Moderation Management

Last updated
Moderation Management
Founded1994
Website www.moderation.org

Moderation Management (MM) is a secular non-profit organization providing peer-run support groups for anyone who would like to reduce their alcohol consumption. MM was founded in 1994 to create an alternative to Alcoholics Anonymous and similar addiction recovery groups for non-dependent problem drinkers who do not necessarily want to stop drinking, but moderate their amount of alcohol consumed to reduce its detrimental consequences.

Contents

Methodology

Moderation Management allows members to set their own drinking goals as they feel appropriate. [1] MM encourages members to follow particular drinking guidelines, limits, goal setting techniques, and a nine-step cognitive-behavioral change program. [2]

The MM limits and guidelines were derived from the work of Dr. Martha Sanchez-Craig. [3] MM members are encouraged, but do not need to follow, the suggested guidelines, limits and steps. MM does not view non-dependent problem drinkers as alcoholics, but rather people with a bad, but controllable, habit. MM does not state that surrender or spirituality is needed to end or control the habit. [4] MM literature makes a similar distinction to Alcoholics Anonymous literature that there are problem drinkers who can return to controlled drinking and alcoholics who can not. [5]

MM groups are intended to give members a chance to identify with other problem drinkers and learn from the successes and failures of each other. Face-to-face meetings last about an hour, whereas online meetings are ongoing. "Crosstalk," members interrupting each other to provide feedback during meetings, is allowed. Mental health professionals are allowed to help start MM meetings, but ultimate control must be left to the participants. [4] [6] A content analysis of online MM meetings found the most common types of communication by members were self-disclosure, provision of information and advice, and provision of emotional support. Similar studies of depression and eating disorder support groups have found the same patterns. [7]

Membership

In a 2001 survey of Moderation Management, most MM members are white (96%), employed (81%), educated (72% have at least a college education) and on average are more secular than the rest of the population (32% identify as atheists or agnostics, only 16% regularly attend religious services). MM attracts an equal number of men and women (49% are female); depending on the kinds of meetings attended, between 11.9% and 33.8% of members were under 35 years of age. [8]

MM members mostly describe themselves as being non-dependent problem drinkers. In general, MM members report having a mild history of substance-abuse problems before joining, with 40% having consumed four or fewer drinks per drinking day and less than 10% experienced serious withdrawal symptoms or comorbid drug abuse. [8]

Alcohol consumption of members

The 2001 survey saw that 87.1% of online-only members (members whose participation in Moderation Management was online only) and 61.7% of face-to-face members (people who went only to real-world face-to-face meetings) drank four or more days a week. 70.6% of online-only and 49.1% of face-to-face-only members had five or more drinks on days they drank. Among members who went to both face-to-face and online meetings, 85.4% drank four or more days a week, and 53.8% had five or more drinks on drinking days. [8]

Effectiveness

A 2009 study saw that subjects using just Moderation Management to reduce their drinking went from having only about one day a week abstinent from alcohol to having 1.5 days a week abstinent (e.g. they would drink six days one week and five days another week). [9]

A 2012 paper argues that, while there is little scientific analysis of MM's efficacy, mutual support groups such as Moderation Management could be effective. [10]

History

Moderation Management was founded by Audrey Kishline, a problem drinker, who did not identify with the disease theory of alcoholism finding that it eroded her self-confidence. Kishline found that she could moderate her drinking with the help of cognitive behavioral therapy principles and in 1994 created Moderation Management as an organization for non-dependent problem drinkers to help maintain moderate alcohol use. MM maintains, however, that it is not for all problem drinkers; that there are some drinkers for whom abstinence will be the only solution. [1]

Kishline had asked many professionals for advice while she was establishing the fellowship, including psychologist Jeffrey Schaler, who wrote the foreword for the first edition of the book, Moderate Drinking, used in the organization and served on the original board of trustees for MM. [11] Schaler split ways with MM over two issues. The first being failure of MM's leadership to condemn member Larry Froistad after he confessed to murdering his daughter on an MM support group email list. The second being a disagreement with MM as to whether there was a medical distinction between problem drinkers and alcoholics. Schaler's foreword was replaced with one by historian Ernest Kurtz in subsequent editions. [12]

In January 2000, Kishline posted a message to an official MM email list stating that she had concluded her best drinking goal was abstinence and that she would begin attending Alcoholics Anonymous, SMART Recovery and Women for Sobriety meetings while continuing to support MM for others. [13] In March 2000, while drunk, [14] she drove her truck the wrong way down a highway, and hit another vehicle head-on killing its two passengers (a father and his 12-year-old daughter). MM continued to grow during Kishline's time in prison. [1] She was released in August 2003 after serving 3½ years of her 4½ year sentence. [15] [16]

Kishline continued to drink once released from prison. [15] Soon after, she divorced from her husband and struggled to find work, in part due to her felony conviction. [15] She developed a friendship with the wife and mother of the victims of her drunk driving crash, and they authored a book together on their relationship. [15] [16] She died of suicide at the age of 59 on December 19, 2014. [15] [17]

Literature

See also

Related Research Articles

<span class="mw-page-title-main">Alcoholics Anonymous</span> Sobriety-focused mutual help fellowship

Alcoholics Anonymous (AA) is a global peer-led mutual aid fellowship begun in the United States dedicated to abstinence-based recovery from alcoholism through its spiritually inclined twelve-step program. AA's twelve traditions, besides stressing anonymity, establish it as non-professional, unaffiliated, non-denominational and apolitical with a public relations policy of attraction rather than promotion. In 2020 AA estimated a worldwide membership of over two million, with 75% of those in the US and Canada.

<span class="mw-page-title-main">Alcoholism</span> Problematic excessive alcohol consumption

Alcoholism is the continued drinking of alcohol despite it causing problems. Some definitions require evidence of dependence and withdrawal. Problematic use of alcohol has been mentioned in the earliest historical records. The World Health Organization (WHO) estimated there were 283 million people with alcohol use disorders worldwide as of 2016. The term alcoholism was first coined in 1852, but alcoholism and alcoholic are sometimes considered stigmatizing and to discourage seeking treatment, so diagnostic terms such as alcohol use disorder or alcohol dependence are often used instead in a clinical context.

Twelve-step programs are international mutual aid programs supporting recovery from substance addictions, behavioral addictions and compulsions. Developed in the 1930s, the first twelve-step program, Alcoholics Anonymous (AA), founded by Bill Wilson and Bob Smith, aided its membership to overcome alcoholism. Since that time dozens of other organizations have been derived from AA's approach to address problems as varied as drug addiction, compulsive gambling, sex, and overeating. All twelve-step programs utilize a version of AA's suggested twelve steps first published in the 1939 book Alcoholics Anonymous: The Story of How More Than One Hundred Men Have Recovered from Alcoholism.

<span class="mw-page-title-main">Alcohol dependence</span> Medical condition

Alcohol dependence is a previous psychiatric diagnosis in which an individual is physically or psychologically dependent upon alcohol.

The modern disease theory of alcoholism states that problem drinking is sometimes caused by a disease of the brain, characterized by altered brain structure and function. Today, alcohol use disorder (AUD) is used as a more scientific and suitable approach to alcohol dependence and alcohol-related problems.

Al-Anon Family Groups, founded in 1951, is an international mutual aid organization for people who have been impacted by another person's alcoholism. In the organization's own words, Al-Anon is a "worldwide fellowship that offers a program of recovery for the families and friends of alcoholics, whether or not the alcoholic recognizes the existence of a alcohol-related problem or seeks help." Alateen "is part of the Al-Anon fellowship designed for the younger relatives and friends of alcoholics through the teen years".

<i>The Natural History of Alcoholism Revisited</i> Book by George Eman Vaillant

The Natural History of Alcoholism Revisited (1995) is a book by psychiatrist George E. Vaillant that describes two multi-decade studies of the lives of 600 American males, non-alcoholics at the outset, focusing on their lifelong drinking behaviours. By following the men from youth to old age it was possible to chart their drinking patterns and what factors may have contributed to alcoholism. Another study followed 100 severe alcoholics from a clinic eight years after their detoxification. The National Review hailed the first edition (1983) as "a genuine revolution in the field of alcoholism research" and said that "Vaillant has combined clinical experience with an unprecedented amount of empirical data to produce what may ultimately come to be viewed as the single most important contribution to the literature of alcoholism since the first edition of AA's Big Book." Some of the main conclusions of Vaillant's book are:

Drug addiction recovery groups are voluntary associations of people who share a common desire to overcome their drug addiction. Different groups use different methods, ranging from completely secular to explicitly spiritual. Some programs may advocate a reduction in the use of drugs rather than outright abstention. One survey of members found active involvement in any addiction recovery group correlates with higher chances of maintaining sobriety. Although there is not a difference in whether group or individual therapy is better for the patient, studies show that any therapy increases positive outcomes for patients with substance use disorder. The survey found group participation increased when the individual members' beliefs matched those of their primary support group. Analysis of the survey results found a significant positive correlation between the religiosity of members and their participation in twelve-step programs and to a lesser level in non-religious SMART Recovery groups, the correlation factor being three times smaller for SMART Recovery than for twelve-step addiction recovery groups. Religiosity was inversely related to participation in Secular Organizations for Sobriety.

<span class="mw-page-title-main">LifeRing Secular Recovery</span> Addiction and recovery organization

LifeRing Secular Recovery is a secular, non-profit organization providing peer-run addiction recovery groups. The organization provides support and assistance to people seeking to recover from alcohol and drug addiction, and also assists partners, family members and friends of addicts or alcoholics. It is an abstinence-based recovery program with three fundamental principles: sobriety, secularity and self-empowerment. The motto of LifeRing is "empower your sober self."

Alcohol use and sleep have a complex relationship. While alcohol may initially induce drowsiness, it can disrupt sleep quality and exacerbate sleep disorders in the long run. During abstinence, sleep disruption is one of the greatest predictors of relapse.

<span class="mw-page-title-main">Alcoholism in family systems</span> Social and psychological factors that cause alcoholism in families

Alcoholism in family systems refers to the conditions in families that enable alcoholism and the effects of alcoholic behavior by one or more family members on the rest of the family. Mental health professionals are increasingly considering alcoholism and addiction as diseases that flourish in and are enabled by family systems.

<span class="mw-page-title-main">Secular Organizations for Sobriety</span> Non-profit network of autonomous addiction recovery groups

Secular Organizations for Sobriety (SOS), also known as Save Our Selves, is a non-profit network of autonomous addiction recovery groups. The program stresses the need to place the highest priority on sobriety and uses mutual support to assist members in achieving this goal. The Suggested Guidelines for Sobriety emphasize rational decision-making and are not religious or spiritual in nature. SOS represents an alternative to the spiritually based addiction recovery programs such as Alcoholics Anonymous (AA). SOS members may also attend AA meetings, but SOS does not view spirituality or surrendering to a Higher Power as being necessary to maintain abstinence.

Women for Sobriety (WFS) is a non-profit secular addiction recovery group for women with addiction problems. WFS was created by sociologist Jean Kirkpatrick in 1976 as an alternative to twelve-step addiction recovery groups like Alcoholics Anonymous (AA). As of 1998 there were more than 200 WFS groups worldwide. Only women are allowed to attend the organization's meetings as the groups focus specifically on women's issues. WFS is not a radical feminist, anti-male, or anti-AA organization.

Dr. Marc Kern is a Los Angeles based psychologist whose practice is focused on substance abuse and addiction treatment. In 2013 he and Adi Jaffe, Ph.D. founded Addiction Alternatives, a Beverly Hills-based addiction treatment program.

Alcohol and cortisol have a complex relationship. While cortisol is a stress hormone, alcoholism can lead to increased cortisol levels in the body over time. This can be problematic because cortisol can temporarily shut down other bodily functions, potentially causing physical damage.

Community reinforcement approach and family training is a behavior therapy approach in psychotherapy for treating addiction developed by Robert J. Myers in the late 1970s. Meyers worked with Nathan Azrin in the early 1970s whilst he was developing his own community reinforcement approach (CRA) which uses operant conditioning techniques to assist those with addictions live healthily. Meyers adapted CRA to create CRAFT, which he described as CRA that "works through family members." CRAFT combines CRA with family training to equip concerned significant others (CSOs) of addicts with supportive techniques to encourage their loved ones to commence and continue treatment and provides them with defences against addiction's damaging effects on themselves.

<span class="mw-page-title-main">Nick Heather</span> British clinical psychologist and alcohol researcher

Brian "Nick" Heather is a clinical psychologist, alcohol researcher and Emeritus Professor of Alcohol & Other Drug Studies at Northumbria University. He was one of the pioneers of brief intervention techniques to reduce alcohol misuse, and has challenged the disease theory of alcoholism and has over five hundred research publications and books.

Linda Carter Sobell, Ph.D., ABPP, is the President's Distinguished Professor at Nova Southeastern University (NSU) in Fort Lauderdale, Florida. She is a professor of clinical psychology, addiction specialist, co-director of NSU's Guided Self-Change clinic, a Motivational Interviewing Trainer, and is board-certified in cognitive and behavioral psychology.

<span class="mw-page-title-main">Keith Humphreys</span> American psychologist (born 1966)

Keith Humphreys is an American psychologist currently the Esther Ting Memorial Professor at Stanford University, a Senior Research Career Scientist in the Veterans Health Administration, and an Honorary Professor at the Institute of Psychiatry, King's College, London.

Jalie A Tucker is a professor of Health Education and Behavior at the University of Florida. She is known for her research on impulsive and harmful behaviors, such as alcohol and substance use, the effect of the environment on addiction, and natural resolutions to risky behavior including alcohol misuse. She has received numerous awards for excellence in clinical psychology and addiction research, including the 2015 Award for Distinguished Scientific Contributions to Clinical Psychology from the Society of Clinical Psychology. She was honored by APA, Division 50 with the Presidential Award for Service to the Division in 2010 and 2012.

References

  1. 1 2 3 Humphreys, Keith (2004). "Chapter 2: An international tour of addiction-related mutual-help organizations: Moderation Management". Circles of Recovery: Self-Help Organizations for Addictions. Cambridge University Press. pp. 70–73. ISBN   978-0-521-79277-6.
  2. Solomon, Melanie (2005). "Part Three: Moderation Management". AA: Not the Only Way. Capalo Press. pp. 39–41. ISBN   978-0-9762479-9-9.
  3. Sanchez-Craig, Martha; Wilkinson, D. Adrian; Davila, Rafaela (1995). "Empirically based guidelines for moderate drinking: 1-year results from three studies with problem drinkers". American Journal of Public Health. 85 (6): 823–828. doi:10.2105/AJPH.85.6.823. PMC   1615483 . PMID   7762717.
  4. 1 2 Rotgers, Frederick; Kishline, Audrey (1999–2000). "Moderation Management: A support group for persons who want to reduce their drinking, but not necessarily abstain". International Journal of Self-Help and Self Care. 1 (2): 145–158. doi:10.2190/8909-FFH3-44BA-HKVN.
  5. Humphreys, Keith (May 2003). "Alcohol & drug abuse: A research-based analysis of the Moderation Management controversy". Psychiatric Services. 54 (5): 621–622. doi:10.1176/appi.ps.54.5.621. PMID   12719491.
  6. Klaw, Elena; Humphreys, Keith (2000). "Life stories of Moderation Management mutual help group members". Contemporary Drug Problems. 27 (4): 779–803. doi:10.1177/009145090002700404. S2CID   141724352.
  7. Klaw, Elena; Huebsch, Penny Dearmin; Humphreys, Keith (2000). "Communication patterns in an on-line mutual help group for problem drinkers". Journal of Community Psychology. 28 (5): 535–546. doi:10.1002/1520-6629(200009)28:5<535::AID-JCOP7>3.0.CO;2-0.
  8. 1 2 3 Humphreys, Keith; Klaw, Elena (July 2001). "Can targeting non-dependent problem drinkers and providing internet-based services expand access to assistance for alcohol problems?: A study of the Moderation Management self-help/mutual aid organization". Journal of Studies on Alcohol. 62 (4): 528–532. doi:10.15288/jsa.2001.62.528. ISSN   0096-882X. PMID   11513231.
  9. Hester, R. K.; Delaney, H. D.; Campbell, W.; Handmaker, N. (2009). "A web application for moderation training: Initial results of a randomized clinical trial". Journal of Substance Abuse Treatment. 37 (3): 266–276. doi:10.1016/j.jsat.2009.03.001. PMC   2739257 . PMID   19339137. The study reported that using MM along with an online drink tracker increased the number of days abstinent from alcohol to three or four days a week
  10. Lembke, Anna; Humphreys, Keith (2012). "Moderation Management: A Mutual-Help Organization for Problem Drinkers Who Are Not Alcohol-Dependent". Journal of Groups in Addiction & Recovery. 7 (2–4): 130–141. doi:10.1080/1556035X.2012.705657. S2CID   145299928.
  11. Schaler, Jeffrey A. (1994). "Foreword". In Kishline, Audrey (ed.). Moderate Drinking: The New Option for Problem Drinkers (First ed.). See Sharp Press.
  12. Schaler, Jeffrey A. (January 2000). "Chapter 10: Moderation Management and Murder". Addiction Is a Choice. Chicago, Illinois: Open Court Publishing. pp. 107–114. ISBN   978-0-8126-9403-1.
  13. Kishline, Audrey (2000-01-20). "Announcement from Audrey". Moderation Management (Mailing list). Archived from the original on 2001-03-06.
  14. Girvan, Amy (March 2015). "The next AA? Welcome to Moderation Management, where abstinence from alcohol isn't the answer". The Guardian . Retrieved 2017-12-29. After starting MM, Kishline left the group, realizing that she could not moderate her drinking after all. She returned to AA, then fell off the wagon, drunk-driving in March 2000 and killing a man and his 12-year-old daughter.
  15. 1 2 3 4 5 Walker, Regina (2015-01-07). "Remembering Audrey Kishline, the Founder of Moderation Management". The Fix. Archived from the original on 2015-09-29. Retrieved 2019-02-28.
  16. 1 2 Audrey Kishline; Sheryl Maloy (2007). Face to Face: A Deadly Drunk Driver, a Grieving Young Mother, and Their Astonishing True Story of Tragedy and Forgiveness. Meredith Books. ISBN   978-0-696-23514-6. OCLC   144226098.
  17. Walker, Regina. "Exclusive: New Details Emerge About Audrey Kishline's Death". Archived from the original on September 24, 2015.