Diverse Belief Systems in Mutual Help Groups for Alcohol Use Disorder: Alcoholics Anonymous and 12-step Alternatives

Mutual help groups that each own a unique belief system are now one of the most common forms for alcohol use disorder (AUD) treatment. While 12-step groups like Alcoholics Anonymous (AA) are globally recognized, numerous 12-step alternatives have emerged in the United States, each grounded in unique philosophical principles. 12-step alternatives offer diverse recovery pathways other than AA. Despite dealing with the same illness of AUD, the approaches of different mutual help groups to understanding and addressing it significantly diverge. However, research into these 12-step alternatives remains limited, especially regarding their belief systems. This study employs a qualitative method to categorize the belief systems of three mutual help groups (AA, LifeRing Secular Recovery (LifeRing), and SMART Recovery (SMART)) and analyze their approaches to AUD and recovery. We conducted a review of official publications issued by the groups. Additionally, we performed semi-structured interviews with key individuals from LifeRing and SMART, who were instrumental in their founding, but not from AA. It organizes each group’s belief system within Arthur Kleinman’s ‘explanatory model’ framework, using the KJ method for typification, and categorized into two typologies: the ‘Giddens model’ and the ‘Bateson model’. LifeRing and SMART align with the ‘Giddens model,’ which advocates an approach centered on the exploration and development of a reflexive self. This model emphasizes the importance of individuals continually examining and adapting their thoughts and actions to function effectively in modern society. It involves deeply engaging with one’s inner strengths and personal resources, aiming to address and resolve issues through evolving self-understanding and interaction with the environment. Conversely, AA adopts the ‘Bateson model,’ where individuals relinquish their own power and rely on an external force, such as a higher power, to address their issues. This approach suggests a departure from the reflexive self required in modern society, favoring alternative, spiritually-oriented living methods. This study highlights the necessity to acknowledge and comprehend the varied belief systems in mutual help groups for AUD, since they provide unique recovery perspectives and methods suited to different needs and philosophies.