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Cited by 12Substance Abuse Treatment and OutcomesHomelessness and Social IssuesCounseling, Therapy, and Family Dynamics

Al-Anon family groups' newcomers and members: Concerns about the drinkers in their lives: Concerns About Drinkers in Al-Anon

Open access
Timko, Christine, Cronkite, Ruth, Laudet, Alexandre, Kaskutas, Lee Ann, Roth, Jeffrey, Moos, Rudolf H·2014·The American Journal on Addictions
DOI 10.1111/j.1521-0391.2014.12122.xPMC PMC4362684
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Abstract

BACKGROUND AND OBJECTIVES: Despite Al-Anon's widespread availability and use, knowledge is lacking about the drinkers in attendees' lives. We filled this gap by describing and comparing Al-Anon newcomers' and members' reports about their "main drinker" (main person prompting initial attendance). METHODS: Al-Anon's World Service Office mailed a random sample of groups, yielding completed surveys from newcomers (N = 362) and stable members (N = 265). RESULTS: Newcomers' and members' drinkers generally were comparable. They had known their drinker for an average of 22 years and been concerned about his or her's drinking for 9 years; about 50% had daily contact with the drinker. Most reported negative relationship aspects (drinker gets on your nerves; you disagree about important things). Newcomers had more concern about the drinker's alcohol use than members did, and were more likely to report their drinkers' driving under the influence. Drinkers' most frequent problem due to drinking was family arguments, and most common source of help was 12-step groups, with lower rates among drinkers of newcomers. Concerns spurring initial Al-Anon attendance were the drinker's poor quality of life, relationships, and psychological status; goals for initial attendance reflected these concerns. DISCUSSION AND CONCLUSIONS: The drinker's alcohol use was of less concern in prompting initial Al-Anon attendance, and, accordingly, the drinker's reduced drinking was a less frequently endorsed goal of attendance. SCIENTIFIC SIGNIFICANCE: Family treatments for substance use problems might expand interventions and outcome domains beyond abstinence and relationship satisfaction to include the drinker's quality of life and psychological symptoms and in turn relieve concerns of family members.

Integrity signals

Registry

Crossref · 10.1111/j.1521-0391.2014.12122.x

Cites

25 of 25 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

6 of 25 cited sources checked · 0 supported · 0 flagged · accuracy not yet measured

  • Interpretationreasoning

    The problematic relationships reported by Al-Anon attendees support the view that concerned others and their drinkers often need relationship counseling.

    “the problematic relationships reported by Al-Anon attendees support the idea that COs and their drinkers are often in need of relationship counseling.2”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [2] O'Farrell, 2012, Review of outcome research on marital and family therapy in treatment for alcoholism, J Marital Fam Ther. source

      In “Helping the Family” (page unavailable), the review says family members troubled by a loved one’s drinking often experience stress and identifies Al-Anon as a source of support. It also discusses couples therapy, but does not report problematic relationships described by Al-Anon attendees or conclude from those reports that attendees and their drinkers often need relationship counseling. (LLM, conf=0.76)

      Experimental — accuracy not yet measured
  • Premisecitation

    In the United States, Al-Anon is the most commonly used source of assistance for family members and friends worried about someone with a drinking problem.

    “Al-Anon Family Groups (Al-Anon), a 12-step mutual-help program, is the most widely-used form of help in the US for concerned other people (COs) who are family and friends of problem-drinking individuals.1–3”
    Quote in the paperNot a substantial claim1 of 3 sources checked
    • cites [1] Miller, 1999, Engaging the unmotivated in treatment for alcohol problems: A comparison of three strategies for intervention through family members, J Consult Clin Psychol. source
    • cites [2] O'Farrell, 2012, Review of outcome research on marital and family therapy in treatment for alcoholism, J Marital Fam Ther. source

      In “Helping the Family” (page unavailable), the review calls Al-Anon the most widely used source of support for family members troubled by a loved one’s alcohol problem. It does not specify that this ranking applies in the United States or extend it to friends who are not family members. (LLM, conf=0.84)

      Experimental — accuracy not yet measured
    • cites [3] O'Farrell, 2001, Family-involved alcoholism treatment. An update, Recent Dev Alcohol. source
  • Interpretationcitation

    The findings indicate a higher level of relationship problems than those reported by spouses and friends of non-problem drinkers.

    “the findings suggest an elevated level of relationship problems compared to those reported by spouses and friends of non-problem drinkers.20,21”
    Quote in the paperSubstantial claim1 of 2 sources checked
    • cites [20] Brennan, 1994, Spouses of late-life problem drinkers: Functioning, coping responses, and family contexts, J Fam Psychol. source
    • cites [21] Schutte, 2009, Treated and untreated remission from problem drinking in late life: Post-remission functioning and health-related quality of life, Drug Alcohol Depend. source

      The Results (§3.2) report more spouse-related stressors among treated and untreated remitters than among lifetime nonproblem drinkers; they report more friend stressors only for treated remitters. The Methods (§2.2.3) describe measures of participants’ relationships with spouses and friends, not reports supplied by those spouses or friends. The claim therefore captures an elevated level of some relationship problems but misstates who reported them and overgeneralizes the friend comparison. (LLM, conf=0.84)

      Experimental — accuracy not yet measured
  • Findingown data

    The main concerns about the drinker that influenced initial Al-Anon attendance were the drinker's negative feelings: depression or moodiness, confusion about coping, missing what is important, stress and anger, and bad feelings about himself or herself, endorsed by 78-85%.

    “The main concerns about the drinker that influenced initial Al-Anon attendance (Table 3, bottom section) were the drinker’s negative feelings: being depressed or moody and confused about how to cope with life’s problems, missing what’s important in life, being stressed and angry, and having bad feelings about him or herself (78–85%).”
    Quote in the paperNot a substantial claim
  • Findingown data

    Most newcomers and members endorsed goals of initial Al-Anon attendance that included a better relationship between the drinker and themselves and better quality of life and well-being for the drinker.

    “Most newcomers and members endorsed drinker-related goals of initial Al-Anon attendance to be a better relationship between the drinker and him or herself (the Al-Anon attendee-respondent), and better quality of life and well-being for the drinker (Table 4).”
    Quote in the paperNot a substantial claim
  • May combine two claims. 23
  • Classified as probably not a substantial claim. 8

  • May combine two claims.

    Premisecitation

    Research consistently shows that concerned others often experience distress and poor functioning.

    “Research findings are clear that COs are often distressed and function poorly.10–13”
    Quote in the paperNot a substantial claim1 of 4 sources checked
    • cites [10] Marshal, 2003, For better or for worse? The effects of alcohol use on marital functioning, Clin Psychol Rev. source

      Section 3.1 reports that spouses of people with alcoholism had lower marital satisfaction than comparison spouses, and the Summary and conclusions describes evidence of maladaptive marital functioning. This supports distress and poor functioning among spouses, but the paper does not establish the claim for concerned others more broadly or for functioning outside the marital relationship. The indexed passages provide section labels but no page numbers. (LLM, conf=0.86)

      Experimental — accuracy not yet measured
    • cites [11] Orford, 2005, Family members of relatives with alcohol, drug and gambling problems: A set of standardized questionnaires for assessing stress, coping and strain, Addiction. source
    • cites [12] Rowe, 2012, Family therapy for drug abuse: Review and updates 2003-2010, J Marital Fam Ther. source
    • cites [13] McCrady, 2012, Treating alcohol problems with couple therapy, J Clin Psychol. source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    Most survey items came from the Health and Daily Living Form, an instrument with strong psychometric properties in family studies of alcohol use and other mental health disorders.

    “Survey items were drawn mainly from the Health and Daily Living Form (HDL),16 which has demonstrated strong psychometric characteristics in family studies of alcohol use or other mental health disorders.17,18”
    Quote in the paperNot a substantial claim1 of 3 sources checked
    • cites [16] Moos, 1992

      Not checked in the free run.

    • cites [17] Brennan, 2010, Patterns and predictors of late-life drinking trajectories: A 10-year longitudinal study, Psychol Addict Behav. source

      The Method > Measures section (page unavailable) says the study used Health and Daily Living Form items, including alcohol-consumption items. It does not say that most survey items came from the form or establish its psychometric properties in family studies; the psychometric findings reported there concern a different instrument, the Drinking Problem Index. (LLM, conf=0.85)

      Experimental — accuracy not yet measured
    • cites [18] Timko, 2009, Parental depression as a moderator of secondary deficits of depression in adult offspring, Child Psychiatry Hum Dev. source

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationown data

    The results suggest that studies of couples and family treatments for substance use problems should broaden outcome domains and interventions beyond reduced substance use and increased relationship satisfaction.

    “These results suggest that studies of couples and family treatments for substance use problems should expand outcome domains and interventions beyond the primary foci of reduced substance use and increased relationship satisfaction.2”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [2] O'Farrell, 2012, Review of outcome research on marital and family therapy in treatment for alcoholism, J Marital Fam Ther. source

      The Future Research Directions section explicitly calls for expanding outcome domains and interventions beyond reduced drinking and increased relationship satisfaction. The cited recommendation concerns alcoholism; the citing sentence broadens it to substance use problems generally. (LLM, conf=0.84)

      Experimental — accuracy not yet measured

  • May combine two claims.

    Findingown data

    The drinkers were on average in their mid-40s, and most were male.

    “On average, drinkers were in their mid-40s and most were male (Table 1).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Drinkers were somewhat more likely to have received outpatient care and even more likely to have attended 12-step groups, with members' drinkers having higher rates of such help.

    “Drinkers were somewhat more likely to have obtained outpatient care, and even more likely to have attended 12-step groups, with drinkers of members having higher rates of such help.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Additional common goals were the drinker having better physical health, meeting responsibilities, and having a more satisfying spiritual life.

    “Additional common goals were the drinker having better physical health, meeting responsibilities, and having a more satisfying spiritual life.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The drinker's drinking had been problematic for an average of more than 12 years and had troubled the Al-Anon attendee for an average of more than 9 years.

    “The drinker’s drinking had been problematic for an average of more than 12 years and had troubled the Al-Anon attendee for an average of more than 9 years.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Concerns that prompted initial Al-Anon attendance focused on the drinker's poor quality of life, poor relationships, and psychological symptoms such as depression, confusion, stress, anger, low self-esteem, and loneliness.

    “Concerns that spurred Al-Anon attendees’ initial meeting attendance focused on the drinker having a poor quality of life, poor relationships, and psychological symptoms (depression, confusion, stress, anger, low self-esteem, loneliness).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Other gains most newcomers and members hoped for were the drinker having less stress, learning better ways to relax, engaging more in what is important, feeling better and more hopeful, and being less depressed, confused, angry, and lonely.

    “Other gains that most newcomers and members hoped for by their Al-Anon attendance were the drinker having less stress and learning better ways to relax, engaging more in what’s important in life, and feeling better about him or herself and more hopeful, as well as less depressed, confused, angry, and lonely.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Secondary concerns prompting attendance were the drinker harming self or others, loneliness and isolation, neglecting responsibilities, drinking too much, hopelessness, and lacking a satisfying spiritual life, endorsed by 64-71%.

    “Secondary concerns about the drinker that prompted attendance were the drinker harming him/herself and others, feeling lonely and isolated, and neglecting his or her responsibilities, in addition to the drinker drinking too much, feeling hopeless, and lacking a satisfying spiritual life (64–71%).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Most newcomers and members reported negative relationship aspects with their drinker in the past six months, especially the drinker getting on their nerves and disagreements about important matters.

    “Most newcomers and members reported negative aspects of their relationship with their drinker in the past 6 months, especially the drinker getting on their nerves, and having disagreements with the drinker about important things.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Almost two-thirds of newcomers had a lot of concern about the drinker's drinking, compared with about half of members.

    “Almost two-thirds of newcomers had “a lot” of concern about the drinker’s drinking, compared to about one-half of members.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Most Al-Anon attendees also wanted the drinker to have better relationships with relatives and friends and a better financial situation.

    “Most Al-Anon attendees also wanted the drinker to have better relationships with relatives and friends, and a better financial situation.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Goals directly related to the drinker's drinking were endorsed less often than all the preceding goals; they mainly involved less risk of harm from drinking and less drinking overall.

    “Perhaps surprisingly, newcomers and members’ goals directly related to the drinker’s drinking were endorsed less frequently than all of the preceding goals of initial Al-Anon attendance; these mainly involved less risk of the drinker’s drinking causing harm to self and others, and less drinking overall.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Initial Al-Anon attendance was also prompted by the drinker's problematic relationships with relatives, spouse or partner, and friends, and by the drinker's financial and work problems.

    “Initial Al-Anon attendance was also prompted by the drinker’s problematic relationships with relatives, the spouse/partner, and friends, as well as the drinker’s financial and work problems.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingnone given

    Newcomers and members generally did not differ on the measured demographic characteristics.

    “Newcomers and members generally did not differ on these demographic characteristics.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Unlike Al-Anon's survey of long-term stable members, which reported that 41% of identified drinkers were still drinking, this study found that 68% of drinkers had used alcohol in the past month.

    “In contrast to Al-Anon’s survey of long-term, stable members, which reported that 41% of identified drinkers were still drinking, we found that 68% of drinkers had used alcohol within the past month.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Al-Anon attendees were less concerned about the drinker's drug use than about drinking, but about one-quarter worried about prescription and non-prescription drug use.

    “Al-Anon attendees were less concerned about their drinker’s drug use; however, about one-quarter were worried about their drinker’s prescription and non-prescription drug use.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    Newcomers and members generally described their drinkers similarly, with only a few key differences.

    “Al-Anon newcomers and members were generally similar in terms of how they described their drinkers, but there were a few key differences.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationown data

    The most common goal of initial Al-Anon attendance was a better relationship with the drinker, which aligns with clinical approaches advising that concerned others do not want to lose their relationship with the person causing them distress.

    “We also found that the most common goal of initial Al-Anon attendance was achieving a better relationship with the drinker, which agrees with clinical approaches advising that COs do not want to lose their relationship with the individual who is causing them distress.28”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [28] Roberts LJ McCrady B. 2003 http://pubs.niaaa.nih.gov/publications/niaaa-guide/index.htm

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Interpretationreasoning

    Newcomers' drinkers were more likely to have driven under the influence, which may have prompted newcomers' concern and greater focus on reducing the drinker's drinking.

    “It is important to note, however, that newcomers’ drinkers were more likely to have driven under the influence of substances, which may have prompted newcomers’ concern and more focus on the drinker reducing drinking.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Study design and conductown data

    The sample was obtained by mailing a random sample of 4,500 Al-Anon groups through the World Service Office.

    “To acquire the sample, Al-Anon Family Groups World Service Office (WSO) mailed (but did not pay for) a random sample of 4,500 Al-Anon groups.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Behavioral couples therapy for substance use disorders helps build support for abstinence and improves relationship functioning.

    “For example, behavioral couples therapy for people with substance use disorders is helpful in building support for abstinence and improving relationship functioning,14,15”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [14] Powers, 2008, Behavioral couples therapy (BCT) for alcohol and drug use disorders: A meta-analysis, Clin Psychol Rev. source
    • cites [15] Ruff, 2010, Behavioral couples therapy for the treatment of substance abuse: A substantive and methodological review of O'Farrell, Fals-Stewart, and colleagues' program of research, Fam Process. source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The survey was pretested with four individuals: an Al-Anon group secretary, a long-term member, a newcomer, and a drop-out.

    “The survey was pretested with four individuals (Al-Anon group secretary, long-term member, newcomer, drop-out).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    Participants' reports about the drinkers reflect the reporters' perceptions and may be inaccurate, especially for participants with less contact with the drinker.

    “It is important to keep in mind that participants’ reports about the drinkers in their lives reflect the reporter’s perceptions; these perceptions may be inaccurate, especially among participants who had less contact with their drinker.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    A recent Al-Anon membership survey of 3,232 members with an average of 12 years of continuous membership found that most of the drinkers were male.

    “A recent Al-Anon membership survey (N = 3,232, averaging 12 years of continuous membership) determined that most drinkers were male.5”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [5] Al-Anon Family Groups http://www.al-anon.org/membership-survey

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Interpretationreasoning

    Because members had less concern than newcomers about the drinker's drinking despite similar drinking patterns, members may have accepted Al-Anon's message of detachment, reducing their concern.

    “Our finding that members had less concern than newcomers did about their drinker’s drinking, even though drinking patterns were similar, suggests that members may have accepted Al-Anon’s message of detachment, thereby lessening their concern.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductreasoning

    Multiple comparisons were conducted without adjustment to maximize detection of differences, meaning the findings require replication.

    “Further, in order to maximize our ability to identify differences between newcomer and member groups that may be informative to providers and 12-step group members, we conducted multiple comparisons without adjustment; however, this means that our findings require replication.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationown data

    Newcomers' greater concern about the drinker's drinking is consistent with their more frequent reports of drinkers driving under the influence and their observations that drinkers less often obtained outpatient or 12-step help.

    “Newcomers more often had “a lot” of concern about their drinker’s drinking, which fits with their more frequent reports that their drinkers had been driving under the influence of alcohol or drugs, and with their observations that their drinkers were less frequently obtaining help from outpatient or 12-step programs.”
    Quote in the paperNot a substantial claim
29 of 29

  • The paper relies on this without support.

    Prior Al-Anon research has mostly examined long-term, stable attendees and is now out of date.

    “Studies of Al-Anon have focused mainly on meeting attendees with long-term, stable membership, and tend to be outdated.”

  • The paper relies on this without support.

    Existing studies have not described concerned others' own reasons for seeking help or what they hope the drinker will gain from that help.

    “However, studies have not reported COs’ perspectives on reasons for seeking help, or on what they hope to gain for the drinker by seeking help for themselves.”

  • The paper relies on this without support.

    Little is known about the drinkers' demographics, their relationships with Al-Anon attendees, their alcohol and drug use and consequences, or their help-seeking.

    “Perhaps in keeping with Al-Anon’s philosophy of focusing on the self instead of on the drinker, very little is known about drinkers’ demographic characteristics, relationships with Al-Anon attendees, amounts and consequences of alcohol and drug use, or help-seeking.”
3 of 3

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

  • Incorrect percentage for one refusal reason

    Minor

    Ten of the 126 groups that refused permission is 7.9%, not the reported 8.1%.

    Reported 8.1 · recomputed 7.936508

  • Respondents per group does not match the reported totals

    Minor

    The reported 627 respondents across 360 groups give an average of about 1.74 respondents per group, rather than 1.9.

    Reported 1.9 · recomputed 1.741667

  • Respondents per group does not match the reported totals

    Minor

    The 627 respondents from 360 groups yield 1.74 respondents per group, not the reported mean of 1.9.

    Reported 1.9 · recomputed 1.741667

3 of 3

Cites

Flagged first, then by citations

Research works printed but not linked: 1

  1. Moos, 1992, Health and Daily Living Form manual

Cited by

Sorted by citations

Related

Authors
Timko, C., Cronkite, R., Laudet, A., Kaskutas, L. A., Roth, J., & Moos, R. H.
Affiliations
  • Stanford Medicine (US)
  • National Development and Research Institutes (US)
  • Alcohol Research Group (US)
  • University of Chicago (US)
Corresponding author
Timko, Christine
ORCID
Venue
The American Journal on Addictions
Publisher
Wiley
Published
2014-03-15
Volume
23
Issue
4
Pages
329-336
ISSN
1055-0496 (ISSN-L)
DOI
10.1111/j.1521-0391.2014.12122.x
PMC
PMC4362684
OpenAlex
W1599499349
Semantic Scholar
dbde0849d82ee1900fe61f5e4b87007629f2857e
Cited by
12
References
25
Citations by year
2025: 1 · 2022: 1 · 2021: 2 · 2020: 1 · 2019: 2 · 2017: 2 · 2016: 1 · 2014: 2
FWCI
1.26
Type
journal article
Language
en
Open access
Licence
doi.wiley.com/10.1002/tdm_license_1.1 (tdm, 535 d)
Locations
  • American Journal on Addictions (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • U.S. Department of Veterans Affairs (RCS 00-001)
  • National Institutes of Health (5r21aa019541-02)
  • National Institute on Alcohol Abuse and Alcoholism (R21 AA019541, 1R21AA019541‐01)
Topics
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Health Sciences › Health Professions › General Health Professions › Homelessness and Social Issues
  • Social Sciences › Psychology › Clinical Psychology › Counseling, Therapy, and Family Dynamics
Keywords
Al-Anon, family members of alcoholics, family relationships, driving under the influence, 12-step programs, quality of life, psychological symptoms
MeSH terms
Adult, Alcohol Drinking, Alcoholics Anonymous, Data Collection, Family, Female, Humans, Interpersonal Relations, Male, Quality of Life

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