The Science of Sponsorship


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Investigations into the efficacy of Alcoholics Anonymous and other 12-Step programs have advanced from what was once little more than popular and clinical folklore. Scientific studies have progressed through the stage of weak methodological designs to quite sophisticated studies measuring both the effects of 12-Step mutual aid participation on long-term recovery outcomes and the most potent ingredients of such participation.

One of the 12-Step mechanisms of change that has been studied in the past decade is sponsorship. These studies have explored the varieties of 12-Step sponsorship, sponsorship characteristics, and the effects of sponsorship for the sponsor and the sponsee. Below are ten conclusions drawn to date from these preliminary studies.

  1. The functions performed by 12-Step fellowship sponsors fall into three broad categories: 1) encouraging participation in core 12-Step activities, 2) providing emotional support and practical recovery guidance, and 3) sharing the sponsor's story and lived recovery experience with the sponsee (Whelan, et al., 2009).
  2. Continuous sobriety increases in tandem with duration of sponsorship (Rynes & Tonigan, 2012; Young, 2013).
  3. Factor analysis of assertive models of linkage to 12-Step programs (e.g., MAAEZ) reveal that sponsorship contributes approximately 25% of the positive effects of these models on drinking outcomes (Subbaraman, Kaskutas, & Zemore, 2011).
  4. The positive effects of sponsorship occur independent of degree of meeting attendance (Witbrodt, et al., 2012).
  5. The rate of sponsorship in A.A. is quite high--82% of members report having a sponsor. Unsponsored A.A. members are more likely to be older A.A. members with prior sponsor relationships rather than new members who have chosen not to use a sponsor (Young, 2013).
  6. The greatest measurable benefits of sponsorship occur early. In terms of recovery initiation and stabilization, the greatest effects of being sponsored occur in the first year of the sponsorship relationship (Tonigan & Rice, 2010). Half of individuals who reduced sponsorship contact over a seven-year follow-up period maintained complete abstinence (Witbrodt, et al., 2012).
  7. The effects of sponsorship on recovery outcomes vary by sponsor and sponsor-sponsee relationship characteristics--a quality that can be measured via the Sponsor Alliance Inventory. Positive sponsor-sponsee alliance is associated with enhanced short-term abstinence outcomes (Kelly, et al., 2015).
  8. Surveyed sponsees report trustworthiness, discretion (respecting confidentiality), and integrity as the most important sponsor characteristics (Stevens, 2013).
  9. In a rare study of former injection drug users, having an AA/NA sponsor did not predict improved recovery outcomes, but sponsoring others produced substantially increased odds of abstinence compared to those who were not involved in sponsoring others (Crape, et al, 2002). The study findings by Crape and colleagues are consistent with other studies reporting exceptionally high abstinence rates among those serving as sponsors in A.A. (e.g., 91% abstinent rate in the 10-year follow-up study by Cross and colleagues (1990). They also support more recent studies documenting the power of helping others in enhancing one's own long-term recovery stability and quality of life in recovery (See Zemore, et al., 2004, 2008, 2013)
  10. Sponsored members of 12-Step fellowships are more likely than those without sponsors to participate in other activities that have been linked to enhanced recovery outcomes, e.g., meeting attendance, home group affiliation, step work, service work, etc. (Young, 2013; Pagano, et al., 2009; Morgenstern, et al., 1996).

Collectively, these studies confirm the value of peer-based mentor relationships within the recovery process and also underscore the value of helping others in enhancing one's own recovery process. These findings underscore a message that I have tried to convey through much of my advocacy work: Recovery is contagious. Get close to it. Stay close to it. Catch it. Keep catching it. Pass it on.

Suggested Reading

Brown, R. E. (1995). The role of sponsorship in the recovery or relapse processes of drug dependency. Alcoholism Treatment Quarterly, 13(1), 69-80. doi: 10.1300/j020v13n01_06

Crape, B.L., Latkin, C.A., Laris, A.S., & Knowlton, A.R. (2002). The effects of sponsorship in 12-Step treatment of injection drug users. Drug and Alcohol Dependence, 65, 291-301.

Cross, G.M., Morgan, C.W., Mooney, A.J., Martin, C.A., & Rafter, J.A. (1990). Alcoholism treatment:A ten-year follow-up study. Alcoholism: Clinical and Experimental Research, 14, 169-173.

Gomes, K., & Hart, K. E. (2009). Adherence to recovery practices prescribed by Alcoholics Anonymous: Benefits to sustained abstinence and subjective quality of life. Alcoholism Treatment Quarterly, 27(2), 223-235. doi: 10.1080/07347320902784874

Kelly, J.F., Greene, M.C., Bergman, B., Hoeppner, B.B., & Slaymaker, V. (2015). The sponsor alliance inventory:Assessing the therapeutic bond between 12-step attendees and their sponsors. Alcohol and Alcoholism, (advanced publication, 1-8, doi: 10.1093/alcalc/agv071.

Moos, R. H. (2008). Active ingredients of substance use-focused self-help groups. Addiction, 103(3), 387-396. doi: 10.1111/j.1360-0443.2007.02111.x

Morgenstern, J., Kahler, C. W., Frey, R. M., & Labouvie, E. (1996). Modeling therapeutic response to 12-step treatment: Optimal responders, nonresponders, partial responders. Journal of Substance Abuse, 8(1), 45-59. doi:10.1016/S0899-3289(96)90079-6

Pagano, M. E., Zemore, S. E., Onder, C. C., & Stout, R. L. (2009). Predictors of initial AA-related helping: Findings from project MATCH. Journal of Studies on Alcohol and Drugs, 70(1), 117-125.

Polcin, D. L., & Zemore, S. (2004). Psychiatric severity and spirituality, helping, and participation in Alcoholics Anonymous during recovery. The American Journal of Drug and Alcohol Abuse, 30(3), 577-592. doi: 10.1081/ada-200032297

Rynes, K. N., & Tonigan, J. S. (2011). Do social networks explain 12-step sponsorship effectsA prospective lagged mediation analysis. Psychology of Addictive Behaviors, 432-439 doi: 10.1037/a0025377

Stevens, E.B., & Jason, L.A. (2015). Evaluating Alcoholics Anonymous sponsor attributes using conjoint analysis. Addictive Behaviors, 51, 12-17.

Subbaraman, M. S., Kaskutas, L. A., & Zemore, S. (2011). Sponsorship and service as mediators of the effects of Making Alcoholics Anonymous Easier (MAAEZ), a 12-step facilitation intervention. Drug and Alcohol Dependence, 116(1-3), 117-124. doi: 10.1016/j.drugalcdep.2010.12.008

Stevens, E. (2013). An exploratory investigation of the Alcoholics Anonymous sponsor: Qualities, characteristics, and their perceived importance" (2013). College of Science and Health Theses and Dissertations. Paper 49.

Tonigan, J. S., & Rice, S. L. (2010). Is it beneficial to have an alcoholics anonymous sponsor? Psychology of Addictive Behaviors, 24(3), 397-403. doi: 10.1037/a0019013

Whelan, P. J. P., Marshall, E. J., Ball, D. M., & Humphreys, K. (2009). The role of AA sponsors: A pilot study. Alcohol and Alcoholism, 44(4), 416-422. doi: 10.1093/alcalc/agp014

Witbrodt, J., Kaskutas, L., Bond, J., & Delucchi, K. (2012). Does sponsorship improve outcomes above Alcoholics Anonymous attendanceA latent class growth curve analysis. Addiction, 107(2), 301-311. doi: 10.1111/j.1360-0443.2011.03570.x

Young, L. B. (2012). Alcoholics Anonymous sponsorship: Characteristics of sponsored and sponsoring members. Alcoholism Treatment Quarterly, 30(1), 52-66. doi: 10.1080/07347324.2012.635553

Young, L.B. (2013). Characteristics and practices of sponsored members of Alcoholics Anonymous. Journal of Groups in Addiction & Recovery, 8, 149-164.

Zemore, S. E., Kaskutas, L. A., & Ammon, L. N. (2004). In 12-step groups, helping helps the helper. Addiction, 99(8), 1015-1023. doi:10.1111/j.1360-0443.2004.00782.x

Zemore, S. E., & Kaskutas, L. A. (2008). 12-Step involvement and peer helping in day hospital and residential programs. Substance Use & Misuse, 43(12/13), 1882-1903.

Zemore, S., Subbaraman, M. & Tonigan, S. (2013). Involvement in 12-step activities and treatment outcomes, Substance Abuse, 34, 1, 60-69.