The Value of Peer Group Meetings
When we think about recovering alcoholics and other drug abusers and addicts, we likely think about “meetings”. Our first image might be of alcoholics trying to quit and/or sustain quitting, sitting on folding chairs in a church meeting room, in a circle, coffee in hand, for an hour of structured discussion. We all know people who have attempted to quit with the help of these meetings. Some have succeeded and others have not. Certainly, Alcoholics Anonymous and its many offspring (NA, GA, Al-Anon, Nar-Anon et al) promote these meetings as a mainstay of recovery. What are these meetings about? Do they work? If they work, why do they work?
An article in “Substance Abuse and Rehabilitation” reviews this topic across a number of relevant studies. The benefit of these meetings comes through individual and group mutual support typically called peer support. Peer support is giving and receiving nonprofessional, nonclinical assistance from individuals with similar conditions or circumstances to achieve long-term recovery. Once the domain of Alcoholics Anonymous, there is now peer support for a variety of behavioral health, life challenges and physical health issues. AA and other group meetings are peer support groups where people in recovery voluntarily gather together to receive support and provide support by sharing knowledge, experiences, coping strategies, and offering understanding. In recovery circles people say they “share their experience, strength and hope with each other that they may solve their common problem”.
Peer mentorship occurs when individuals in later stages of recovery provide nonprofessional, nonclinical assistance to individuals in earlier recovery. This is the concept of sponsorship in twelve step circles where the new member finds a senior member to share more intimate details and obtain more direct support and advice.
There are also certified Peer Support Specialists. An article in Love and Respect reviewed the evolution of this credential stemming from use in psychiatric settings in 1800s France. There is a recent trend toward the use of these specialists as part of intense, outpatient clinical support as part of wrap around services among other deployments.
Structured twelve step meetings usually involve gathering and discussion before the official meeting. Coffee is ubiquitous. Opening the session might involve reading “approved” literature describing what meetings in general and this meeting specifically are about, what the process and ground rules might be for this specific meeting, and the “chair” telling a little bit about themselves. There are several types of meetings. Speaker meetings involve one or more people relating “what it was like, what happened, what they are like now”. Discussion meetings will introduce a topic from the attendees often and sometimes assigned to a regular member to bring to the next meeting. There are Big Book (“Alcoholics Anonymous”) and Twelve Step meetings where a passage from one of the “approved literature” sources is read and discussed. After the meeting closes there will be putting things away and lingering discussion. It is sometimes said that more peer support (“recovery”) occurs in the parking lot than the meetings.
Do these meetings work? Study after study has found much value and improved outcomes from these peer support meetings. The outcomes for those who were regular participants, defined variously but always by at least weekly attendance over time, in comparison to those who attempt recovery without peer group meetings show increased likelihood of abstinence, reduced relapse, fewer risk behaviors such as frequenting places and associating with people that might involve alcohol or drugs especially those from the recovering person’s past. Interestingly, there was also a reduction in associated issues such as arrest, HIV/AIDS and other sexually transmitted diseases, and increases in employment.
What is it about these meetings and peer support that provides these benefits? One key element is increasing self-efficacy. People with substance use disorder tend to engage treatment after a lengthy period of active use and the attendant, traumatic events. They suffer shame, a sense of personal failure, and long held stigma may make them doubt their worth and whether or not they deserve to recover. They have a lower sense of their own worth and ability. Participation in these peer groups imparts the sense that they can achieve recovery. They see examples of individuals just like them who have achieved recovery and they are encouraged to believe that they too can succeed.
In “The Power of Peer Support: A Bridge to Mental Health Recovery”, Mikayla Miller discusses other benefits. She notes that by creating connections with peers the newly recovering find a sense of belonging and acceptance. After perhaps years of isolation they find a sense of community and overcome a sense of loneliness all through building meaningful peer relationships.
In peer sessions the newly recovering also find a pattern that has led to success for others. People with the desire or necessity for recovery do not automatically know what to do next. In peer group sessions they find a few, very similar patterns that they see as working for others and perhaps themselves. They are encouraged to find a “sponsor” among those with whom they may identify. In this peer mentoring process the newly recovering find a guide that will walk with them as they try their pattern for recovery. This access to individuals with shared experiences both helps overcome shame and loneliness as well as avoid pitfalls that will inevitably present. The benefit extends to the sponsor as well. “Giving it away to keep it” is spoken about with specific reference to the AA Founders. They believed in some measure that what they discovered, their secret, was in working with others like them.
Another benefit is in achieving a metaphysical perspective and support system. Many people in twelve step programs adopt a newfound spirituality and often in formal religion. Even those communities formed specifically to avoid the reliance on God promote a spiritual awakening which seems also to promote more successful recovery.
For many people in twelve step communities the Twelve Steps provide a ready program of recovery. “The Steps” are read frequently at these meetings and reinforced in this and many other ways. While people are encouraged to find the path that works for them, it is also made obvious that millions of people have found successful recovery through these steps and they do form a basis for overcoming the emotional and social wreckage that results from active addiction.
There is a strong correlation between success and the degree to which the newly recovering individuals accepts these peer group communities. In 12 Step circles it is said that “the result was nil until we let go absolutely”. As we noted elsewhere, however, it is very natural for someone solidly in recovery to want to moderate their dependence on these peer group communities. If done right this may occur after many months or many years (or never). The individual will likely find other ways to continue the advantages of these peer groups often through continued but less frequent attendance or through friendships that naturally develop.
At the time of the founding of AA there were few other alternatives including in physical or mental health medicine. Peer group participation was the best option. Over the ninety years since there has been much development in evidence based physical and mental health protocols. Studies have shown that including twelve step, peer group meetings almost always provides great benefit and better outcomes when combined with another form of treatment. Millions made it through peer groups alone. It is recommended even in those peer groups that people take advantage of the advances of physical and mental health services alongside peer group membership.+
Our purpose here is to help the lay person and perhaps the codependent to understand why peer group communities work. However, there is no need for that individual to know this in order to know that it works or to encourage their loved one. Nor does the addict really need to know. Today each of us will work a light switch in our homes and other places several times. Very few of us will know how or why the lights go on and off. Yet we know they will almost always do so. Now, however, you have a better sense of how these peer group communities work and benefit that individual to early recovery.
Gene Gilchrist
July 2025
