FACTORS THAT INFLUENCE POSTTREATMENT ATTENDANCE IN ALCOHOLICS ANONYMOUS: THEORY AND METHODS TO INFORM PROVIDER REFERRALS

Substance abuse researchers are reporting that weekly posttreatment twelve-step (TS) meeting attendance predicts substantially superior drinking outcomes. Unfortunately, research has consistently observed a high rate of posttreatment AA attrition and underutilization. The primary aims of this analysis are to advance theory of TS affiliation and to test the feasibility of identifying patients who are at risk for posttreatment AA disaffiliation. The analysis uses Project MATCH data consisting of subjects who were assigned to the twelve-step facilitative treatment condition (N = 582). Corroborating other research, results suggest that average weekly attendance at one year posttreatment is associated with abstinent rates almost two times that of less than weekly attendance; unfortunately, over 70% of the subjects attended less than weekly. Analysis using binary logistic regression suggests seven variables can explain a large proportion of the variance among those with less than weekly or no AA attendance at the one year follow-up interval. The results are explained in terms of two theories: First, those who attend weekly may have a greater need for social support (stress and copying theory); and second, those who are a better fit within the AA culture (person-in-AA organizational fit theory). Last, a simple four variable prediction model was able to predict a large proportion of those who reported less than weekly attendance (sensitivity = .78, specificity = .77). Although research has generally reported favorable effects related to treatment, alcohol dependence is best characterized as a chronic-relapsing condition with