That makes 100% scientific sense. I bet that the coins it doesn’t work for just weren’t trying hard enough to land face-up, anyway.
There were other studies posted in this thread that also said that correlations between abstinence and any treatment were low. In some of the analyses (like the one on MATCH) even people with “no treatment” can improve nearly as well as those with therapy or 12 step. When you actually look at the numbers, the correlations are stinkin’ weak (0.4 at best).
Here’s another one that shows only slightly higher levels of recovery with those who go into 12 step or formal treatment. This paper has already been posted. I’ll post it again. The clincher is that only 30% even joined a 12 step or formal treatment. So in that study, taking raw numbers (no rates), twice as many people recovered on their own than those who joined a program. Even more interesting, the time to recovery was quicker for those with no treatment.
http://onlinelibrary.wiley.com/doi/10.1111/j.1360-0443.2006.01433.x/full
If you think of this in terms of efficacy, AA is not really efficacious. Maybe serious, serious alcoholics need this but for most acoholics, AA appears to be “pointless”.
Again, there are studies which show that AA is effective; that’s why I put more reliance on the Cochraine meta-analysis than on any one particular study - because the studies are, to an extent, contradictory. What I’m interested in is determining the scientific consensus. The point being that there isn’t one, not yet. It is simply untrue to state that “the science says” AA is pointless. Rather, some studies say it is, and some studies say it isn’t. Those that say it isn’t, tend to hold that no treatment is effective - not just AA.
Thus, assuming that those studies prove to be accurate, it is not the case that those participating in AA are being diverted away from actual, scientifically-verified treatment. They may be wasting their time - just as their time would be wasted, equally, with all of the other available treatments.
Knowing this - that there is an approximately equal weight of authority, so far, that holds that AA is effective, and that holds that no treatment is effective (or at least, very effective) - is it better to have no treatment, on the chance that it is a waste of time? I suppose this depends on the relative adverse effects.
BTW, I cannot access your second link; it appears as subscription/purchase-only.
I want to be very clear here. My problem isn’t with people like you, who know the data and make conclusions based on it. My problem is people who reject the data outright and refuse to even discuss it or consider it because of some anecdotal experience. Worse, for Shodan and Clockwork to be pilloried for critical thinking is fucking unreal. My dog in this fight isn’t about whether or not AA works, it’s whether or not we can even talk about whether it works or not without getting shut down by emotional appeals.
So I made an emotional appeal of my own. I lost 8 years of my life and I can never get it back, because of stupid shit like this, because therapists don’t want to look themselves in the mirror after 15 years of practice and admit they don’t know what the hell they’re doing.
If I were an alcoholic, you can bet I’d want to know the research on what works. I’d want the treatment closer to 90% than placebo if you get my drift. We may not have conclusive evidence for any program*, but anyone considering AA deserves to know that. It’s very simple. ‘‘There’s little to no evidence that this works, but my father had great success in AA.’’ Then that person looking for help is fully informed.
*FTR, a new study just published, which has yet to be replicated, found significant positive outcomes in alcoholics by paying them not to drink. Kind of puts a hole in the ‘‘disease’’ model. However, when it comes to behavioral changes, there is great evidence that social support is key to long-term change, and that is a significant component of AA, so maybe there is something to the social process. I’d be curious to see a comparison study between an alternative social treatment and AA.
**Full disclosure: My bio father is a severe alcoholic. He told me when I was 7 that I’d better get used to it, because he wasn’t going to change. And he hasn’t. It doesn’t really affect how I view this issue, I don’t think, because he never even considered treatment, not for a second, despite the fact that he is fully aware he is an alcoholic. But I certainly have a personal stake in finding treatments for alcoholism.
The Effectiveness of the Twelve-Step Treatment
What works? A summary of alcohol treatment research
Please read in its entirety before replying. Emotional pleads/anecdotal evidence are not welcomed.
Enjoy.
Your second cite is by far the more persuasive, though I’m not in any position to rate the table they produce. I cannot tell, for example, what exactly it is that they are measuring: it appears to be some sort of multiplication of the rigour of the study by number of studies and outcome. From the table:
I don’t know what to make of this methodology, but it makes me somewhat skeptical. For example, assume for the moment that no method actually “works” - that is, that the position taken (as far as I can see) in your first link is actually true, and that it is totally irrelevant whether one has “interventions”, attends AA, or takes Naltrexone: those who are going to get better, get better, and those who are not, are not. In that case, the best thing to do would be nothing, since anything else you do would be a waste of time, right?
With that in mind, examine the “what works” table. Is there any way from this table to deduce “what works”, if I wished to choose a method? No, because if one treatment had a lot of studies, and those studies were methodologically sound, it would get a high “CES” score, even if they all had the exact same outcome (that is, in accordance with our assumption, the results for all studies all demonstrated that the tested method did nothing at all). The “no.1 rated method” may, in fact, be no better than the “no. 30 rated method”, merely have methodologically sounder studies, and more of them.
What is missing, at least as far as I can see, is the ability to say 'the following methods are better than doing nothing, and by this much … '.
I still love you guys.
But I’m not commenting about the pit. I’m commenting about saying something in the other forums when you know it will piss people off. Not just offend, but piss off. If you know that what you say is going to piss a flipping mod off enough to break the number 1 rule here, then, yes, I say you are trolling to use it. And Melon flat out said that he would have posted the same exact post even knowing it was going to piss twickster off that much.
In the pit, I used to think trolling was allowed. But then I saw Carol Stream banned for it. It took me a while, but I got an idea of what trolling is in the pit. Apparently, it involves hijacking a thread in order to make fun of everyone who posted in it, to the point where the thread becomes completely derailed into discussing how annoying that person is. As you’ll note, that’s what I called SfG on in a different thread.
I didn’t post what I did to get a rise out of her or anyone. What if you knew that posting that your favorite color is blue would piss me off enough to break the first rule of SDMB ([del]Don’t talk about SDMB[/del])? Now imagine that you’re in a thread regarding the favorite colors of the user base. Are you going to refrain from saying that your favorite color is blue because of whatever reaction I’d have to it? If so, I’m sorry, but that’s just now how I operate. My post wasn’t insulting or antagonistic and it was made with complete disregard to whatever unreasonable reactions people would have to it. Your expectations are silly; it’s like expecting me to refrain from participating in a debate on evolution because there might be some creationists in the crowd who’d be offended. This board isn’t a padded box that we can climb into to hide from the world.
Aww.
Hey, don’t blame AClockworkMelon for the inappropriate conduct of a mod - or anyone else. That is just beyond absurd.
See, where *I *would say that anyone who takes an issue *so personally *that they can let a non-trolling, earnest, and factual post that disagrees with their personal woo piss them off to the extent that they break rule #1 shouldn’t be a fucking mod.
Isn’t it interesting how [del]I’m for (relatively) free speech and you’re a lickspittle[/del] people are different?