Help-seeking for alcohol-related problems: Social contexts surrounding entry into alcoholism treatment or alcoholics anonymous

Objective: The role of problem drinkers' social contexts in help-seeking patterns was investigated using recent entrants into outpatient alcoholism treatment or Alcoholics Anonymous (AA). Untreated, active problem drinkers served as controls. Merited: Subjects (N = 45, with 15 per group; 62% male) were recruited from the community. Habitual drinking practices, social network characteristics, social support, help-seeking barriers and incentives, and event occurrences during the 2 years prior to help-seeking were assessed during structured interviews. Collaterals verified subject reports. Results: Alcohol-related psychosocial problems and social network characteristics specific to drinking and help-seeking differentiated the groups, whereas drinking practices, general measures of social support and event occurrences did not. Both groups who sought help reported less network encouragement to drink, more network encouragement to seek help and greater alcohol-related psychosocial problems compared to untreated problem drinkers. AA participants also received more conflicting messages about seeking help than did treatment participants, and features of AA variously attracted and repelled different problem drinkers. Conclusions: The findings indicate the importance of separating alcohol-specific social influences on help-seeking from more general social contextual variables and provide a social basis for distinguishing the appeal of AA from that of formal treatment. The results generally concur with studies of help-seeking for other medical and psychological disorders and support a common approach that emphasizes the social nature of help-seeking and focuses on functional rather than structural influences.