|
Article Excerpt
In the early days of Alcoholics Anonymous (AA), women's way into the meetings were fraught with resistance from male members, as well as with a higher degree of social stigma than surrounds women's drinking today (Makela et al., 1996). One relatively early review concluded that affiliates of AA were more likely than nonaffiliates to be male (Ogborne & Glaser, 1981), and it has also been suggested that AA is less likely to be of benefit to women (Galaif & Sussman, 1995). However, more recent population studies indicate more similar rates of AA attendance for men and women (Ogborne & DeWit, 1999), and that AA is increasingly important, and even more important to women, when it comes to a choice among treatment alternatives (Weisner et al., 1995). This state of affairs is reflected also in the results from the International Collaborative Study of Alcoholics Anonymous (ICSAA), where women in AA seem overrepresented relative the proportion of female problem drinkers in professional alcoholism treatment, as well as in the general population, in each of the eight study countries (Makela et al., 1996, p. 175). Thus, in spite of AA being a male-oriented organization, women actually may affiliate more easily than men, as well as benefit as much (Kelly, 2003).
In Sweden, the first AA group was formed in 1953, which was eight years after the formation of the Swedish Links; the dominating local self-help movement at that time (Helmersson Bergmark, 1995). During the 1950s through the 1970s, AA grew at a slow pace, and much work was spent on separating the steps and traditions of AA from those of the Links (Helmersson Bergmark, 1995). During the 1980s, Minnesota Model treatment programs were introduced in the Nordic countries, and except for in Finland, this was accompanied by a dramatic increase in the number of AA groups and meetings (Stenius, 1991). Between 1980 and 1990, the number of Swedish AA groups increased by over 1,100% from 23 to 278 (Eisenbach-Stangl & Rosenqvist, 1998), and currently, there are 423 AA groups generating approximately 1,140 weekly meetings in Sweden (AA Sweden, 2005). Because AA attendance often is a part of treatment (in general, and of Minnesota Model treatment in particular), groups are regularly attended and visited by individuals in treatment. As in Canada and the U.S., approximately 30% of the AA members in Sweden are women, which is more than the proportion of women among heavy drinkers in the Swedish general population (17%), as well as among clients in Swedish professional alcohol treatment (18%) (Makela et al., 1996). Research has shown that female alcoholics are especially likely to attend AA in countries where the alternative is a traditional, male oriented recovery moment (Humphreys, 2004), and since the Swedish Links appeal primarily to men (Helmersson Bergmark, 1995, p.86), the coexistence of this movement might have contributed to a possible over-representation of women in Swedish AA. The number of Swedish AA groups with women-only meetings has increased by 80% during the last decade; from 25 in 1994 (Helmersson Bergmark, 1995, p. 85) to the current number of 45 such groups (AA Sweden, 2005), but compared to countries like the U.S., women-only meetings are of minor significance (Makela et al., 1996). One explanation to this might be that there is some opposition towards gender-specific groups from both men and women in the Scandinavian countries (Makela et al., 1996; Rosenqvist, 1991), and it is suggested that women in these societies "have become sober on male terms or that they have not felt a need to separate themselves from men" (Makela et al., p. 178). The fact that Sweden was one of two countries among the eight studied in the ICSAA project where women were not heavily underrepresented in the national service boards of the AA structure (Makela et al., 1996), suggests that Swedish men and women participate in AA on relatively equal terms.
Studies that have considered the gender aspect of AA attendance during or after formal treatment have generated diverse findings, some showing no differences in meeting attendance between men and women (Kingree, 1997; Moos et al., 1990, p. 79-80), and others showing a higher attendance among women than among men (Alford, 1980; Humphreys et al., 1991; Timko et al., 2002). In the methodologically rigorous Project MATCH, females in the twelve-step facilitation condition in the aftercare arm, they reported a higher meeting attendance than males at four of the five follow-up points (Del Boca & Mattson, 2001). Because meeting attendance does not equate with engagement and commitment, attendance alone is likely to give an erroneous estimate of AA involvement (Miller, 2003) and behavioral indicators provide complementary information about the affiliation process. Such indicators are working the 12 steps, doing service (organizing or managing the logistics of meetings), and being or having a sponsor. Del Boca & Mattson (2001) reported no gender differences when behavioral indicators were considered as a composite measure. Kingree (1997) found that in a sample attending an 12-step inpatient treatment program in a large U.S. metropolitan area, more men than women reported having obtained an AA sponsor at the midst of treatment (85% vs. 68%) and men were more comfortable with speaking in meetings than women; no gender differences were reported for meeting attendance. Beckman (1993), referring to general social psychological research, suggests that many of the steps and practices of AA are better suited...
|
