Mutual help programs are popular resources for persons with alcohol use disorder (AUD) and clinical referral to such programs is common. This chapter describes what is currently known about four established mutual help programs in the United States: Alcoholics Anonymous (AA), SMART Recovery, Women for Sobriety (WFS), and LifeRing. Strong correlational research indicates that AA is associated with increased abstinence and that this association arises in part because of increased social support, abstinence self-efficacy, and spiritual practices. There is little support that reductions in anger, selfishness, and depression account for AA-related benefit. Preliminary evidence indicates that persons reporting lower religiosity and higher education are more likely to affiliate with non-AA mutual help programs and that these programs may be efficacious. A series of recommendations are made to advance our knowledge of these mutual help programs, with an emphasis on the need for future investigations of SMART, WFS, and LifeRing.

The complexity of addiction has led to the emergence of free community-based peer-led resources for their management, which have grown substantially in many countries to help initiate and sustain recovery-related changes. This chapter highlights the similarities and differences between these mutual help organisations (MHOs; also referred to as mutual-aid or self-help groups), such as Alcoholics Anonymous (AA), Narcotics Anonymous and other 12-step-based entities, as well as newer entities, such as SMART Recovery, LifeRing, Women for Sobriety and Celebrate Recovery. The chapter begins by outlining the different major MHOs and reviewing the scientific research conducted on them pertaining to recovery benefits; the mechanisms of behaviour change through which they are purported, and have been shown, to convey benefits; and the potential for healthcare cost reductions and cost effectiveness. In the final section commonalities among these ostensibly different MHOs are described and future directions are discussed.