Brazil study: Does AA really work?

"Do Alcoholics Anonymous groups really work? Factors of adherence in a Brazilian sample of hospitalized alcohol dependents." -- That's the title of a study in the current issue of the American Journal of Addiction, published by a American Academy of Psychiatrists in Alcoholism and Addiction. A team of researchers headed by M.B. Terra followed 300 alcoholics committed to three hospitals in Puerto Allegre, Brazil. Results (from the abstract):

AA adherence was below 20%. The main factors reported by patients as reasons for non-adherence to AA were relapse, lack of identification with the method, lack of need, and lack of credibility. The factors reported by patients as reasons for adherence were identification with the method and a way to avoid relapse. Although AA is considered an effective intervention for alcoholism, its adherence rate was excessively low. The identification of these nonadherence factors could help health professionals in referring certain alcoholic patients to therapeutic interventions other than AA.

The result of this study is unsurprising; essentially the same finding was made in a meta-analysis almost two years ago reported in the Cochran Report (Source) What's noteworthy here is that patients were asked their reasons. It would be useful if the various threads in the responses (objections to the 12-step approach on the one hand, denial on the other) were explored in more depth and an attempt made to untangle them.