Communication skills training with alcoholics for improving performance of two of the alcoholics anonymous recovery steps

Thousands of men and women have begun their recovery from alcoholism through the support of Alcoholics Anonymous (AA). AA recognizes its social support role in defining itself as a "fellowship," but it also sees itself as offering a program of recovery. This program is comprised of the well-known "12-Step" method, which has been adapted by a variety of self-help groups. The purpose of the present study was to determine whether performance of two of these steps, Steps 4 and 5, could be facilitated by teaching communication skills specifically designed to improve their performance. Hospitalized alcoholics were assigned to communication-skills training, discussion and assessment-only groups, and their pre- and posttreatment performance on videotaped role-plays of Steps 4 and 5 was assessed. Subjects in the communication-skills training group were found to improve significantly on internal versus external focus, personal responsibility taking, congruent affect and composite skill variables compared to the discussion and assessment-only groups. These results suggest that, among treatment programs that utilize AA's recovery program, the behavioral skills inherent in completing Steps 4 and 5 need to be taught. Merely discussing or alluding to the steps, as is often-times done in group therapy of "step-study" sessions, is unlikely to have any effect on alcoholics' abilities to "work the steps."