Face-to-face AA Trumps Online Groups – For Now

By John Thomas, Associate Editor
October 13, 2015

Therapy-patientToronto – Despite growing numbers of web-based sobriety support sites, face-to-face meetings are more effective and popular for those striving to overcome alcohol abuse, a researcher reported at the annual APA convention here.

Donald S. Grant, Ph.D., of the Fielding Graduate University in Santa Barbara, Calif., told a symposium on “Social Media for Social Good” that “Face-to-face killed it, crushed it.”

Around 8,000 psychologists attended the four-day convention that also included lectures and discussions about gifts, money and client curiosity about the therapist. Another session looked at several attempts being made to train the next generation of health service psychologists for integrated health care.

Grant, who said he has been sober for 14 years, reported that while his research showed a preference among 196 adults in the study for face-to-face meetings, online support was increasingly being used, corresponding with a moderate drop in in-person attendance at Alcoholics Anonymous meetings.

“Sadly, they are reporting that they are decreasing their face-to-face meetings. They are going and engaging more online. It wasn’t huge, but it was scary. And it was enough to look at what is coming as the millennials, who are much more facile and live online, start to assume the majority. It did show enough of a migration to online to show that AA face-to-face could be in trouble.”

Grant added online sobriety support sites have advantages, such as being available any time. Lack of meetings in some areas also contributes to the migration to online programs. It’s also easier to deal with lapses, shame and social anxiety than in face-to-face meetings.

In a session on gifts, money and client curiosity, agreement emerged that it wasn’t that graduate schools ignore these subjects, but that there are no simple answers to the problems posed by clients who offer gifts to therapists. In many cases, it was agreed,  accepting a gift would be better than outright refusal, depending on the cultural and social implications.

Examples abounded. What to do when a client offers her male therapist a bottle of perfume for his wife? What about a jar of syrup from a client’s sugar bush? Or just a plate of chocolate chip cookies? Clients offering cookies may be thinking of how their mothers made cookies for them to provide a sense of belonging, love and comfort. The gift of a jar of syrup might indicate the client wished only to provide something sweet and nutritious for morning waffles.

The most challenging gifts are those that are offered at the last meeting.

Charles Waehler, Ph.D., called the subject of money “the last taboo” but one that a therapist must deal with during the first encounter with a client.

“Get everything in writing,” he urged. “Many clients are embarrassed to talk about money because of their income level, both low and high. Above all, don’t take an attitude that says ‘don’t worry about it’ or ‘I charge what everyone does.’” Many clients think therapists are greedy and arrogant by insisting on talking about money first, he added.

Randolph B. Pipes, Ph.D., said therapists shouldn’t be surprised by clients who say they have Googled them. It says a lot about the client who would Google and then talk about what they learned about the therapist.

“Googling is okay, but telling psychologists that you Googled is a problem,” Pipes explained. The practice, he added, enters into the ‘how many clicks to creepy’ territory.

Stephanie Wood, Ph.D., Della Ducker, Ph.D., Gilbert Newman, Ph.D., and Jeffrey Baker, Ph.D. discussed changes that will be made in anticipation of the next generation of health service psychologists for integrated health care. While basic skills that psychologists need to have to provide services in the integrated health care area will remain the same, graduate students will also be expected to become more proficient in  financial conditions of their workplace and budgets.

As more health psychologists join medical staffs in primary care due to the Affordable Care Act, attention must be paid to avoid looking and acting like social workers. Psychologists must insist on their appropriate and special places in the health care field, the panelists said.

Early career psychologists need to think about their relationships with clients as long term in nature. They also need to become educated in more medical-related subjects, including psychopharmacology.

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