RATIONAL RECOVERY (RR)

Rational Recovery (RR) is one of a number of self-help movements that have emerged as alternatives to Alcoholics Anonymous (AA) for those with drug and alcohol problems. Rational Recovery began with the publication of Rational Recovery from Alcoholism: The Small Book by Jack Trimpey in 1988. The program is based on Rational Emotive Therapy, a mental-health treatment with a cognitive orientation developed by the psychologist Albert Ellis. It is premised on the assumption that psychological difficulties are caused by irrational beliefs that can be understood and overcome, not by existential or spiritual deficits. The emphasis is on rational self-examination rather than on religiosity.

An RR "coordinator" leads a group of five to ten members, who meet once or twice weekly for ninety minutes. Each coordinator maintains contact with an adviser, a mental-health professional familiar with the RR program. RR emphasizes cognitive devices for securing abstinence, such as discussion of "the Beast," a term used to personify the compulsive thoughts that drive an individual to drink. Members use a "Sobriety Spreadsheet" on which they write out irrational beliefs that activate their desire to drink. They also read Trimpey's The Small Book to develop the proper attitude toward abstinence. These devices are used in RR meetings as well as outside to examine vulnerability to drinking and to overcome it. At meetings these issues are also addressed in a less formal way in "cross-talk," an open, face-to-face exchange among participants.

RR differs from AA in that it does not encourage supportive exchanges and phone calls between meetings, nor does the enrollee solicit a sponsor among established members. Also in contrast to AA, there is no equivalent of "working" the Twelve Steps, and a spiritual or religious orientation to treatment is explicitly eschewed. Like Secular Organizations for Sobriety (SOS), RR encourages study of its methods and outcome. One such study by Galanter and coworkers sent follow-up questionnaires to seventy RR groups in nineteen states and received sixty-three responses. Ninety-seven percent of participants in the responding groups filled out questionnaires. They were mostly men about forty-five years old, each with about a twenty-five-year history of alcohol problems. The majority were employed, had attended college, and had heard about the program through the media or by word of mouth. A majority had used marijuana, a substantial minority had also used cocaine, and a small minority had used heroin.

At the time of the study (the early 1990s), RR was a much younger organization than AA. Most of the coordinators had been members for only nine months, most groups had been meeting for about a year, and the implementation of the movement's specific techniques (use of the Sobriety Spreadsheet and discussion of "the Beast") was not consistent. Nevertheless, the members' commitment to the central tenet of the movement, sobriety, was considerable. Although 75 percent had previously attended AA meetings, the majority (82%) rated RR principles higher than AA principles in helping them achieve sobriety. However, it seems quite likely that RR benefits considerably from the experience these former AA members bring with them. A sizable percentage of RR participants who returned questionnaires were involved with mental-health care as well as with RR. Thirty-six percent had seen a psychotherapist the week before the survey, and 21 percent were currently taking medication prescribed for psychiatric problems. Many group coordinators had formal mental-health training, and 24 percent had graduate degrees or certificates in mental health. It is likely that, just as AA derives some legitimacy from its spiritual roots, RR derives some of its influence from the credibility of the professional psychology with which it is associated. Without carefully controlled studies that adjust for differences in patient backgrounds, it is hazardous to compare outcome studies from RR to studies of AA and other self-help groups. The data that do exist, however, tentatively suggest that RR may do at least as well.

An RR group can be formed at no cost by a recovering substance abuser in consultation with the executive office of the Rational Recovery movement (Box 800, Lotus, California 95651).

(See also: Sobriety ; Treatment Types: Self-Help and Anonymous Groups )

BIBLIOGRAPHY

Galanter, M., Egelko, S., & Edwards, H. (1993). Rational Recovery: Alternative to AA for addiction? American Journal of Drug and Alcohol Abuse 19, 499-510.

Gelman, D., Leonard, E. A., & Fisher, B. (1991). Clean and sober and agnostic. Newsweek, July 8, pp. 62-63.

Trimpey, J. (1988). Rational recovery from alcoholism: The small book. Lotus, CA: Lotus Press.

Marc Galanter