Saturday, April 20, 2013

Alcoholics Anonymous, community needs assessment and implementation of a carpool program

About the community

The community is a twelve step fellowship.

This community was chosen for assessment because the author was a member of the community for several years in the past. This close-knit community, like all communities, has experienced many varied types of needs over the years. The group is lively and diverse. The community needs assessment was conducted through individual and small group interviews with prominent and non-prominent members of the community. A review of the fellowship member database was made. A monthly fellowship business meeting was attended by the author to see the group in process addressing needs. Quoted words and phrases in the text are taken from interviewed members' statements.

Kretzmann & McKnight (1996) note that communities cannot be developed from outside-in or top-down in order for there to be lasting change. Due to this, the writer spent time getting to know the change process the community already had in place. The author was an active member of the community a few years prior. Community membership does not grant immune from failure imposing a top-down change. The needs of the community were assessed from the community's perspective, as suggested by Kretzman & McKnight.

Geographic location

The fellowship rents a building in old town, and has been holding over 20 meetings per week for about seven years. This local fellowship of Alcoholics Anonymous has formally existed for about 20 years, and many of the individual meetings have been around for much longer. The community consists mostly of local residents, however some members are in town during the week and utilize meetings, and others drive up to 45 minutes regularly for meetings. The primary purpose of the community is to empower existing members to continue sobriety and to assist new members in achieving sobriety. The fellowship functions as an informal social support center. Though technically the AA bylaws do not allow for any particular member to hold more authority than another, members who have been at the group tend to have more sway in business meetings. Money is received in the form of donations. Small amounts of funds are raised through a soda machine situated inside the building.

Diversity and homogeneity metrics

The population is quite diverse. A recent group census revealed that there are approximately 220 people who claim membership. It was estimated that there are 15-35% more attendees any given week week who are not formal members. Socioeconomic status various greatly; it is not uncommon for newer members to be far below the poverty line, but many new members also are economically well-off. The majority of members are working class or middle class, with several members in the middle-upper class range.

All members claim to have addiction to alcohol.

Due to the wariness of members regarding anonymity, no educational or economic data was able to be obtained. Formal statistics on population age were not available either. Very few members are under 25. An informal survey of long-time members yielded the belief that 60% of members are between the ages of 40 and 75. The average years of continuous sobriety of members who elected to be part of the 2009 group census was 7.44, with a range of < 1 year to 38 years.

An informal survey of members' perceptions of ethnicity yielded a consensus that most members of the group are caucasian. Other well-represented ethinicities include Latino, African American, and Filipino. A handful of members are Native American.


Community members cite several norms. Talking about emotionally charged, "taboo" subjects for many other cultures. Members typically greet each other with hugs. Members often to not know each others' last names, only their last initial. This practice originates from the 12-step program requirement of "anonymity at the level of press, radio and films."

There is an unwritten initiation into the community through working on the twelve steps, "sponsoring" or mentoring other members through the twelve steps, attending business meetings and volunteering for positions, and racking up clean time all are things which seems to raise a person within the hierarchy of the community.

There is a loose hierarchical web structure of members through their sponsors, as almost invariably a sponsor has more sobriety than a "sponsee."

Beliefs and values

The group believes that alcohol is a disease made manageable through the practice of the twelve steps.

Twelve formal traditions are outlined and strictly adhered to by all twelve step groups. Several themes are present. Anonymity, autonomy and respect of other members is necessary, as unity of the group and it's purpose are held in high esteem. Alcoholics Anonymous has no affiliates and has no public opinion.

Value is placed on service, in part because without service, the program would not continue. Being of service is instilled in members as a necessary character building activity.

Community structure

Different meetings within the fellowship attract different members, so each of the over 20 weekly meetings has a different culture. For example, the weekday noon meetings consist mostly of business people on their lunch break, unemployed members, and retired members.and There are a few members who are not particularly welcoming, however for the most part a new meeting attendee is treated with respect and invited to participate in the meeting by sharing their story of recovery.

Each individual meeting holds a business meeting once per month, where service positions such as coffee maker, clean up, and secretary are chosen. Any attendee is welcome to attend and vote. Members are particularly encouraged. An informal survey of prominent fellowship members estimate business meeting attendance to average 50% of that group's attendees, with great variation between meetings. Service position terms vary between meetings, either being three months, four months, or six months. The meeting secretary chooses a different speaker for each meeting, to share their story and conduct group discussion of a recovery-related topic.

Each meeting secretary must attend a once-monthly fellowship-wide business meeting. They are required to bring any individual group concerns to the fellowship business meeting. Examples of concerns during the meeting the author attended: parking problems, keeping peace with the neighbors (the fellowship hall is in a residential area), low attendance at two meetings.

Community strengths

A strength of this fellowship is it's organization. Issues are discussed and addressed in a formal way during the meeting. One person has a service position of moderator, ensuring each member wishing to speak on a particular issue is given a change. A time keeper ensures an individual's time does not exceed 2 minutes at a time. All attendees can vote for amendments and motions. Attendees need not be fellowship members, however all persons present were members.

The business meeting attended by the author was noticeably tense. Members report that this is typical.

All fellowship meetings start and end with a prayer. The ending prayer is an interpretation of the Christian "Lord's Prayer." Talk of "God" is common in meetings and in AA literature. While "God" is defined as "your conception of a higher power," many members and potential members are discouraged by the seemingly necessary and integral religiosity.

Secretaries are not allowed to hold fellowship service positions. Service positions for the fellowship not previously named are Hospitals and Institution Chair, refreshments coordinator, and representatives who attend larger gatherings of AA regional service meetings. Two treasurers keep track of money received through donations, pay bills, and give monthly reports to the group. The fellowship holds occasional barbecue events, dinners, parties, and other events. For any event, a members volunteer to be on the committee and are confirmed through election.

The group has a strength in that it is a true democracy. While not all fellowship members attend the monthly business meetings, they are able to do so, and able to vote.

A huge strength of the community is it's ability to get and keep chronic alcoholics and drug addicts sober for long periods of time. The group believes sobriety is obtained through a combination of working the twelve steps, attending and sharing at meetings, being involved in service, and eventually taking other newer members through the twelve steps.


There is a detectable level of dogma in regards to the "basics of 12-step recovery," stated one member, "including sponsorship, working the steps, adhering to the twelve traditions, and going to meetings." The members interviewed described this as a strength and necessity for their community to continue, but acknowledged that many people are "scared off because we don't budge."

Despite that most members of the fellowship have used drugs besides alcohol, a strictly policy of not discussing drug use is always in effect. This is observed by the author to be an unfortunate and superficial norm, due to it's ability to scare off potential new members, and the fact that many members acknowledge that they are in recovery from other addictive disorders such as gambling, tobacco addiction, "codependent relationships," eating disorders, stealing, and sex addiction, among others. Members believe that their addiction to alcohol makes other intoxicating substances and behaviors, as well as behaviors which support addiction, difficult to stop once started. This potentially makes recovery from non-alcohol addictions more difficult for members because they cannot as freely discuss the issues at a group level.

Financial standing

Despite members referring to the fellowship as "poor," there has never been an issue paying rent or utility bills, the building is in good repair, and a new parking lot is scheduled to be poured - payed for by the fellowship - to replace a gravel one. Coffee and tea is provided for meeting attendees. Several upgrades to the building have been made over the years, including the addition of a "whole-house fan," an air conditioning unit, furnace upgrade, ceiling fan installation, bathroom remodels, and shelf installation. All of the work was done by fellowship members. The varied skills of fellowship members is a huge asset, as is members' willingness to occasionally donate time for the good of the group. The fellowship hall is thoroughly cleaned once per month. Individual meetings rotate through the cleaning schedule, so that each meeting is responsible approximately twice per year.

Potential needs

Since the group moved to the fellowship hall in 2002, they have struggled to secure adequate parking for members. A parking lot on one side of the building holds 6 cars, with room for two more if two cars stack behind the parked ones and block them in. Two parking spaces are reserved for handicapped access in front of the building, along with two more regular spaces. The other side of the building allows parking for four cars, though the spots cannot accommodate most trucks. Other parking is available on surrounding residential streets, and in front of a park one block from the fellowship hall. Some neighbors complained about consistently not being able to park in front of their houses, which led to special announcements before each meeting to remind attendants not to park in specific spots. Interviewed members state that most meetings have about 20-25 attendees, with the largest meetings having upwards of 75 attendees. Parking is identified as a growing problem. As fellowship membership continues to grow about 10% per year, the need for parking will only increase.

During the business meeting, a member suggested that several new members experienced issues when sponsorship by new members did not result in helpfulness. A few members spoke up about poor sponsorship experiences that led to relapse. One member remembered how their fourth step was shared, which normally is considered confidential. Another member shared how her sponsor relapsed, leaving her feeling hopeless. Another spoke of going through four sponsors in the course of six months, getting drunk several times before finding a person that was knowledgeable and experienced enough to help them.

A few members agreed that there is no quick fix to poor sponsorship, but that it can be solved through personal responsibility. It was proposed that experienced, mentally healthy members of the community could make an effort to actively enlist sponsees. The suggestion did not appease the group majority, but no solution was identified.

Formal sponsorship training session, complete with questions and answers, would be developed. A difficulty with this will be focusing on the core components of sponsorship, as sponsorship is as diverse as  Understanding the complexity of AA dynamics is difficult for the outsider. There is a saying "place principles before personalities," and it is well rehearsed due to alcoholics at times having quite rigid thinking patterns and strong personal traits.

The two identified needs, one of parking congestion, and the other of sponsorship issues, are equal in urgency. Parking has been an issue since the fellowship has resided at its present location. Low quality sponsorship is a problem which plagues the majority of 12-step groups.

The community does not appear to have the means to add additional parking. Building a parking garage on the property would not be possible due to residential zoning restrictions. There are no empty lots within walking distance which could be rented. No foreseeable resource barriers are present for improved sponsorship.

Implementation of a solution

The community itself is it's greatest resource, as explained in an article on community asset mapping (Kretzmann & McKnight, 1996). The people in the community were used to implement an ongoing, low cost and self-sufficient solution to the parking problem. A map of the greater metro area was used to show available carpool drivers and passengers. Members wishing to provide carpool transportation identified themselves on a map using a pin with their name written on an attached piece of tape. The addition of a "D" indicated they were willing to drive, "R" indicated they were willing to ride, and "B" indicated both. This is not precisely the same type of community asset map identified in the community asset mapping article, but it did provide a graphical representation of the available carpool resources. Participating members were encouraged to record their name and contact information on a clipboard hanging on the wall next to the map.

The evidence-based community tool box suggests effective interventions include many components, including identifying all the basic logistics and timelines of the intervention (Work Group for Community Health and Development, 2010). For this reason, a list of guidelines for carpooling was established and posted next to the map and list of carpool drivers. Some community members were included in developing the carpool logistics during a meeting with the writer. Coffee was purchased by the writer as a token of compensation for their time.

The main goal of the action plan is to decrease the problematic and mounting effects of limited parking upon the community. The main objective to be attained by the plan is to increase carpooling among members by raising awareness and decreasing the response effort of carpooling. A secondary objective is for members to have

The cost of the project was negligible. The entire project cost the fellowship less than $10. A map was printed on four 8 1/2" x 11" sheets of paper and adhered to an available fellowship-owned cork board. All other materials were purchased by the author and reimbursed with fellowship funds.

It is likely that members may not pay attention to the parking need and continue driving alone. Many members are busy and/or have been in a routine. In an effort to increase participation, a short script will be read at the beginning of all fellowship meetings that identifies the carpool sign-up and gives several gains for participation, including reducing parking congestion, getting to better know other members, giving a new member a ride, and practicing the twelfth step of service.

Success assessment

The carpool project was implemented, however at press time a true evaluation was not possible. It is thought by members and the author that if the intervention will succeed, it will take at least 1-2 months. The intervention is low maintenance and sustainable.

No comments:

Post a Comment