Resisting Twelve-Step Coercion: How to Fight Forced Participation in AA, NA, or Twelve-Step Treatment.

Resisting Twelve-Step Coercion: How to Fight Forced Participation in AA, NA, or Twelve-Step Treatment by Stanton Peele and Charles Bufe, with Archie Brodsky (Tucson, AZ: See Sharp Press, 2000), 204 pp,; $14,95 paper.

--reviewed by Michael Lemanski

When William Griffith Wilson and Dr. Robert Smith founded Alcoholics Anonymous in 1935, no other alcoholism treatment programs were available in the United States. For this reason, AA was accepted by the U.S. medical and psychological treatment communities by default.

AA's twelve-step approach has since branched out to treat a variety of other compulsive behaviors and maladies that have become classified as diseases. Unfortunately, AA also has become entrenched and institutionalized within the addiction treatment field to the detriment of other self-help and treatment approaches.

AA's domination exists despite the fact that only a very small percentage of the organization's members manage to achieve sustained abstinence. Of this minority, many believe that AA (literally) saved their lives, and these individuals often become obsessed with spreading their quasi-religious beliefs to others. In part because of this, many former AA members say the organization is nothing more than a religious cult and find the AA teaching that alcoholism is a lifelong, incurable disease is both disempowering and harmful.

Resisting Twelve-Step Coercion provides the reader with the practical scientific information necessary for making informed decisions concerning addictions treatment and self-help approaches--two areas that are sadly lacking in adequate consumer information and consumer protection. This groundbreaking book fills the void.

The authors provide practical information that will help both laypeople and professionals fight coerced referrals into twelve-step programs. They examine and refute the U.S. disease model of addiction, which is entrenched in the AA model of recovery, and analyze the actual effectiveness of twelve-step groups and twelve-step treatment, as well as the effectiveness of the new alternatives. They also analyze the routine violation of medical ethics by twelve-step addictions treatment providers.

The book details the many ways in which individuals are coerced into twelve-step programs and the religious nature of these programs. For example, several appellate-level court decisions have legally defined twelve-step programs as "religious" in nature and have ruled that government-coerced participation in them violates the First Amendment's establishment clause. However, the U.S. Supreme Court recently refused to hear the appeals of two such cases, so there is no national binding precedent on this issue.

Because of this, coercion into twelve-step groups and treatment programs continues on a massive scale, even in areas in which there have been court rulings against this practice. To assist those who would legally challenge mandated participation, the book analyzes existing court decisions at length and includes a chapter demonstrating that AA is indeed a religious organization.

Although the one-size-fits-all approach to addiction and recovery still dominates the U.S. treatment field and recovery movement, individuals dealing with addictive behaviors would be well advised to consider all of the available options in order to make informed decisions on what is in their best interest. This book is very helpful in this matter; it is one of the few books that provides the reader with a broad view of addiction and treatment, as opposed to the sea of traditional publications with a narrow twelve-step-only focus.

Resisting Twelve-Step Coercion is very well written, easy to understand, and thoroughly documented. It's a good read for anyone interested in the nature of addiction and recovery.

Michael Lemanski is a member of the National Association for Children of Alcoholics and has been active in the Adult Children of Alcoholics movement since its inception in the early 1980s. He currently serves as coordinator for Self Management and Recovery Training in Massachusetts.