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The type of group that I chose to observe was a 12-step Alcoholics Anonymous (AA) group. The AA group that I attended was an open group. Before attending the group, I called the Las Vegas Central Office for Alcoholics Anonymous to inquire about AA groups. When asking about AA groups, I let them know that I am a student looking to attend to observe, not participate. I received verbal permission from the Las Vegas Central Office for Alcoholics Anonymous to attend an open AA group, and they instructed me to look at their schedule online to see which AA meeting I would like to attend. The date of the AA meeting that I chose to participate in was on Saturday, November 23, 2019.
After finding the meeting I wanted to go to and attending, the first thing I did was speak to the facilitator of the group to make sure that I could observe. I explained to the facilitator that I am a student, looking to observe a group for a class I am taking. In AA groups, the facilitator of the group is called the chairman. We then discussed confidentiality. The chairman was accepting of me observing the group. The size of the group I attended was small, only 21 people attended, varying from young adults to older adults. The ages of those that attended the meeting were not discussed. All 21 people were seated in a circle around the chairman. Including me, there was two new people that attended this AA meeting. This meeting was held at the KCB Club in the Northwest area of Las Vegas. The meeting lasted about one hour.
This meeting started with the chairman reading the AA Preamble, the group prayer, and the Serenity Prayer. Following this, the chairman explained how an AA meeting works, the “Twelve Traditions” and “The Promises.” After the prayers and discussing what AA is, the newcomers then introduce themselves. The group then read chapter three out of 12 chapters in the Twelve Steps book. After reading this chapter, the group then spent the remaining time discussing any experience and strength they would like to share.
The person that leads an AA group is called a chairperson. To qualify to become a chairperson, it is mandatory to be sober from alcohol for at least a year; usually, they hold a different position within the group before becoming the chairperson. The chairperson is required to serve for six months to one year after committing. As far as education, they need to know the 12-step process. There is another form of a facilitator called a sponsor. Sponsors are members of the group that have been sober at least a year that act as a support system to newer members.
During the group, it appeared that the participants that have been attending longer were more open to sharing their experiences related to the chapter that we read in the Twelve Steps. One newcomer shared some personal experiences that he has had related to the start of his journey of sobriety. At the beginning of the meeting, the newcomer appeared more reserved. The other participants welcomed his story and encouraged him. Some participants also shared their stories of when they first started their journey of sobriety. Sharing their stories appeared to give the newcomer a sense of hope. The chairperson did an excellent job of leading the group through the opening prayers, introductions, and through the reading of the chapter in the book without distractions or interruptions.
It was interesting to watch the group and see how the participants responded to each other after someone would share. I am used to groups where a participant shares, and the facilitator responds to the participant and asks open-ended questions to keep the group open. The participants seemed to respond well to their peers, responding to them instead of the chairperson; the participants appeared hopeful. During this AA meeting, it was not apparent that there were any issues with transference or countertransference.
The intervention that an AA group uses is self-help. Alcoholics Anonymous groups typically fall into self-help groups because they are groups of people who are there for a common problem. These groups of people come together to help each other understand and solve the problem of alcohol use as well as provide support for other members in the group. In self-help groups, it is important to encourage and empower other members to help them through the problem. Alcoholics Anonymous groups began as a religious movement and developed into a fellowship that showed characteristics of a therapeutic community, a philosophy, and a social organization (Young, 2011). ‘Over the first 15 months after baseline the three conditions did not differ on most outcome variables, although significantly more outpatient subjects in the TSF (twelve-step facilitation) condition were continuously abstinent than in either of the comparison conditions (cognitive behavioral therapy and motivational enhancement therapy)’ (Mccrady, Epstein, & Hirsch, 1999). Alcoholics Anonymous does not follow the typical model of an evidence-based group. However, they are still useful in reducing the use of alcohol. Self-help groups are facilitated by a nonprofessional leader, meaning the leader of the group is typically a member who has been sober for over a year.
Not only was the group that I attended a self-help group, but it was also an open group. I could only attend open groups, per the Las Vegas Alcoholics Anonymous Central Office, due to confidentiality. An open group allows new members to come to any meeting as long as the group exists. An open group does have more turnover as opposed to a closed group. With there being a higher turnover rate, it is harder for members to establish close relationships with other members. Also, the pace material is shared faster in an open group.
In AA groups, hope is something that occurs in members that continue to participate in the group. ‘Group members who believe that treatment is purposeful and effective and will eventuate in improvement are biased or predisposed toward a positive outcome’ (Maguire, 2002). This is shown by members witnessing the positive effects of the group on their peers and how the group has positively affected their peers into making lifestyle changes will encourage other members to make lifestyle changes. An example of this would be a member sharing the testimony of their long addiction to alcohol and the difficulties the person faced because of their addiction. After sharing a testimony, others in the group can then relate to their testimony.
During AA groups, altruism is also evident. Altruism is being aware of others’ welfare without thinking about getting a reward. Altruism is used in AA meetings when a member is tempted to start drinking again. When a member is tempted to start drinking again, a sponsor or fellow members willingly help out and encourage the member not to start drinking again. These sponsors or fellow members help out their other members in their group without receiving a reward.
Alcoholics Anonymous groups can be considered culturally sensitive and applicable to different minority groups. AA groups are self-help groups, and they are not facilitated by a licensed professional; a member of the group facilitates them. Having the group facilitated by a member of the group makes it easier for the facilitator to relate and be culturally sensitive to the group that they have. Many AA groups develop the things that they consider normal, their behaviors, and even their language. Another factor that makes groups culturally sensitive is that many AA groups are open, meaning new members can come to meetings whenever they would like. In Las Vegas, there are a variety of different AA meetings that are specifically just for women or just for men and meetings all over the city; anyone wanting to attend a meeting can go where ever they feel comfortable attending a meeting. Las Vegas also has an AA group specifically for the LGBTQ community and Native American or American Indians.
One way that social workers and the population could be more culturally sensitive in AA meetings is by discussing things that people in the Drug Courts may have experienced. Those in the Drug Courts that are mandated to attend AA meetings are frequently quiet in meetings. The participants from the Drug Courts do not feel safe to share in a group setting. They are guarded with their feelings because they do not feel comfortable talking about their usage and personal things in front of people they do not know. To be more culturally sensitive to those in the Drug Courts, social workers and other members in AA groups can take the chance to get to know these individuals on an individual level.
Another culture that social workers and members of AA groups need to be aware of and sensitive to is those that are Jewish. There is a Yiddish saying, ‘a shicker (a drunk) is a goy (non-Jew)’. Although there is this stereotype towards the Jewish and alcoholism, there is increasing awareness and resources. Social workers and AA members need to take into consideration that those that are Jewish may attend a 12-step AA program. However, they might feel more comfortable in some settings that are non-church related settings. This is something that social workers and AA members need to be culturally sensitive to since most AA groups can be spiritual.
Observing this group influenced my development as a professional social worker by showing me to give more encouragement and positive feedback, instead of just using reflective statements to show that I am listening. Also, observing this group taught me to listen more and speak less, meaning listen to the client more and let them talk or vent as opposed to me speaking and asking questions more. I have noticed I spend a significant amount of time asking questions instead of just listening to the client talk. I will continue to learn and develop my skills by continuing to observe different groups, and after I have observed enough times, ask if I can co-facilitate (for practice, in a practicum setting).
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