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Tradition Six: can an A.A. group partner with a treatment centre?

In short:

  • No. The Long Form says an A.A. group "may cooperate with anyone," but "such cooperation ought never go so far as affiliation or endorsement, actual or implied" (p. 564). "An A.A. group can bind itself to no one" (p. 564).
  • The 1946 text doesn't use the words "treatment centre." Its words are "hospitals, as well as other places of recuperation," and it says they "ought to be well outside A.A.—and medically supervised" (p. 564).
  • Cooperation is fine. In 1946 Bill W. wrote, "Everywhere we cooperate with hospitals" (P-17, "Money", 1946), and today's group pamphlet describes groups renting rooms in facilities and members taking A.A. to patients (P-16, 2018). A partnership, a shared name, money in either direction, or anything that makes the group look like part of the facility is not.
  • The Tradition binds A.A. groups. It doesn't govern treatment centres, which are free to run as their owners decide.

What the Long Form says

Tradition Six is the longest of the twelve (pp. 563–564). In order: - Money, property and authority "may easily divert us from our primary spiritual aim" (p. 563). - Property of real use to A.A. should be separately incorporated, "thus dividing the material from the spiritual" (p. 564). - "An A.A. group, as such, should never go into business." (p. 564). - Clubs and hospitals that need much property or administration should be incorporated "and so set apart that, if necessary, they can be freely discarded by the groups" (p. 564). "Hence such facilities ought not to use the A.A. name." (p. 564). Running them is "the sole responsibility of those people who financially support them" (p. 564). - "But hospitals, as well as other places of recuperation, ought to be well outside A.A.—and medically supervised." (p. 564). - Cooperation with anyone, but never "affiliation or endorsement, actual or implied" (p. 564). "An A.A. group can bind itself to no one." (p. 564).

Tradition Three's Long Form makes the same point from the other side: two or three alcoholics may call themselves an A.A. group "provided that, as a group, they have no other affiliation" (p. 563).

The short form keeps the core: "An A.A. group ought never endorse, finance or lend the A.A. name to any related facility or outside enterprise" (p. 562). A treatment centre is a related facility.

Why: what A.A. tried in the 1940s

Bill W.'s essays show the Tradition came from experience with exactly this kind of arrangement.

Group-run drying-out places. Some groups, short of affordable hospital beds, set up their own, hiring managers and nurses. Run by a group, it "has almost always backfired" (P-17, "Hospitals and A.A.", 1947), because it put the group into a business few A.A.s knew anything about. Groups that raised public money for "A.A. hospitals" fared no better. Places run by individual A.A.s under medical supervision did better, and the reason Bill gives is the Tradition in a sentence: "Not being a group project and not bearing the A.A. name, these ventures can be taken or left alone." (P-17, "Hospitals and A.A.", 1947).

A.A. hospitals. "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" (P-17, "Money", 1946).

What cooperation looked like. In the same essay: "Everywhere we cooperate with hospitals." (P-17, "Money", 1946). Hospitals gave A.A. special privileges and working arrangements; some consulted A.A.; some hired A.A. nurses and attendants. "But none of these institutions are known as 'A.A. hospitals.'" (P-17, "Money", 1946).

Other causes, however good. "As groups, we cannot endorse, finance or form an alliance with any other cause, however good" (P-17, "Dangers in Linking A.A. to Other Projects", 1947). A.A. members may work in the alcohol field, including treatment, "if they act as individuals only, and are careful of the A.A. name" (P-17, "Dangers in Linking A.A. to Other Projects", 1947). Bill's summary: "A.A. does not sponsor projects in other fields." (P-17, "Dangers in Linking A.A. to Other Projects", 1947).

In 1957 he was specific about treatment. Nor should an A.A. group ally itself, he wrote, "with any particular brand of medical or psychiatric treatment" (A.A. Comes of Age, 1957). In the next breath: "We can cooperate with anyone." (A.A. Comes of Age, 1957).

In practice

Putting the Long Form and the essays together: - Fine: a group renting a room in a treatment facility; members carrying meetings into a facility; members working at a facility as individuals; giving staff information about A.A. - Not fine for a group: being run, funded or paid by a facility, or funding one; a facility using the group's A.A. name, or the group taking the facility's name; any joint program or "partnership" that would make the group look like part of the facility, even by implication ("actual or implied," p. 564).

A later pamphlet applies the same reasoning to group names: a group that meets in a treatment facility should call itself something quite different from the facility, so it's clear the group "simply rents space there for meetings" (P-16, 2018). It sums up the policy as "cooperation but not affiliation" (P-16, 2018).

What the Tradition doesn't do

It doesn't judge treatment. The Long Form says hospitals and places of recuperation belong outside A.A. and under medical supervision; it doesn't say they're bad. Bill thought hospitalization was the doctor's job (P-17, "Money", 1946), and praised the A.A. members who managed such places well (P-17, "Hospitals and A.A.", 1947).

And it doesn't bind the treatment centre. The Traditions govern A.A. groups and A.A. as a whole. A facility is responsible to the people who pay for it (p. 564), not to A.A.'s Traditions. The question the Tradition answers is what an A.A. group may tie itself to, and the answer is no one.

Read it yourself

Sources

Source Pages First published
Alcoholics Anonymous, Appendix I, Tradition Six (short and Long Form); Long Form Three 562–564 1946
P-17, "Money" — 1946
P-17, "Hospitals and A.A." (excerpts from "Adequate Hospitalization"); "Dangers in Linking A.A. to Other Projects" — 1947
A.A. Comes of Age, "Unity" (Tradition Four and Six) — 1957
P-16, The A.A. Group 17–18, 25, 39 2018 printing

Big Book page numbers are from the fourth edition (2001). Our copy of A.A. Comes of Age has no printed page numbers, so it's cited by book and year.

Recovery Starts is independent and not affiliated with Alcoholics Anonymous. Quotations are brief and cited; the Big Book, A.A. Comes of Age 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.