If you’re comparing recovery coaching vs. AA, you’ve probably noticed alcohol taking up more room in your life than you want it to. You may have tried rules and willpower already, and found yourself back where you started.
I’m a coach. I’ll still tell you up front that AA has the stronger research behind it.
Where coaching can help is with a different starting point, for people who aren’t yet sure whether they want to stop.
Does AA work? What the evidence shows
AA describes itself in its preamble as “a fellowship of people who share their experience, strength and hope with each other.” There are no dues or fees. The program is built around the Twelve Steps, and newer members can ask a more experienced one to be their sponsor.
The strongest summary of how well that works came in 2020, when a Cochrane review gathered 27 studies covering 10,565 people with alcohol problems. Structured programs that help people get involved in AA (known as Twelve-Step Facilitation) led to more people staying continuously sober at 12 months than other established treatments, cognitive behavioral therapy among them.
The reviewers rated that finding high certainty, the top of their scale, and the effect held at 24 and 36 months. Most of the cost studies they looked at also found larger healthcare savings with AA.
Does recovery coaching work?
Nobody can honestly promise you that coaching beats AA on outcomes.
A 2019 systematic review of peer recovery support, the wider field recovery coaching belongs to, looked at 23 studies. The authors saw reasons for tentative hope. Positive effects “appeared small to moderate in magnitude,” though there were also “many null findings to date,” and very little of the research separated coaches from the other services people were receiving at the same time.
The review also groups together a wide mix of peer roles and programs. It can’t tell you how well any one private coach’s approach works, and that includes mine.
Do you have to be an alcoholic to go to AA?
No. AA’s only requirement for membership is “a desire to stop drinking.” You don’t need a diagnosis to walk in, and a desire to stop isn’t the same as a promise about forever.
The program itself is built around stopping, though. Its stated primary purpose is to help “other alcoholics to achieve sobriety,” and the first of the Twelve Steps asks members to admit they were “powerless over alcohol.”
Some people hear that and recognize themselves straight away. Others don’t.
It may help to know that drinking too much and being dependent on alcohol aren’t the same thing. A 2014 CDC study of US adults found that only about one in ten excessive drinkers met the criteria for alcohol dependence. The study didn’t ask anyone about AA, so it can’t say who would do well in meetings.
If the word alcoholic doesn’t feel like yours, or you can’t yet say you want to stop for good, AA isn’t closed to you. You might still prefer individual support, where the conversation starts from your own questions rather than a shared program.
Recovery coaching vs. AA: how a coach differs from a sponsor
AA starts from that desire to stop. A sponsor is a fellow member who volunteers, unpaid, and guides you through the steps that helped them. A coach is someone you hire and pay for their time. Coaches don’t share one program or method, so ask any coach how they work before you start.
In my own coaching, we begin with curiosity about your drinking, before any decision about it.
For years, I believed alcohol was the problem. Eventually I saw that the beliefs behind my drinking were what needed my attention.
That’s where the pause comes in. Say it’s the end of a hard day and you’re reaching for a drink. Instead of a rule that says no, we slow that moment down and look at it together: what you’re feeling, and what you expect the drink to do for you. Then you choose what happens next.
I use the same approach with people in the gray area of drinking, who aren’t sure they need a label at all. Because this is one-on-one coaching, you and I set the pace and the goal together. For some people the goal turns out to be stopping. For others it’s understanding first, and deciding later.
When to see a doctor, choose AA, or use both
Coaching isn’t the right first step for everyone. In a few situations, a doctor or AA should come first, or alongside coaching.
If you drink heavily every day
Please speak with a doctor before you stop, because alcohol withdrawal can be dangerous. Coaching is not medical treatment, and that includes mine.
If you want to stop drinking
If you already know you want to stop, AA’s evidence is hard to argue with, and it costs nothing where coaching costs money.
Using both
You don’t have to pick one. Nothing stops you from going to meetings and working with a coach. If you do hire one, ask what training they have and what they do when someone needs more than coaching can give.
If you’re still working out what you want, the pause assessment is a free self-reflection tool you can take on your own time.
