of other like members makes the environment conducive for the recovery program (Bernstein & Nash, 2006).
A given situation may either motivate or discourage someone to behave in a certain way. In addition how an individual perceives a given situation may have an effect on the course of action to be taken depending on whether the situation was perceived as encouraging or discouraging. AA uses this technique to make the newcomers feel comfortable in the knowledge that they are in the presence of people who have gone through a similar situation and this is actually a motivation for new members to continue with the recovery program (Bernstein & Nash, 2006).
Expectancies which can be viewed as valuable or the importance an individual places on the expected results or rewards may have a great impact on the level of motivation for that person. People who place a higher value on the outcome are more likely to be more motivated than those who do not value the outcome as much.
In AA the 12 principles places a lot of importance to the kind of life one is likely to enjoy after recovery from alcoholism. The new members actually get a chance of interacting with the already recovered members and this is a motivation enough to make them stick to the program however difficult it may seem to be.
Self-control plays a very important role in motivation. People who have the internal strength of self-control may exhibit a result oriented behavior and as such they are likely to be more motivated if they are presented with conditions or situations that will demand determination or control in order to achieve the desired results.
The AA program calls for determination to accept one’s alcoholic condition and surrendering to a higher authority which has the power to heal the spiritual and psychological sickness. They advocate for stepwise self-control whereby one is not required to automatically quit drinking but rather practice self-control for short durations which can then be extended to achieve the desired results. This is likely to motivate self-controlled individuals (Dick, 1998).
There are individuals who learn from others and are more likely to be motivated not because of what they are doing or capable of doing but by simply admiring what other people around them are doing. Individuals who are addicted to alcoholism can be motivated by being exposed to individuals who have already quite taking alcohol.
AA program offers the best opportunity for the individuals struggling with alcoholism to interact with the recovering or the already recovered individuals, otherwise known as sponsorship. Through sponsorship individuals are able to associate and take after their sponsors. This can be the best method of motivation for some of the members (Dick, 1998).
Self-efficacy is also believed to influence the level of motivation in a person. Some people are more motivated in the belief and knowledge that they have what it takes to complete the given task.
By understanding how different people are in terms of how they are motivated, then it becomes easier to help them achieve their goals and objectives. This is best applicable in the AA program whereby alcoholics are made to believe that the desired outcome can only come from their personal will to give up themselves to a greater power for healing (Dick, 1998).
Eclectic theorists try to explain motivation and behaviour of people by taking on pieces of what they believe to be the best from other theories. They claim that the human nature is so complex and as such not one approach may suffice to explain the relationship between motivation and human behaviour. The 12 principle AA motivational program employs all the methods as a mixture in order to achieve the desired results.
Strengths of AA program
Galanter and Kaskutas (2008) claimed that “AA program is complex, implicitly grounded in sound psychological principles, and more sophisticated than is typically understood” (Galanter & Kaskutas, 2008, p. 10).
Although much criticism has been thrown over the program, it can be claimed that such criticism may be due to the misunderstanding of the whole idea behind the program. In addition, the fact that the program works under anonymity makes it difficult and tricky to research, analyse and document success or failure of the program.
We can arguably say that the program has achieved success as compared to other programs offering the same type of service. From basic knowledge the program started in 1935 and has only grown, gaining membership every year.
Then we can claim that if there was no any considerable success then the program would have died long time ago. It is also claimed that “an increasing number of DUIs are court ordered to AA” (Galanter and Kaskutas, 2008, p. 13) arguably for a simple reason, the judicial systems have confidence in the AA program.
Success can also be based on the methodology of the program. The program employs a self-healing process where the victim plays the major role in initialising and maintaining the recovery process with the help of other members of the group (Deci & Ryan, 2008). The fact that the program allows for personal participation, motivational environment and a chance to put into practice what one has learned by sharing with others and mentorship program suffices that a degree of success is likely to be achieved (AA, 2008).
The fact that the AA program seeks to change the way of thinking of the alcoholics and not merely helping them stop the drinking habit implies that the impact of the program will be astounding. AA defines alcoholism as “spiritual, mental, and physical illness and healing require healing all aspects of the illness” (Galanter & Kaskutas, 2008, p. 14).
This posits that either 100% success may be achieved when an individual has fully recovered from alcoholism and thus in a better position mentally, spiritually and physically or at least some degree of success when one is not able to recover in all aspects (AA, 2002).
Another point worth noting is that AA provides a program that is fit and comfortable for everyone, both spiritual and non-spiritual. Each person can customise the recovery program according to personal preferences “the house that AA helps a man build for himself is different for each occupant because each occupant is his own architect” (Galanter & Kaskutas, 2008, p. 18).
Atheists, believers, radicals as well as conformists can fit in the program and that is arguably the greatest achievement of the AA program. Other recovery programs such as religious sponsored institution are not compatible to such a wide variety of individuals.
A statistical approach to the question of the success of the program indicates that the program has met and even exceeded expectations. A report carried out to determine success rate claimed that:
A total of 68% of the women in the survey reported that they had stopped drinking within a year of their first meeting as compared with only 63% of the men. At the same time, 74% of those under thirty reported they had stopped drinking within a year of attending their first AA meeting, compared with 63% of those over thirty. (AA, 2008, p. 6)
One of the strengths of AA is in the structure. AA works as a community though anonymous. A community of people with a common challenge in life and this is perhaps one of the greatest advantages members have, to work and share with people who have or are already undergoing what one is going through. When a new person hears the testimonies of other members who have experienced to be AA community then they get encouraged that all is not lost for them (Medvene, 1989).
Another advantage of the AA program lies in the fact that individuals who have the will to stick around for some time get a chance to accelerate their recovery through mentoring the young members in the group. This can be seen as a helper therapy which is believed to help mentors affirm the need to quit alcoholism. A research done to confirm whether indeed this was true found out that “those helping other alcoholics were less likely to relapse (60%) than those who did not help their peers (78%)” (Galanter & Kaskutas, 2008, p. 24).
The element of reciprocity in AA gives it an upper hand over other programs. Since the program works on the principle of self-help with the help of others and that there is no any monetary payments to be made, then the only way members can give back is by doing good to themselves by quitting alcoholism. It is claimed that “many follow moral norms or reciprocity found in society at large and believe that they should give back, if not to their immediate benefactor, to some generalized other in the future” (Galanter & Kaskutas, 2008, p. 25).
It can be argued that one of the greatest weaknesses of AA lies in its structure. The fact that there are no any official or managerial structures makes the program vulnerable to abuse and expression of personal interests, for instance it is claimed that, at times “members of AA groups may dispel disruptive drunk attendees or treat newcomers in such a way that they feel unwelcome” (Galanter & Kaskutas, 2008, p. 13).
This may not be the case if there was some kind of management that may regulate the response and reaction of other members towards newcomers.
The principle of freewill entry to anyone including disruptive drunkards may also be one of the disadvantages. Disruptive drunkards may be more of a discouragement than a motivation to others who may be trying to concentrate on their recovery program (Dick, 1998).
The fact that the program is based on a spiritual background may not work for people who do not have any spiritual relation. The success of the program depends on the individual willingness and strength to change the way of thinking. This may be a goal hard to achieve given that the drunkards, in their state of drunkenness, have already given up and may not have the inner drive to change their way of thinking (Medvene, 1989).
The effect of alcohol on our community is such a great issue that it can simply not be ignored. The community always finds a way of helping those of us struggling with alcoholism and other forms of addiction. Alcoholic people need a lot of motivation in order to encourage and help them out of the alcohol menace.
Different kinds of motivational theories such as biological, eclectic, social/cognitive do exist and their applicability in motivating alcoholics to recover is very instrumental. AA is one of the most widely used alcoholic recovery programs and its efficiency in its task mostly lies in the motivations that do exist in different aspects of the program. Though there has been much criticism about the program, it appeals to many and its strengths may far outweigh its weaknesses.
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