Some limitations of Alcoholics Anonymous.

While recognizing AA's many positive features, this chapter focuses on AA's limitations with respect to the kinds of help the movement provides as well as its overall efficacy and appeal to persons with alcohol-related problems. Among the issues identified as limiting AA's effectiveness are the movement's preoccupation with drinking and sobriety and lack of concern for other problems. Also, the possibility is raised that AA's insistence that its members are but "one drink away from a drunk" can become a self-fulfilling prophecy. Empirical studies indicate that those who affiliate with AA are, in several respects, different from those who do not. In particular, AA seems to appeal to drinkers who have a long history of drinking and have experienced loss of control. Reasonable levels of social stability, a lack of significant psychopathology, and signs of religiosity and authoritarianism have also been shown to characterize those who affiliate with AA. Some implications of these and other limitations for management of alcohol abuse are discussed. Specific emphasis is placed on the need for systematic assessment and the ongoing monitoring of AA referrals. The need for further research into the efficacy of AA is also emphasized.