Is A.A. a treatment program? Does it provide detox, housing or counselling?
In short:
- No. A.A.'s literature describes a fellowship of alcoholics helping each other, not a treatment service. The 1946 Long Form says hospitals and "other places of recuperation" ought to be "well outside A.A.—and medically supervised" (p. 564), and defines professionalism as "the occupation of counseling alcoholics for fees or hire" (p. 564), which A.A. is never to become.
- In the 1939 text, individual members did a great deal for newcomers: got them into hospital and visited them there, helped find jobs, lent money, took men into their homes (pp. 91, 96–97, 159, 161). The book also warns that putting this work "on a service plane" makes the newcomer rely on the helper instead of God (p. 98).
- Bill W. in 1946: "Hospitalization is most definitely the job of the doctor" (P-17, "Money", 1946), and there can never be an "A.A. therapist."
- Today's group pamphlet lists what A.A. does not do: no hospitalization, drugs or treatment; no housing, food, clothing, jobs or money; no domestic or vocational counseling (P-16, 2018).
What the 1939 text describes
The Big Book's members weren't against medical help, and they did practical things for each other. But the help came from individual members, and the recovery itself came from somewhere else. - Hospital care, through a doctor. "If your man needs hospitalization, he should have it, but not forcibly unless he is violent." (p. 91). An approach through a doctor or an institution "is a better bet" than through his family (p. 91). For an employee still drinking, physical treatment "should, of course, be referred to your own doctor" (p. 143). - Practical help, given with care. If a newcomer is broke and homeless, "you might try to help him about getting a job, or give him a little financial assistance" (p. 96), without depriving your own family. You might take him into your home for a few days, with discretion (p. 96). Chapter 11 lists "lending money and securing jobs for each other, when justified" among everyday events (p. 161). - The limit. The man who expects you "to act only as a banker for his financial difficulties or a nurse for his sprees" may have to be dropped until he changes his mind (p. 95). "The minute we put our work on a service plane, the alcoholic commences to rely upon our assistance rather than upon God." (p. 98). Physical treatment "is but a small part of the picture" (p. 143).
See Should I give a newcomer money or a place to stay? for Chapter 7's full advice.
The 1946 Long Form
- Tradition Six. Clubs and hospitals that need much property or administration should be incorporated separately and kept apart, so the groups can discard them if necessary; such facilities "ought not to use the A.A. name" (p. 564). "But hospitals, as well as other places of recuperation, ought to be well outside A.A.—and medically supervised." (p. 564).
- Tradition Eight. "Alcoholics Anonymous should remain forever nonprofessional." (p. 564). "We define professionalism as the occupation of counseling alcoholics for fees or hire." (p. 564). A.A.'s Twelfth Step work "is never to be paid for" (pp. 564–565).
Bill W.'s essays (1946–47)
- "Years ago we used to think A.A. should have its own hospitals, rest homes and farms." By 1946: "Nowadays we are equally convinced we should have nothing of the sort." (P-17, "Money", 1946).
- "Hospitalization is most definitely the job of the doctor, backed, of course, by private or community aid." (P-17, "Money", 1946). It is not a function of A.A. in the sense of management or ownership; everywhere, A.A. cooperates with hospitals.
- On counseling: an A.A. member may go into alcohol therapy as a trained social worker, psychologist or psychiatrist, but there is not, "and can never be, any such thing as an 'A.A. therapist.'" (P-17, "Money", 1946).
- Groups that set up their own drying-out places, Bill wrote in 1947, nearly always found it "backfired" (P-17, "Hospitals and A.A.", 1947), because it put the group into business.
Later texts (dated)
1971 (this printing updated 2023). The Twelve Traditions Illustrated (P-43), on Tradition Five: a member may, with discretion, lend a few dollars or put up a broke alcoholic for a while, but the A.A. group as a whole "is not a friendly finance company, nor a welfare department, nor a housing bureau" (P-43).
Undated statement in P-17 (2019 printing). "A.A. and Alcoholism," a policy statement the General Service Conference has affirmed, says members recognize "that some may require professional counseling or treatment" (P-17, "A.A. and Alcoholism") and that the movement does not engage in medical or psychiatric treatment.
2018. The A.A. Group (P-16), "What A.A. Does Not Do," includes: - Make medical or psychological diagnoses or prognoses. - "Provide hospitalization, drugs, or medical or psychiatric treatment." (P-16, 2018). - "Provide housing, food, clothing, jobs, money or other such services." (P-16, 2018). - "Provide domestic or vocational counseling." (P-16, 2018).
The same pamphlet: "There is no such thing as an 'A.A. hospital' or an 'A.A. halfway house'" (P-16, 2018), though A.A. meetings are held in many such places and many members work in them. Intergroup offices "sometimes provide information on treatment facilities, hospitals and halfway houses" (P-16, 2018).
What this means
Read together, the texts draw the same line from 1939 on. Doctors and hospitals provide medical care; individual A.A. members may help a newcomer in practical ways, carefully; A.A. itself, as a fellowship and as groups, runs no treatment, housing or counseling service and has no professional class. The Traditions keep facilities outside A.A.; they don't say treatment is bad, and they don't govern the facilities themselves (see Tradition Six: can an A.A. group partner with a treatment centre?).
Read it yourself
- Chapter 7, "Working With Others" (pp. 89–103): https://www.aa.org/sites/default/files/2021-11/en_bigbook_chapt7.pdf
- Chapter 10, "To Employers" (pp. 136–150): https://www.aa.org/sites/default/files/2021-11/en_bigbook_chapt10.pdf
- Chapter 11, "A Vision for You" (pp. 151–164): https://www.aa.org/sites/default/files/2021-11/en_bigbook_chapt11.pdf
- Appendix I, "The A.A. Tradition" (pp. 561–566): https://www.aa.org/sites/default/files/2021-11/en_bigbook_appendicei.pdf
- P-17, A.A. Tradition — How It Developed: https://www.aa.org/sites/default/files/literature/assets/p-17_AATraditions.pdf
- P-16, The A.A. Group ("What A.A. Does Not Do," p. 39): https://www.aa.org/sites/default/files/literature/p-16_0723.pdf
- Related: Should I give a newcomer money or a place to stay? · Does the Big Book endorse treatment centres? · Tradition Six: can an A.A. group partner with a treatment centre? · Tradition Eight: can anyone be paid for Twelfth Step work?
Sources
| Source | Pages | First published |
|---|---|---|
| Alcoholics Anonymous, Chapters 7, 10, 11 | 91, 95–98, 143, 159, 161 | 1939 |
| Alcoholics Anonymous, Appendix I, Traditions Six and Eight (Long Form) | 564–565 | 1946 |
| P-17, "Money" | — | 1946 |
| P-17, "Hospitals and A.A." | — | 1947 |
| P-43, The Twelve Traditions Illustrated, Tradition Five | — | © 1971; this printing updated 2023 |
| P-17, "A.A. and Alcoholism" (Conference policy statement) | — | undated; in the 2019 printing |
| P-16, The A.A. Group | 38–41 | 2018 |
Big Book page numbers are from the fourth edition (2001).
Recovery Starts is independent and not affiliated with Alcoholics Anonymous. Quotations are brief and cited; the Big Book, P-43 and P-16 are © A.A. World Services, Inc.; the P-17 articles are © AA Grapevine, Inc.
These pages answer questions about A.A. from A.A.'s own published literature, read in full, with every quote checked word for word against the page it cites. Recovery Starts is independent and not affiliated with Alcoholics Anonymous. What we read, and when each source was written.