Al-Anon/Alateen

Al-Anon and Alateen are international organizations with a membership of more than half a million men, women and teens, providing a Twelve Step program of recovery for friends and family members of alcoholics. Al-Anon is for adult friends and family members of alcoholics whereas Alateen is for children and friends (ages 12 to 20) of alcoholics. Al-Anon was formed in 1951 by Lois Wilson, wife of Alcoholics Anonymous (AA) co-founder Bill Wilson. She recognized the need for such an organization as family members living with AA members began to identify their own pathologies associated with their family members' alcoholism. Al-Anon is organized as a 501(c)(3) organization in many states. In Lois's Story, she explained why, as the spouse of an alcoholic, she also required treatment.

"After a while I began to wonder why I was not as happy as I ought to be, since the one thing I had been yearning for all my married life [Bill's sobriety] had come to pass. Then one Sunday, Bill asked me if I was ready to go to the meeting with him. To my own astonishment as well as his, I burst forth with "Damn your old meetings!" and threw a shoe as hard as I could.

This surprising display of temper over nothing pulled me up short and made me start to analyze my own attitudes. ... My life's purpose of sobering up Bill, which had made me feel desperately needed, had vanished. ... I decided to strive for my own spiritual growth. I used the same principles as he did to learn how to change my attitudes. ... We began to learn that ... the partner of the alcoholic also needed to live by a spiritual program."

- Lois Wilson

Alcoholism and family systems
Mental health professionals are increasingly considering alcoholism and addiction as diseases that flourish in and are enabled by family systems. Family members react to the alcoholic with particular behavioral patterns. They may enable the addiction to continue by shielding the alcoholic from the negative consequences of his actions. Such behaviors are referred to as codependence. In this way, the alcoholic is said to suffer from the disease of addiction, whereas the family members suffer from the disease of codependence.

Alcoholism is one of the leading causes of family dysfunction. As of 2001, there were an estimated 26.8 million children of alcoholics (COAs) in the United States, with as many as 11 million of them under than age of 18. Children of such mentally ill people have an increased suicide rate and on average have total health care costs 32 percent greater than children of nonalcoholic families.

Adults from alcoholic families experience higher levels of state and trait anxiety and lower levels of differentiation of self than adults raised in non-alcoholic families. Additionally Adult children of alcoholics have lower self-esteem, excessive feelings of responsibility, difficulties reaching out, higher incidence of depression, and increased likelihood of becoming alcoholics.

Processes and benefits
Research suggests that as family members of alcoholics learn to recognize the pathologies in their families, assign the responsibility of those pathologies to a disease, forgive themselves, accept that they were adversely affected by the pathologies, and ultimately learn to accept their parent's shortcomings, they begin to improve.

When an alcoholic's spouse is active in Al-Anon and the alcoholic is active in AA, not only is the alcoholic more likely to be abstinent but marital happiness improves and both the alcoholic and their spouse become better parents. Participation in Al-anon has also been associated with less personal blame among females, though not among males.

As used to encourage alcoholics to participate in treatment
Research on methods used by Concerned Significant Others (CSOs) to encourage alcoholics to seek treatment has shown participation in Al-Anon to be effective towards such goals. However, the Community Reinforcement and Family Training approach (CRAFT) has been shown to be significantly more effective than Al-Anon participation for this purpose. Though spouses of alcoholics wait, on average, seven years before taking such an intervention.