ABSTRACT
Despite the extensive utilization and immense popularity of the twelvestep abstinence-based approach for addiction treatment, this model remains surprisingly ignored and much maligned by many researchers. In a recent comprehensive and extensive literature review on addiction treatment, the twelve-step abstinence model or the AA disease concept approach was identified as the most widely used form of addiction treatment in this country (Miller, 1995). This fact was juxtaposed with another somewhat surprising discovery that, despite the wide popularity of this treatment approach, the twelve-step abstinence model has been largely and arbitrarily excluded from most previous reviews on addiction treatment. Attempting to explain this exclusion, Miller wondered if it was because of the limited number of studies conducted on this approach or if it had to do with methodological difficulties (no adequate control groups, self-selection bias, etc.) that rendered results which were judged to be unscientifically sound. Certainly, AA's requirement of anonymity for its members does not lend itself easily to scientific investigation and for obvious ethical reasons, an alcoholic could not be excluded from AA attendance in order to satisfy scientific rigor in research. However, Miller also asks if the exclusion from research reviews may be due to ideological differences between researchers and the twelve-step programs. He speculates that the "advocacy of a spiritual form of treatment contributed to the lack of scientific appeal and acceptance by the medical community" (1995).
