Leave the Past Behind by Recognizing the Effectiveness and Cost-Effectiveness of 12-Step Facilitation and Alcoholics Anonymous.
Leave the Past Behind by Recognizing the Effectiveness and Cost-Effectiveness of 12-Step Facilitation and Alcoholics Anonymous.
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通过认识 12 步促进法和戒酒互诫协会的有效性和成本效益，将过去抛在脑后。
DOI：
10.1093/alcalc/agab010
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发表时间：
2021
期刊：
影响因子：
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通讯作者：
Abry,AlexandraW
中科院分区：
文献类型：
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作者：
Kelly,JohnF;Abry,AlexandraW
We thank Professor Heather (2020) for critiquing our distillation (Kelly et al., 2020a) of our recently published Cochrane Review of the effectiveness of Alcoholics Anonymous (AA) and related clinically delivered 12-step facilitation (TSF; AA/TSF). Our review subjected AA/TSF interventions to the same highly rigorous independent scientific evaluation standards used for medical and psychological treatments. AA/TSF proved at least as effective and in some cases more effective than comparison conditions on all reported outcomes and was also substantially more cost-effective (Kelly et al., 2020a, b). For decades, AA has often been dismissed as superstitious, backwards and lacking in evidence of effectiveness. Our review indicates that it is time to turn the clock forward and leave those prejudices behind. As we acknowledge in our review, this does not mean that every person with an alcohol problem can or should recover in AA, any more than the effectiveness of cognitive behavioral treatment (CBT) carries such implications. But it does indicate that given the health and economic burden of problem drinking and the ubiquity and low cost of AA, it may be the closest thing public health has to ‘a free lunch’(Kelly, 2017).Heather makes some general critiques of our work that apply to all reviews of controlled research (eg around sampling and generalizability), and which echo points we raised ourselves in our review. We focus here, therefore, on Heather’s more specific criticisms. His raising of several of these points, however, was somewhat puzzling to us given we addressed all of these same points in our published reviews (Kelly et al., 2020a, b), as detailed more below. Nevertheless, we expand upon the three broad themes raised by Heather in the hope of clarifying them further. These were:(a) internal and external validity of our review,(b) whether our 2020 Cochrane review is an advancement over the 2006 Cochrane review on AA/TSF (ie Ferri et al., 2006) and (c) how applicable the results are in countries other than the USA.
