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Article Excerpt
This content analysis of reflective papers examined undergraduate and graduate students' reactions to attending a 12-step meeting. Qualitative analysis of student comments suggested that meeting attendance had a personal impact and increased understanding of the purpose of 12-step programs. Implications for counselor educators are discussed.
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In the United States, 9% of adults have attended an Alcoholics Anonymous (AA) meeting at some point in their lives and 3.6% have attended an AA meeting in the past year (Room & Greenfield, 1993). Of those, approximately one third attended a meeting because of their own alcohol-related problems, whereas others attended AA meetings for reasons such as concern for a loved one's drinking problem or to learn more about AA. Recent studies suggest that AA involvement as an adjunct to formal treatment is associated with better treatment outcomes (Brown, Seraganian, Tremblay, & Annis, 2002; Fiorentine, 1999; Moos & Moos, 2005). Given the widespread use and effectiveness of AA, it is important that counselors and counselors-in-training have exposure to and knowledge of this 12-step program.
Counselor educators teaching substance abuse counseling often require students to attend 12-step meetings such as AA, Narcotics Anonymous (NA), or Al-Anon (Fisher & Harrison, 1999; Zweben 1995). Attendance at a 12-step meeting is believed to be a learning tool for students to gain awareness and understanding of the addiction and recovery processes, as well as a way to view how self-help groups function. Often, new counselors working with individuals with substance abuse issues are encouraged by supervisors to attend 12-step meetings. Fisher and Harrison cited three reasons why helping professionals should gain awareness of and exposure to self-help groups such as AA or NA. First, many substance-abusing clients attend or have attended self-help groups, and therefore counselors need to have a working understanding of such groups. Second, conflicts may arise between helping professionals and advocates of self-help groups. Suggestions given to a client by 12-step group members may not support the counseling process (Room & Greenfield, 1993). For example, a client who is taking medication for depression may be encouraged to discontinue the medications in an effort to avoid all mind-altering drugs. Discontinuing the antidepressants may exacerbate the depressive symptoms, leading to a relapse in drug use. To prevent problems in client care, these contradictions must be discussed. Finally, the rapid growth of self-help groups has led to some confusion about the purpose of such groups. For example, self-help groups are usually peer led with the purpose of providing support through the sharing of experiences (Hester & Miller, 2003; Holmes, Karst, & Goodwin, 1990). These groups are not counselor led and do not provide clinical interventions. A well-informed clinician, who has explored the utility of these groups, is in a better position to assist clients in deciding whether a self-help group is appropriate for them.
The aforementioned reasons cited for practicing counselors to attend 12-step meetings may apply equally to counselors-in-training. It is assumed that by attending 12-step meetings, counselors and counselors-in-training will gain a greater understanding of the methods, purposes, and potential benefits for those clients who attend such meetings. Many counselor educators have integrated attendance at 12-step meetings into the assignment structure of substance abuse counseling courses, with generally favorable results (MacMaster & Holleran, 2005; Osborn & Lewis, 2004). Even so, little data have been collected to explore either student reactions to these assignments or the value of 12-step meeting attendance as a learning tool (Bristow, Provost, & Morton, 2002; Osborn & Lewis, 2004). Whereas the literature does suggest that experiential and reflective learning is an appropriate learning model for adults (Boud, Cohen, & Walker, 1993; Miller, 2000), most research has focused on classroom-based activities rather than on learning in informal or social situations (Wilson & Hayes, 2000).
Recently, educators have focused more on the learning that takes place outside of the classroom environment and have developed theoretical models of experiential learning to explain how such learning occurs in everyday situations. Many of these models are based on the work of Lewin (1951) and Piaget (1970). One such model is Kolb's (1984) Four Stage Learning Cycle, which describes four successive stages: concrete experience, reflective observation, abstract generalization, and active experimentation. A concrete experience is based on direct experience (rather than that found in the classroom) and the knowledge that is gained from such an experience. Reflective observation occurs when an individual takes time to contemplate and make meaning of the experience on a personal level. Abstract generalization is the development of new rules and theories or the modification of existing theories used to describe the experience. Active experimentation is the testing of the theory in practice, which leads to the next concrete experience (Atherton, 2005; Kolb, 1984). In short, learning is said to occur when an individual undergoes an experience, reflects on said experience, develops a theory based on self-reflection, and finally formulates new ways of behaving.
Having students attend a 12-step meeting and reflecting on the experience is compatible with Kolb's (1984) model of experiential learning. The concrete experience involves attending the 12-step meeting, the need for reflection is met through the writing of a reflective paper and through classroom discussions, abstract generalization or the development of a theory is based on hearing firsthand accounts of addiction and its impact, and active experimentation or the formulation of new behaviors involves challenging stereotypical views of addiction and gaining a better understanding of the purpose of self-help groups. It is for this reason that assigned attendance at a 12-step meeting may indeed be viewed as a powerful learning experience.
To determine whether student attendance at a 12-step meeting is an effective learning tool, we completed a content analysis of student reflective papers. Undergraduate and graduate students were asked to...
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