Kickbacks from helping others: health and recovery.

AA is often viewed as a spiritual organization, but it is less commonly recognized that helping others is a fundamental part of AA's conception of spirituality. Helping others by bringing AA's program to other alcoholics (articulated in Step 12) is understood as the culmination of AA's program and the behavioral manifestation of a spiritual awakening (Step 11). Also, members are encouraged to help in all stages of their involvement in AA's, and it is this helping that is thought to keep them sober. Accordingly, the current chapter addresses the question of whether helping benefits the helper from an empirical standpoint-and specifically, whether helping might contribute to recovery in the context of AA involvement. In addition to describing AA's approach to helping, we review research on associations between helping and (a) health outcomes in the general population, (b) recovery in diverse mutual help groups, and (c) recovery from chemical dependency within and outside of AA. We find evidence supporting benefits for helpers in each of these domains and tentatively conclude in favor of helper therapy principles. However, the work is limited by the lack of experimental studies and by problems in defining helping. Other concerns are that "over-helping" can be worse than not helping at all and that helping may sometimes harm the intended recipients. Recommendations for further research are to address these limitations. Particularly useful would be research designing and testing interventions aiming to increase helping, perhaps informed by social model programs and principles.