12-step class vs. 12-step fellowship

There are a few randomized controlled trials out there, such as Brandsma 1980 [1] and Stahlbrandt 2007 [2] where the "Alcoholics Anonymous" experimental condition was questionable. With both of these experiments, there was no difference between subjects who had the 12-step-like condition and the control group.

What happened?

The 12-step condition was not an actual AA meeting.

With Brandsma 1980, as Kaskutas 2009 [3] describes it, the subjects undergoing "AA" treatment weren't actually going to AA meetings:

The description of the AA condition states that the steps were used for discussion content, the group focused on newcomers, and they told patients about sponsors, but it is not clear whether the meetings were led by AA members, whether crosstalk was allowed, whether the meeting leader shared their story as part of the meeting, or whether the meeting format was what one would encounter at an actual AA meeting. The meetings may not have been open to other AA members in the community, and not been listed in the AA meeting directory, which would mean that a potentially important therapeutic ingredient of AA--the experience of longer-term members--would not have been present in the AA condition.

With Stahlbrandt 2007, here is how the supposed "AA" meetings were run:

The TSI intervention was a 3-hour formal lecture, given by
therapists trained in the 12-step method.

Like Brandsma 1980, they did not see a difference between the supposed AA condition and the control group.

Point being, if an experimental condition is supposed to be an AA meeting, the numbers will not be reliable unless the AA condition is, in fact, an actual meeting. Which it wasn't with these two studies.

More recent studies, such as Litt et al. 2009, where we give the experimental group treatment which gets them going to more real AA meetings, show that the more people go to meetings, the more days they will be sober. It is unfortunate that these poorly done surveys have incorrectly given the wrong impression about 12 step efficacy.

[1] Brandsma, Jeffery M; Maultsby, Maxie C; Welsh, Richard J (1980). Outpatient Treatment of Alcoholism: a review and comparative study. Baltimore, MD: University Park Press. ISBN 0-8391-1393-5

[2] Stahlbrandt, Henriettæ; Johnsson, Kent O.; Berglund, Mats (2007). "Cluster Randomized Trial". Alcoholism: Clinical and Experimental Research. 31 (3): 458–66. doi:10.1111/j.1530-0277.2006.00327.x. PMID 17295731

[3] Kaskutas, Lee Ann (2009). "Alcoholics Anonymous Effectiveness: Faith Meets Science". Journal of Addictive Diseases. 28 (2): 145–157. doi:10.1080/10550880902772464. PMC 2746426. PMID 19340677.