Sober For Good: New Solutions for Drinking Problems--Advice from Those Who Have Succeeded

by Anne M. Fletcher, M.S., R.D. (Houghton Mifflin, 2001)

Review by A. Thomas Horvath, Ph.D., Practical Recovery Services, La Jolla, CA

Anne Fletcher’s Sober for Good provides a unique and much needed service for individuals who are making significant decisions about their personal approach to recovery.  The book is based on interviews with 222 individuals who have resolved alcohol problems for at least five years.  These individuals have been drawn from the full range of recovery approaches.  How convenient, for the individual with current alcohol difficulties, to be able to experience the insights of so many successfully recovered individuals in their own words (via extended quotations), and to have these individuals be drawn from such a diverse array of recovery approaches!  Although books describing the diversity of recovery approaches are now emerging, to my knowledge no other work contains such an extensive presentation of the actual experiences and insights of successfully recovered individuals.

The 222 interviewees used the following primary recovery approaches:

Traditional (12-step): 97

Alternative: 125

            On their own: 25

            Alternative support groups: 46

                        Secular Organizations for Sobriety: 18

                        SMART Recovery: 13

                        Women For Sobriety: 15

                        Moderation Management: 1

            Went to AA but quit: 12

            "Multiple paths": 25

            Treatment center, then on their own: 5

            Psychological counseling: 3

            Religion: 4

            Rational Recovery techniques: 4

          For this audience it is noteworthy that even though psychological counseling was not the primary approach for many, 28% indicated that it was of importance to them (and they distinguished it from chemical dependency counseling, which was not rated as highly). The average length of recovery was 13 years.  All completed a seven page questionnaire, and some were interviewed in depth.

Author Anne Fletcher is an award winning medical writer and former executive editor of the Tufts University Health and Nutrition Letter.  Her consultants for Sober for Good, as noted in the Acknowledgements, include Alan Marlatt, John Allen, Mark Sobell, Marc Kern, William Miller, Ernest Kurtz, Stanton Peele, this reviewer, and many others.  Her book reveals her complete familiarity with the treatment outcome literature, natural recovery, harm reduction, moderation approaches, and the full range of support groups.

Based on her interviews Fletcher challenges some of the common wisdom of the professional treatment community.  She found less than full support for the following ideas:

1) You'll never get sober until you admit you're an "alcoholic" (about 12% of her sample did not do this)

2) You have to "hit bottom" (30% did not think this necessary)

3) Alcohol problems are progressive (many consumed the same amount for years)

4) If you stop attending meetings you'll relapse (only 50% still attend meetings)

5) An "alcoholic" is never "cured" (many felt they were)

6) If you drink at all, you will relapse (about 10% still consume some alcohol)

7) There is no recovery without a "higher power" (most reported spiritual growth but the accounts are complex and "higher power" was not prominent in most accounts)

She did find several important common threads across all the approaches to recovery:

1) Commitment to sobriety

2) Remembering the past to preserve the present

3) Enjoying sobriety

4) Support (but it doesn't have to come from others in recovery)

There is an extensive appendix entitled "Consumer Guide to Recovery Options," and sufficient referencing for the reader motivated to learn more.  There is also a chapter of recommendations from the interviewees about how family and friends should respond to the self-destructive drinker.  Contrary to common wisdom their recommendations emphasize support more than confrontation.

            I appreciated the objective manner in which each recovery approach is described.  No approach is labeled good or bad.  Interviewees are allowed to describe in their own words how the particular approaches they tried did or did not match their particular needs and situation.  From a practicing clinician's perspective there may be more to learn about treatment matching from this book than there is an all of Project MATCH.