Treatment Curriculum · Pomona, California
You Will Be Required to Attend AA or NA. What If You Do Not Believe a Word of It?
It is one of the most common reasons people hesitate before enrolling, and it is rarely answered honestly. Here is what the evidence actually shows, where it is weaker than people claim, and how atheists and skeptics use the rooms anyway.
7 min read · Updated July 2026 · What a Cochrane review of 27 studies found
This article is general health information rather than a treatment recommendation. Mutual-help attendance is one component of a program, not a substitute for clinical care or for medication where that is indicated.
The Objection, Said Out Loud
People raise it carefully, as though it might disqualify them. I am not religious. I do not believe in a higher power. I am not going to stand in a church basement and hand my will over to something I do not think exists. Some have tried meetings before and left because the language felt like a doctrine they were being asked to sign.
This deserves a real answer rather than a reassuring one, because the objection is intellectually serious and because the requirement is genuine. Clients here are required to attend AA or NA meetings while completing treatment. So the honest question is why a program would require something a person does not believe in, and whether the evidence justifies it.
What the Best Available Evidence Actually Says
For most of AA’s history the honest answer was that nobody knew. It was enormously popular and barely studied, and the confident claims came from both directions with little behind them. That changed.
In 2020 a Cochrane review by Kelly, Humphreys and Ferri examined AA and Twelve-Step Facilitation interventions for alcohol use disorder. Cochrane reviews are the high bar in evidence synthesis, and the conclusion was not the one many people expect.
The headline finding
The review found high certainty evidence that manualized AA and Twelve-Step Facilitation interventions are more effective than other established treatments, including cognitive behavioral therapy, for increasing abstinence. Randomized trials showed improved rates of continuous abstinence at twelve months, with a risk ratio of 1.21 across 1,936 participants.
Expressed as plain numbers, the evidence suggested around 42 percent of participants in AA remained completely abstinent a year later, compared with about 35 percent receiving other treatments including CBT.
On the other outcomes, drinking intensity and alcohol-related consequences, AA and TSF performed about as well as the established alternatives rather than better. The advantage was specifically in continuous abstinence and remission. The review also found evidence of greater healthcare cost savings.
One mechanistic detail is worth noting because it bears directly on why a treatment program would require attendance. The effect appears to be achieved largely by fostering ongoing participation that continues after the professional program ends. The clinical work is finite. The rooms are not.
Three caveats, because leaving them out would be dishonest
The evidence is about alcohol. The Cochrane review covered alcohol use disorder. The research base for Narcotics Anonymous and other drug-focused fellowships is thinner, and it is not sound to transfer the finding wholesale.
Manualized and non-manualized are not the same. The strongest result attached to structured, manualized Twelve-Step Facilitation delivered clinically. Non-manualized versions were found to perform about as well as other treatments rather than better.
It is not a replacement for medication. Where medication for alcohol or opioid use disorder is indicated, mutual-help attendance sits alongside it. Anyone framing meetings as an alternative to medication is going beyond the evidence.
Which Leaves the Actual Question
Suppose you accept all of that. It still does not tell you what to do on a Thursday evening when the room says something you consider untrue.
Here it helps to be precise about what the program is asking. It is asking you to attend and participate. It is not asking you to undergo a conversion, sign a statement of belief, or resolve a metaphysical question you have thought about for years. Plenty of long-term members are atheists and agnostics, and the fellowship’s own literature has always allowed considerable latitude on what a higher power means, including groups, principles, and the process itself.
One
Treat the mechanism as separable from the metaphysics
A great deal of what the rooms provide is unmysterious: regular contact with people who understand the problem, a place to be honest without consequence, structure on the evenings that are hardest, and access to people further along. None of that requires believing anything in particular.
Two
Meetings vary enormously, so shop
People who quit after one bad meeting usually generalize from a single room. Across Los Angeles County and the Inland Empire the range is wide, and agnostic and secular meetings exist in this area. A meeting that suits you is a different experience from one that does not, and finding it is a matter of attending several rather than deciding after one.
Three
You are allowed to disagree silently
Nobody is checking your convictions at the door, and there is no requirement to announce your objections or to argue. Taking what is useful and leaving the rest is not cynicism, it is roughly what most members do.
Four
Secular alternatives exist and are worth knowing about
SMART Recovery, LifeRing and similar programs use non-spiritual frameworks. Their evidence base is smaller than AA’s, largely because they are younger and less studied, which is a different thing from being shown not to work. Raise them in counseling if the spiritual framing remains a genuine obstacle rather than a passing discomfort.
Two Things People Confuse
| AA and NA meetings | Voluntary Bible study | |
|---|---|---|
| Required? | Yes, attendance is part of completing treatment here | No, entirely optional and separate |
| What it is | Peer-led mutual-help fellowship, free, open to anyone | A faith-based option offered for those who want it |
| Belief required | No specific belief; the higher power concept is left open | Explicitly religious, which is why it is opt-in |
People sometimes assume a program offering Bible study is asking everybody to be religious. Those are separate things here, and the fact that one is voluntary is the point. Group work, CBT, DBT, psychoeducation and individual counseling make up the clinical program, described on our treatment programs page.
If the Objection Is Really About Something Else
Worth naming, because it is common. For some people the stated objection is the spiritual language, and the actual objection is being seen. Walking into a room in your own town and admitting out loud what has been happening is a large thing, and it is easier to describe as a philosophical disagreement than as fear.
Both are legitimate, and they need different responses. If it is the belief content, the approaches above help. If it is exposure, that is something to raise in individual counseling, and it usually gets smaller once it has been said to one person.
Common Questions
Can I complete the program without going to meetings?
Attendance is part of the curriculum here, and the evidence on continued participation after professional treatment ends is a substantial part of why. If you have a specific reason it is not workable, raise it at assessment rather than after enrolling, so it can be discussed openly rather than becoming a compliance problem.
Does AA work for drugs as well as alcohol?
The strong Cochrane evidence is specifically about alcohol use disorder. NA and other fellowships are less studied, which means the honest position is that the evidence is weaker rather than that they do not help. Many people use both, and the social and structural benefits are not substance-specific.
What if I take medication for my substance use disorder?
Individual members have historically held varying views on this, and some rooms are better than others. Medication decisions belong with your prescriber, not with a meeting. If you encounter a room where this becomes uncomfortable, find another one, and tell your counselor what happened.
I tried a meeting once and hated it. Now what?
Try four more, in different places, before drawing a conclusion. Rooms differ by neighborhood, by format, by time of day and by who happens to be in them. Judging the whole fellowship from one meeting is like judging every group therapy session from the first twenty minutes of the first one.
Ask Us the Awkward Question Before You Enroll
One Touch Recovery Center provides outpatient addiction treatment in Pomona, California, with day and evening programs serving the eastern San Gabriel Valley and the western Inland Empire.
References
Kelly JF, Humphreys K, Ferri M. Alcoholics Anonymous and other 12-step programs for alcohol use disorder. Cochrane Database of Systematic Reviews, 2020, Issue 3, CD012880. cochranelibrary.com
Kelly JF, Abry A, Ferri M, Humphreys K. Alcoholics Anonymous and 12-Step Facilitation treatments for alcohol use disorder: a distillation of a 2020 Cochrane review for clinicians and policy makers. Alcohol and Alcoholism, 2020.
Cochrane, summary of findings on continuous abstinence rates at twelve months for AA and Twelve-Step Facilitation compared with other active treatments. cochrane.org
National Institute on Drug Abuse, Principles of Effective Treatment, on combining behavioral therapies, mutual-help participation and medication where indicated.
Substance Abuse and Mental Health Services Administration, National Helpline, 1-800-662-HELP (4357).