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Similar to discussion on Twelve-step program, I've updated the lead paragraph to read "mutual help" in place of "mutual aid"(linked to mutual aid (organization theory). The citation(Mäkelä 1996) is about AA as a mutual help program, as opposed to a mutual aid one, and includes discussion differentiating it from mutual aid. I'm not sure why this got translated to "mutual aid", but none of the other citations for this section mention mutual aid, so I think this is a better representation of the source.

The 2020 cochrane review refers to AA/TSF as a "peer to peer support" programme, which may be a better substitute if we wish to avoid these subtle differentiations, and is both recent and very reliable as a source- maybe we should use that? Adacable (talk) 18:00, 30 August 2022 (UTC)[reply]

“Mutual-help” is how Cochrane 2020 describes AA, so I think that wording is more apt than “mutual aid”. SkylabField (talk) 14:22, 31 August 2022 (UTC)[reply]

Bill Wilson openly acknowledged Kropotkin’s book Mutual Aid as extremely influential to him. Also, AA is an intentional anarchy due to Wilson’s devotion to the Kropotkin’s anarchist ideology. Mutual self help conveys none of that as essential. Mutual aide is the most descriptively appropriate and most historically relevant descriptor. Finally, as a movement, as far as I can tell, mutual self help has no standing in comparison to mutual aid. It is a generic and anodyne term, which is probably why some academics like it, with no wiki page to be found. — Preceding unsigned comment added by 66.60.170.151 (talk) 03:58, 1 September 2022 (UTC)[reply]

Additional note: AA can be argued to the most prominent, representative and successful example of the Mutual aide movement. — Preceding unsigned comment added by 66.60.170.151 (talk) 15:37, 1 September 2022 (UTC)[reply]

One more thing: That AA is an anarchy to its very core is so poorly understood and appreciated results in off the money edits by well intentioned good faith editors. Fair play, no harm no foul, but we’re here to keep the record straight. — Preceding unsigned comment added by 66.60.170.151 (talk) 07:00, 2 September 2022 (UTC)[reply]

Since 66.60.170.151 has started an edit war by reverting my edit correcting what the 2020 Cochrane Report actually says, let me clear things up.

Here is the wording the IP editor wants:

Regarding its effectiveness, a recent scientific review has shown that when engaged with AA through clinically delivered 12 step facilitation programs (AA/TSF), the results are as good or better than other clinical interventions or no treatment at all.

Here is my wording correcting the record:

Regarding its effectiveness, a recent scientific review has shown that when actively directed to go to AA through clinically administered 12 step facilitation programs (AA/TSF), the results are as good or better than other clinical interventions or no treatment at all.

Here is what the source document says:

The evidence suggests that compared to other well‐established treatments, clinical linkage using well‐articulated Twelve‐Step Facilitation (TSF) manualized interventions intended to increase Alcoholics Anonymous (AA) participation during and following alcohol use disorder (AUD) treatment probably will lead to enhanced abstinence outcomes over the next few months and for up to three years.

[...]

Thus, a relatively brief clinical intervention (AA/TSF) can help people with AUD to become engaged in a long‐term, freely available, community‐based, recovery support resource that can help them sustain ongoing remission.

Point being, the IP’s wording implies that it’s only with people actively engaged in AA who have better outcomes than other treatments, but, according to Cochrane 2020, it’s the entire sample of subjects who went through treatment “intended to increase Alcoholics Anonymous (AA) participation” who did better compared subjects going through other treatments.

When we compare the people actively engaged in 12-step programs to people who weren’t engaged with 12 step programs, as was done in Moos and Moos 2006, we get even better results than what Cochrane found (Cochrane 2020 saw a 42% abstinence rate one year after treatment; Moos and Moos 2006 saw 67% 16 years after treatment) but there’s the thorny issue with self selection bias which Cochrane 2020 doesn’t have.

SkylabField (talk) 16:24, 12 September 2022 (UTC)[reply]

That unfortunate accusation of edit warring has no basis since it was about a good faith edit—not a revert—given a good explanation is never a commencement of an edit war. An apology is due me an actually reverting editor is encouraged to become familiar with wiki’s page edit warring.

You’re edit warring:

• Revert #1
• Revert #2
• Warning placed on talk page

SkylabField (talk) 19:31, 12 September 2022 (UTC)[reply]

As for the edit itself, per the source, as noted above, engagement with AA is what results in long term remission. The editor thinks the previous wording had excluded TSF/AA:

No, I thought the wording you recently added in this edit misrepresents what the Cochrane 2020 review actually says. SkylabField (talk) 19:59, 12 September 2022 (UTC)[reply]

In that editor’s words, “the IP’s [myself] wording implies that it’s only with people actively engaged in AA who have better outcomes than other treatments”

per the actual edit objected to for excluding TSF/AA

“Regarding its effectiveness, a recent scientific review has shown that when engaged with AA through clinically delivered 12 step facilitation programs (AA/TSF), the results are as good or better than other clinical interventions or no treatment at all.”

Explicity the offending edit does not excluded TSF/AA and in no way suggests that AA alone would have result in likewise outcomes. In fact, when the edit was made, my editor’s note said that AA alone could as beneficial, but that was beyond the scope of the review and should be avoided.

Cochrane 2020 does not compare AA by itself to other treatments, but uses TSF because one can not effectively randomize for AA alone. See Kaskutas 2009 or the popular press article In Defense Of 12 Steps: What Science Really Tells Us About Addiction for further information. SkylabField (talk) 19:59, 12 September 2022 (UTC)[reply]

Essentially we do and have agree, and have both made edits that TSF/AA is the sole context of the review. A better and less careless reading of the objected to edit would have ben preferred. 66.60.170.151 (talk) 17:03, 12 September 2022 (UTC)[reply]

The difference may seem subtle to people not familiar with how medical studies are performed, but it’s a very important distinction for people familiar with how medical studies strongly suggest that AA itself helps keep alcoholics sober. As per Moos and Moos 2006 (linked above), we’ve known for a long time that people actively engaged in AA are more likely to stay sober. However, we still didn’t know back in 2006 if this was correlation (people who have the type of personality to go to AA meetings on a regular basis also happen to have the type of personality to stay sober) or causation (AA itself helps keep alcoholics sober). By using the word “engage”, we’re implying that we still don’t know if it’s correlation or causation. We now know that simply being encouraged (“directed”, whatever) to engage in AA results in more people being sober, since people randomly assigned to a treatment which doesn’t mention AA are less likely to stay sober compared to people randomly assigned to treatment which encourages going to AA. The wording in the lede should make this distinction clear. SkylabField (talk) 19:30, 12 September 2022 (UTC)[reply]

The editor is also encouraged to know the difference between a scientific study and a scientific study and to thereby learn the inadvisability of making a very recent review, which I will presume acknowledged and accounted for Moos study, subordinate to a 18 year old study. — Preceding unsigned comment added by 66.60.170.151 (talk) 17:12, 12 September 2022 (UTC)[reply]

Please become more familiar with Wikipedia’s policies, in particular WP:MEDDATE SkylabField (talk) 19:30, 12 September 2022 (UTC)[reply]

The editor insists on a distinction that makes no difference. To engage with through TSF/AA and to be directed to AA by AA/TSF have exactly the same meaning, hence a distinction with no difference. Unfortunately the editor in this case also prefers bad writing. Since there is no real difference and the insisted upon edit misleads or will confuse no one, I will make a concession to bad writing since the editor is so bent on taking the article hostage for this silly issue of their manufacture. It is hoped for all of our sakes the editor now knows the difference between a single study as opposed to a comprehensive review that takes account for that study as well as other relevant studies — Preceding unsigned comment added by 66.60.170.151 (talk • contribs) 21:18, 12 September 2022 (UTC)[reply]

I have already explained how “directed to” (told by a doctor to go to AA) and “engaged” (actively going to AA) are very different above. I feel no need to repeat myself. I should also point out that I am well aware that Moos and Moos 2006 is a single study and Cochrane 2020 is a comprehensive review, and my edits have been to have the article correctly reflect what the comprehensive review Cochrane 2020 has to say about AA efficacy (Moos and Moos 2006 is mentioned but given much less prominence in the article). More to the point, this is a formal warning to 66.60.170.151: You have been warned by multiple editors that your pattern of edit warring goes against Wikipedia policy and violates Wikipedia’s guidelines. Since you have erased those warnings from your talk page we can safely assume you understand that you have been given multiple warnings from multiple editors about your behavior. Should a pattern of reverting other editor’s contributions continue, you may have your editing privileges on the Wikipedia revoked. SkylabField (talk) 22:07, 12 September 2022 (UTC)[reply]

That was unlettered, and and unnecessary flex (oddly and inappropriately energetic and out of touch with forms of courtesy regarded as ideal from wiki editors), and all in the face of a concession. The word graceless comes to mind.

I’m reminded of how many times my mom directed me to do something, you know like clean my room, and, well, never mind. The suggestion in the editors’s mind is that everyone told by a doctor, or similar professional, to become active in AA did so—if it were only that simple—and this is the actual population the Cochrane review was concerned with. This is atoundoundly incorrect. In fact, the Cochrane review carefully focused on the much much smaller population of those actually engaged with AA (again, engaged is their their defining behavioral descriptor). But if the editor must, It’s on that editor if they wish to insist on perpetrating the indefensible error, but one that will lead to no harm since despite the faulty logic, the reader will know well enough what is meant. Nonetheless, if the editor does now realize what defines a scientific review, some good will have been done. A return to civility might even be possible, and I will be glad to join the editor towards that end going forward. 66.60.170.151 (talk) 22:35, 12 September 2022 (UTC)[reply]

To say the Cochrane Study’s populations are only those told to go—actively directed— to AA is to say the populations include both those told to go and didn’t along with those who are directed and do engage. The review explicitly eliminates those told to go but who don’t. If only telling folks to go to AA was what it took to get the superiors results attributed to TSF/AA clinical interventions. This is sadly not the case and the additional qualifier “and actually do go to AA” was not removed for any good reason but to instigate an officious wasting of time that seems obstinate more than anything else since the truth of who makes up the populations is clarified up and a falsehood is left in it’s place. 66.60.170.151 (talk) 03:08, 13 September 2022 (UTC)[reply]

Show me where the review eliminates people who were told to go but do not. Please quote the exact part of the the Cochrane 2020 review where it “eliminates those told to go but who don’t”. The qualifier “and actually do go to AA” was removed because Cochrane 2020 does not measure sobriety rates among people who actually go to AA. It measures sobriety rates among people directed to go to AA, because we can not effectively randomize for people who actually go to AA because of self-selection bias issues, and proper randomization is very important with these kinds of high quality reviews. SkylabField (talk) 12:21, 14 September 2022 (UTC)[reply]

• "The review explicitly eliminates those told to go but who don’t." - That is not accurate. The TSF studies compare one treatment intervention, Twelve-Step Facilitation, to other established interventions, e.g., MET or CBT. Each treatment group has individuals who do not follow recommendations, e.g., for TSF, participants are encouraged to go to AA meetings but some don't, and for CBT, participants are encouraged to, for example, record their activities and corresponding mood and mastery ratings, but some participants never or rarely do such therapeutic homework. Mark D Worthen PsyD (talk) [he/him] 06:28, 15 September 2022 (UTC)[reply]

Edits to improve coverage of the Cochrane review

I made some edits to improve accuracy, clarity, conciseness, and concordance with what the Cochrane review actually says (diff). Mark D Worthen PsyD (talk) [he/him] 06:28, 15 September 2022 (UTC)[reply]

I’m thinking we should maybe restore a description of Humphreys 2014, which uses instrument modelling to show less severe negative consequences w.r.t. alcohol for people who went to more AA meetings as determined by randomization (drinking days per week, as I recall). Perhaps more in-depth discussion of the strong correlation between self-selected AA attendance and better outcomes for alcoholics from the older longitudinal studies we have. The big point of Cochrane 2020 is that if we carefully only use studies with good randomization, we get better results with treatments which should make people more likely to attend AA meetings. But, things look pretty good and are rigorously accurate right now. SkylabField (talk) 08:23, 15 September 2022 (UTC)[reply]

Another thing to keep in mind is, when we added the Cochrane information to the lead, the consensus at the time was to make the summary a short one-sentence summary. See Talk:Alcoholics_Anonymous/Archive_9#Adding_sentence_on_effectiveness_to_the_lead

Right now, the summary is “Regarding its effectiveness, a recent scientific review indicated that manualized Twelve-Step Facilitation (TSF) interventions designed to increase AA participation are more effective than other clinical interventions as measured by abstinence from alcohol, and are likely more cost-effective as well”, which, yes, is one sentence, but a bit wordy. I would reduce it to “Regarding its effectiveness, a recent scientific review saw interventions encouraging increased AA participation resulting in more sobriety than other interventions”, but will not edit it without consensus at this point because of edit warring over the wording. SkylabField (talk) 14:58, 15 September 2022 (UTC)[reply]

Good point. I would replace "sobriety" with "higher abstinence rates" or similar. I know what you mean by "sobriety", but the word has various denotations. Mark D Worthen PsyD (talk) [he/him] 17:21, 15 September 2022 (UTC)[reply]

How about “Regarding its effectiveness, a recent scientific review saw interventions encouraging increased AA participation resulting in higher abstinence rates than other interventions” SkylabField (talk) 22:57, 15 September 2022 (UTC)[reply]

Perfect. :0) Mark D Worthen PsyD (talk) [he/him] 22:45, 18 September 2022 (UTC)[reply]

After a discussion on the talk page (see above), consensus is the following wording for AA's effectiveness in the lead:

Regarding its effectiveness, a recent scientific review saw interventions encouraging increased AA participation resulting in higher abstinence rates than other interventions

Despite being given warnings by other editors, and despite consensus to the contrary, 66.60.170.151 continues to edit war, restoring their wording which goes against consensus in a series of edits. I have warned the editor, but since they have blanked other warnings, should the edit warring continue, it is time to escalate this to WP:AN/I as per the discussion we had at the 3 revert noticeboard. This is a final warning. SkylabField (talk) 19:57, 24 September 2022 (UTC)[reply]

This is specious edit war charge made by an aggressive and contentious editor who is given themselves to edit warring and then running to the wiki police. The editor did file an edit warring charge which the last charge was closed as unfounded. The editor just did the first revert of a good faith edit for no reason than apparent animosity. The editor seems to be unconcerned with the merits of an edit and instead seeks ownership of the article through police actions.The edits of mine, however, were duly noted noted as clarifications and changed noting but remove vague wording that did not clearly convey what the review actually said. What was objectionable about the edit besides the editor?

The main unfortunate outcome of the revert at issue:

The review only concerns itself with only the AA/TSF interventions while the edit, as it now stands, categorically includes the much broader realm of all interventions. Why the insist on the falsehood remaining? If there is no substantial reply, an edit warring charge can be submitted for that editor. Do, really need to do that over a clear and simple factual matter that should be easy to resolve? 66.60.170.151 (talk) 20:25, 24 September 2022 (UTC)[reply]

Please be aware it is not a single editor who you disagree with. You have been reverted multiple times by multiple other editors. Multiple editors have asked you to seek consensus on the wording, and you have been told your proposed wording is inaccurate by another editor. Consensus has been established by multiple editors, and your continuing to edit against consensus goes against Wikipedia policy. The only reason Daniel Case marked it no violation is because, at the time, you stopped your reverting and edit warring. Since you have since reverted again, that changes things. SkylabField (talk) 20:37, 24 September 2022 (UTC)[reply]

I expected a legalistic response and got one.

So, why do we leave in place a revert grossly misstating the scope of Cochrane review as covering all intervention, and not the much more narrower and truthful fact that it was limited to TSF/AA clinical interventions. This will be second time this has been asked. 66.60.170.151 (talk) 20:55, 24 September 2022 (UTC)[reply]

We use the current wording because that is the wording which we decided upon via consensus with multiple editors. To change the wording requires discussing it on the talk page, and, this is very key: Since an edit war has been done over the wording of that sentence, other editors must agree to the new wording here on the talk page before editing it in the article. You are the only editor which desires different wording than “Regarding its effectiveness, a recent scientific review saw interventions encouraging increased AA participation resulting in higher abstinence rates than other interventions”, so that is the wording that remains until multiple editors agree on another wording. Please review and understand WP:CONSENSUS. SkylabField (talk) 21:01, 24 September 2022 (UTC)[reply]

Great, lets get your opinion.

Do you insist on letting the article say all AUD interventions are the scope of the review? No answer will taken as an abstention on the matter. 66.60.170.151 (talk) 21:10, 24 September 2022 (UTC)[reply]

A non-response from another editor does not mean they agree with your edits. Again, other editors must agree to the new wording here on the talk page before editing it in the article. For them to agree with a given wording, they have to make an edit on the page saying words to the effect of “I agree with the wording”. SkylabField (talk) 21:17, 24 September 2022 (UTC)[reply]

This is evasive. Since the edit is up for discussion, do you, and you only, agree with or not and why in either case? 66.60.170.151 (talk) 21:23, 24 September 2022 (UTC)[reply]

That claim is incorrect. Multiple editors have agreed on the current wording. It is not just one editor. Consensus has been established. This will be my last reply to the IP in this discussion; should the IP attempt to revert the sentence again in the article without consensus from other editors, they may be reported. It does not matter if they revert the sentence today or revert in the future. SkylabField (talk) 21:29, 24 September 2022 (UTC)[reply]

Since my edit does not contradict but only clarify, why do you, and you only, have issue with it? 66.60.170.151 (talk) 21:33, 24 September 2022 (UTC)[reply]

This is a flex and a flex only to keep an article in poor shape. 66.60.170.151 (talk) 21:35, 24 September 2022 (UTC)[reply]

The IP editor is now blocked for engaging in disruptive editing. Yes, being argumentative and engaging in personal attacks on talk pages is disruptive editing. Hopefully they have learned their lesson, and will learn to work better with other editors. If not, then this matter will be escalated. SkylabField (talk) 02:33, 25 September 2022 (UTC)[reply]

That’s a misleading overstatement. The block was for 24 hours only while Skylab is apparently content to let the conflation that all interventions, including non clinical ones, are what the Cochrane review only addresses clinical interventions having no argument accept that is the consensus and has persistently refused to materially address and correct the clear falsehood. This is a second known instance suggesting that Skylab may be habitually given to making or supporting misleading declarations. That with a predilection towards the fallacy of authority makes me profoundly doubt that editor’s judgement. Though the article suffers badly for that, oh well, it’s not for lack of one editor trying to fix the error. 66.60.170.151 (talk) 21:03, 29 October 2022 (UTC)[reply]

I think it would be best if you dropped this matter. You have already been blocked once. SkylabField (talk) 01:34, 30 October 2022 (UTC)[reply]

Aga — Preceding unsigned comment added by 105.112.126.181 (talk) 14:20, 28 September 2022 (UTC)[reply]