REDUCING OBSTACLES TO AFFILIATION WITH ALCOHOLICS-ANONYMOUS AMONG VETERANS WITH PTSD AND ALCOHOLISM

Alcohol use is prevalent among Vietnam veterans who suffer from chroni c combat-related posttraumatic stress disorder (PTSD). Although Alcoho lics Anonymous (AA) is the mainstay of ambulatory alcoholism treatment , adherence to particular components of the AA philosophy may prove es pecially challenging for alcoholic Vietnam veterans with PTSD. The aut hors describe elements of AA's philosophy, such as ''surrendering'' to a ''higher power, '' making amends to persons one has harmed, and sha ring one's story publicly, that may be difficult for the Vietnam veter an with PTSD. The authors suggest that an important factor in the succ essful affiliation of these patients with AA is their capacity to sepa rate their alcohol-related problems and treatment from their PTSD symp toms and treatment and to accommodate dual identities as both an alcoh olic and a traumatized soldier. Preparing such patients for AA by refr aming some of the 12 steps is recommended.