The Social World of
Alcoholics Anonymous


Annette R. Smith, Ph.D.

Annette R. Smith, Social World of Alcoholics Anonymous, Annette Smith
Annette R. Smith, Ph.D., The Social World of Alcoholics Anonymous: How It Works, December 2007, ISBN 978-0-595-47692-3, xx + 150 pp., $15.95 U.S.

With an introduction by Linda Farris Kurtz, DPA, Professor Emeritus, Eastern Michigan University School of Social Work, author of Self-Help and Support Groups: A Handbook for PractitionersClick here to read Dr. Kurtz's introduction.

Using qualitative field study, including participant observation and unstructured interviewing, this work focuses on Alcoholics Anonymous as a social world. The social organization of A.A. is linked to social world constructs, and aspects of A.A. social life, both formal and informal, are described. It is suggested that success in A.A. is dependent on integration into the social world, and that there are variations in the interactional processes by which this is achieved.

Data is presented to illustrate that integration into the social world leads to the A.A. conversion, a transformation of self-identity in which the alcoholic accepts at the deepest level of being that he or she is alcoholic and that recovery depends on the acceptance of A.A. values and practice of A.A. principles. A typology of A.A. social world participants is established which is informed by high or low levels of affiliative needs and group dependency, group- versus individual-focused social world participation, and affective versus cognitive conversion experiences.

Praise from scholars who know the A.A. program

Annette Smith holds a place on my short shelf of social scientists with a deep and nuanced knowledge of A.A. Although I am always wary of what too easily turns into Procrustean efforts to fit a phenomenon such as Alcoholics Anonymous into larger schematic constructs, hers is one of the rare examples that avoids the traps and maximizes the value of such an approach.
Ernest Kurtz, Ph.D., author of Not-God: A History of Alcoholics Anonymous
Alcoholics Anonymous has proliferated and is virtually omnipresent. It holds the greatest promise for recovery from alcoholism. But just what is A.A.? What does it consist of? Describing the structure of something that has no structure seems to be an impossible task, but Dr. Annette Smith has done just that. It is a social world, and the understanding of this concept clarifies A.A. and its success.
Rabbi Dr. Abraham J. Twerski, Founder and Medical Director Emeritus of the Gateway Rehabilitation Center in Pittsburgh, and author of the best-selling Addictive Thinking: Understanding Self-Deception
With astute application of sociological concepts, Annette Smith unravels the processes by which Alcoholics Anonymous is successful in assisting alcohol-dependent men and women to become long-term sober citizens. Dr. Smith's careful qualitative research, based on personal interviews with A.A. members, captures the nuances of the self-transformation that occurs over time. Her investigation reveals that a combination of frequent meetings, the Twelve Steps, an encompassing concept of God and the pressure of groups and mentors that are integral to the A.A. program, have the unintended consequence of creating a "larger whole than the sum of its parts." A.A. members find themselves in a social world offering individuals of diverse personality types an ongoing sense of belonging that is as important to their general sense of well being as their continued sobriety. Parenthetically, Dr. Smith's analysis explains an aspect of AA that has puzzled many researchers in this field -- why persons who have been sober for many years continue to attend AA meetings five, ten, fifteen or more years after their drinking problem is apparently cured.
Jacqueline P. Wiseman, Ph.D., author of Stations of the Lost: The Treatment of Skid Row Alcoholics
Despite decades of analysis by scholars with different degrees of insider-ness, A.A. has limited systematic understanding by the communities of treatment and rehabilitation specialists. A diffuse sense of A.A.'s limitations is pervasive today, usually accompanied by groundless generalizations. Smith's study and its typological approach offers a large step forward in this pursuit, moving away from the misplaced question of "how's it work" to the question of "what are the many ways in which it works"? Her qualitative approach refines much quantitative data on A.A.'s limitations, re-casting the questions into a framework of relative rather than absolute effects. This book can provide a magnificent introduction to A.A. for the serious student or for the counselor dedicated to an in-depth understanding of "how it works." At the same time, Social World offers a wealth of insights to established researchers and scholars. A great read!
Paul M. Roman, Ph.D., Distinguished Research Professor and Director of the Center for Research on Behavioral Health and Human Service Delivery, University of Georgia

About the Author

Annette R. Smith, author of Social World of Alcoholics Anonymous, Annette Smith
Annette Smith received her masters in social work from the University of California, Berkeley in 1961. She worked for several years as a psychiatric social worker at Napa State Hospital in California, where she helped develop an innovative co-educational unit for treating alcoholics, who had long been merely warehoused in those giant institutions.

As one of the key elements in this new approach, she worked with the local A.A. Hospital and Institutions Committee in bringing A.A. to the inpatients in that program. This experience began her lifetime association with the fellowship.

After moving to San Diego in 1969, Smith worked for the County's Departments of Health and Mental Health, and in health services administration, performing clinical functions as well as developing more effective treatment services.

In 1975, as County Administrator of Alcoholism services, she coordinated funding for the County's network of programs, including A.A.-based recovery homes. She helped establish the local chapter of the Employee Assistance Professional Association, taught classes at local colleges, conducted community workshops, and served on several organizational boards, including that of the local affiliate of the National Council on Alcoholism and Drug Dependence.

In the early 1990s, Smith worked for the County Schools Employee Assistance Program and had a limited private practice, primarily devoted to work with alcoholics and their family members.

After receiving her Ph.D. from the University of California, San Diego in 1991, she joined the faculty of the San Diego State University School of Social Work, where she developed a course in alcoholism and drug dependence practice for graduate students, and served as Coordinator of the Center on Substance Abuse. She directed several grant projects, including the production of a training film for child welfare workers in recognizing and dealing with alcohol and drug problems among clients, and the development of one of the largest Driving Under the Influence education and counseling programs in the State.

She served on the statewide DUI advisory committee and continued conducting workshops and delivering presentations on alcoholism and recovery, including presentations at several national and state conferences, to the California Association of Alcoholism And Drug Administrators and Counselors, and to the local A.A. Committee on Professional Relations.

In 2004, Smith received a life-time achievement award from the San Diego Chapter of the National Association of Social Workers and the California Society for Clinical Social Work. She is now retired and living in Florida.

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