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The Guardian - US
The Guardian - US
Politics
Cecilia Saixue Watt

From Sober Mom Squads to anti-anxiety workbooks: do new AA alternatives work?

illustration shows woman having dropped glass of wine, looking out at a landscape with a giant laptop emitting light, and a circle of people in chairs
A cohort of online sobriety groups became popular early in the pandemic, and they appear to be here to stay. Illustration: The Guardian

One of Victoria Smith’s first assignments after joining A Sober Girls Guide was to come up with a name for her “self-saboteur”, her inner voice of insecurity.

“The inner saboteur?” Smith thought to herself. “I already learned about that from RuPaul’s Drag Race.”

Smith had paid $297 for the month-long sobriety program, which she’d found on Instagram, but wasn’t finding the content particularly enlightening as she participated in group chats, and practiced the introspective exercises – another was to write steps to becoming the 2.0 version of herself.

“I wanted more from it. Maybe I wanted something deeper,” said Smith, a 39-year-old special education teacher in Phoenix.

Victoria Smith celebrates seven months of sobriety in a photo posted to her Instagram in July.
Victoria Smith celebrates seven months of sobriety in a photo posted to her Instagram in July. Photograph: Victoria Smith

She was hesitant to dive straight into Alcoholics Anonymous (AA) – she thought of herself as a binge drinker, but not as an alcoholic. A Sober Girls Guide is a blog, podcast and online sobriety group. With articles like “5 Red Flags Your Relationship with Alcohol is Toxic” and “How to Have the Best Sober Girl Summer”, it offers “an alternative or addition to AA”. Where AA demands that all members identify as alcoholics, Sober Girls Guide goes against strict labels and embraces the millennial doctrine of mindfulness over the spirituality emphasized in AA.

A Sober Girls Guide is one of a cohort of online sobriety groups that became popular as more people grappled with sobriety early in the pandemic, and they appear to be here to stay. They have less rigid standards than AA, which has dominated the alcohol recovery space since its founding in 1935. Many, like Tempest and The Luckiest Club, offer regularly scheduled virtual meetings, and are staffed by people with varying degrees of professional training – Tempest, for instance, has an advisory board of clinicians, in addition to peer recovery coaches more akin to AA sponsors. Many were founded by and center women, a demographic who – even before the start of the pandemic, which saw alcohol abuse statistics soar – had been catching up with men in consumption and binge drinking but were less likely to seek treatment for substance abuse. Most of these online programs charge membership fees, and are run by paid staff, which is in sharp contrast to the free, completely non-hierarchical and volunteer-run AA model.

Some may find this new online approach a little too lax. Not all creators or founders are trained in recovery. Efficacy rates are unknown. Critics take issue with not just charging for membership, but also for “add-ons” – for example, for $8 you can download an 11-page “Slay Your Anxiety” workbook from A Sober Girls Guide, which features worksheets and a mood tracker. Access to Sober Mom Squad’s private community forum starts at $15 a month; a package with daily support meetings, group coaching and webinar access costs $190 per month. And though inclusivity of women is a focus, these programs seem to cater specifically to upwardly mobile white women, despite racial discrimination being correlated with alcohol abuse.

Still, the urge to explore alternatives is valid. Dr Lance Dodes, a retired assistant clinical professor of psychiatry at Harvard Medical School, has conducted extensive research into addiction treatment. He estimates that AA’s success rate is very low – between 5 and 10%. “It basically fails most of the time, and it causes an enormous amount of harm,” he said. “People believe in a program that will never be able to help them, a program that tells them, ‘This is the only way you should do it.’”

AA was founded in 1935 by two white men who were members of a Christian revivalist group, Bill Wilson and Bob Smith – a Wall Street analyst and a surgeon, respectively – and boasts an estimated 1.5 million members in North America. The efficacy of the program has long been the subject of debate among researchers, with the first critical research starting in the 1980s. There are many different ways to measure the success of sobriety: how long a person remains abstinent, how much they manage to cut back on drinking by volume, how much less likely they are to suffer from health-related consequences like high blood pressure or liver disease. In 2020, a review of 27 clinical studies suggested that AA is effective by one of these measures (rate of continuous abstinence) – but not others.

Sarah Allen Benton is a clinical consultant at the Strathmore House, a sober living program in Boston, Massachusetts. She says while people want to avoid shaming or labeling, there can be therapeutic value in “owning the term” and identifying as an “alcoholic”, a tenet of AA. But Benton says it makes sense that people like Smith, who admit they lose control at times over their drinking but don’t feel they are alcoholics would hesitate to join AA.

“That’s problem drinking,” said Benton. “I can see why they don’t want to go to AA because they really aren’t sure they’re an alcoholic. They’re just looking for a place where they can explore their relationship to alcohol in a safe environment.”

Laura McKowen, founder of The Luckiest Club, credits AA with her own sobriety, but also recognizes its limitations. “I am a fan of AA, and I see its beauty, but it can be quite dogmatic,” she said on a video call. “It gets to be very, ‘this is the only way, and if you refuse to accept a higher power, you’re just kidding yourself and you can’t really get sober.’”

In 2020, when her local AA chapter shut down because of the pandemic, McKowen – who had just published a memoir about her sobriety, We Are the Luckiest, that January, and had amassed a significant social media following – began to host free online meetings, multiple times a day, using a format of her own design. To sustain the community that soon formed, McKowen implemented a subscription fee and hired employees to lead more meetings; currently, access to The Luckiest Club’s group sobriety meetings is $22 a month.

Laura McKowen, founder of The Luckiest Club. McKowen amassed a social media following after publishing a book about her sobriety journey.
Laura McKowen, founder of The Luckiest Club. McKowen amassed a social media following after publishing a book about her sobriety journey. Photograph: Courtesy of Laura McKowen

One of AA’s core principles is that membership will always be free, and McKowen said that she’s often been criticized for charging money. “It’s hard work to lead those meetings, and people should be paid for their work,” she said.

Like The Luckiest Club, Sober Mom Squad – an online community formed during the early days of the pandemic for mothers as well as women who plan on having children – initially held free meetings.

“One of the things we’ve had to combat is ‘mommy wine’ culture. ‘When your kids whine, I wine.’ It’s cute for moms to be drinking,” said Kristi Tanner, a single mother of four, who spent about a year moderating Sober Mom Squad meetings.

As demand for meetings grew, a $15 monthly fee was added.

“I understand the need for it to become a business, but then it becomes a business and not a support group,” said Tanner. “When I was hosting, things started changing when the membership fees started. There were rules, timers, policies. I understand nothing runs for free, but it does make it a little bit less intimate.”

There’s also the tricky ethical matter of profiting off people in need of help, a situation that has led to widespread abuses in the for-profit rehab industry. Lewis Nelson MD, who spoke on behalf of the American Society of Addiction Medicine, expresses a need for caution around this model. “The profit motive is historically a strong driver of suboptimal behavior, so we need to approach this new form of care delivery with caution,” he said.

In addition to charging fees, which she defends, McKowen receives criticism for something she also sees as an issue. People of color are underrepresented in AA, with 89% of members in North America identifying as white, according to AA’s most recent survey, and that doesn’t seem to be changing with newer programs.

“I do agree that the representation in online recovery is not great,” said McKowen. “It’s still very white. We’re constantly working on that.”

When New York-based attorney Khadi Oluwatoyin couldn’t find a recovery program that connected with her experiences, she created her own. “As the recovery realm expands, our conversations needs to expand as well,” she said. In 2018, she founded Sober Black Girls Club, a free online collective Black women and non-binary people “living or considering beautiful sober lives”.

Khadi Oluwatoyin couldn’t find a recovery program that connected with her experiences, so she created her own
Khadi Oluwatoyin couldn’t find a recovery program that connected with her experiences, so she created her own. Photograph: Courtesy of Khadi Oluwatoyin

“Self-recovery for me was more than just putting down the bottle. It was about being OK with being Black,” Oluwatoyin says. “I wanted to talk about the systems that made it hard for me to succeed in life.”

Sober Black Girls Club holds group meetings for Bipoc and queer participants, offers a mentorship program similar to AA’s sponsorship system, and manages a medical fund to help members with rehab-related healthcare expenses. Membership is free, and the group’s operational costs are paid for with donations and Oluwatoyin’s personal funds.

Victoria Smith echoes Oluwatoyin’s feeling of alienation within the online recovery community. Smith is a member of the Hualapai Tribe. Recovery, for Indigenous people, often involves the discussion of specific phenomena – intergenerational trauma, forced assimilation, the abuses prevalent within American and Canadian Indian residential schools – but few recovery programs address these issues.

“I have not met anybody like me in sobriety at all. I have a hard time in the recovery community. It’s a lot of white women,” she said. “I found some stuff, like [the blog] Sober Brown Girls, but I haven’t really connected with anything yet. There’s not a lot of stuff for Natives at all.” Regardless, she is sober now, having put together a “toolkit” that works for her. She goes to a gym in Phoenix run by a non-profit called the Barbell Saves Project, which provides free fitness programs for people in recovery from substance abuse and gets support from a weight loss group where she discusses her sobriety. Smith said not drinking allows her to live more authentically. “I get to really feel my emotions, and myself.”

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