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Identification, Service, and Recovery in Overeaters Anonymous Erin R

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Identification, Service, and Recovery in Overeaters Anonymous Erin R Individual-Group Dynamics in a 12-Step Fellowship: Identification, Service, and Recovery in Overeaters Anonymous Erin R. Powers A dissertation Submitted in partial fulfillment of the Requirements for the degree of Doctor of Philosophy University of Washington 2014 Reading Committee: Edgar Kiser, Chair Steven Pfaff, Chair Jerald Herting Program Authorized to Offer Degree: Department of Sociology © Copyright 2014 Erin R. Powers University of Washington Abstract Individual-Group Dynamics in a 12-Step Fellowship: Identification, Service, and Recovery in Overeaters Anonymous Erin R. Powers Chairs of the Supervisory Committee: Professor Edgar Kiser Professor Steven Pfaff Department of Sociology Self-help/mutual-aid groups, relative to other forms of voluntary association, continue to thrive. Many of these groups follow the 12-Step model of Alcoholics Anonymous. One such organization is the fellowship of Overeaters Anonymous, a group for those with a desire to stop compulsively overeating and/or recover from other eating disorders. I analyze this group using mixed methods and relying on data I collected primarily from 2010 to 2012, including 151 participant surveys, 16 group surveys, 30 interviews, and 366 discrete observations of 21 OA groups (i.e., meetings) located in a large Pacific Northwest city. In this dissertation, I explore 12-Step groups as sociological phenomena, addressing identification processes, the effects of costly behavioral dictates on group members, and the diverse determinants and types of recovery experienced by members. TABLE OF CONTENTS Page List of Figures ......................................................................................................................... iv List of Tables .......................................................................................................................... v Chapter 1: Introduction ............................................................................................................ 1 1.1 Background on 12-Step Fellowships………………..………...................... 3 1.2 Analytical Chapters ……………….............................................................. 7 Chapter 2: Data and Methods ................................................................................................... 11 2.1 Human Subjects and 12-Step Traditions ..................................................... 11 2.2 Researcher Positionality .............................................................................. 12 2.3 Instruments and Protocols ........................................................................... 13 2.4 Initial Procedures ......................................................................................... 15 2.5 Analytical Procedures .................................................................................. 20 Chapter 3: The Correlates of High Identifiers in Self-Help Groups……………..................... 23 3.1 Background .................................................................................................. 26 3.2 Data and Methods ........................................................................................ 33 3.3 Analysis of Survey Data …………………………………………………...41 3.4 Discussion .................................................................................................... 47 3.5 Conclusion ................................................................................................... 56 i Chapter 4: Helping Others in a Self-Help Group: Commitment and Investment in Voluntary Associations................................................... 59 4.1 Introduction .............................................................................................. 59 4.2 Data and Methods ……………................................................................. 64 4.3 Findings ……………................................................................................ 72 4.4 Discussion …………................................................................................. 86 4.5 Conclusion …………................................................................................. 91 Chapter 5: Recovery in a 12-Step Group ………………............................................................. 94 5.1 Introduction ................................................................................................ 94 5.2 Background ............................................................................................... 101 5.3 Data and Methods...................................................................................... 115 5.4 Findings .................................................................................................... 131 5.5 Discussion ..................................................................................................142 5.6 Conclusion ………….................................................................................180 Chapter 6: Conclusion ……………………............................................................................... 185 6.1 Key Findings from Each Analysis ................................................................185 6.2 Insights Across Analyses ............................................................................. 189 6.3 Study Limitations ..........................................................................................192 6.4 Directions for Future Research......................................................................193 6.5 Study Contributions ..................................................................................... 194 6.6 Final Thoughts ............................................................................................. 195 ii Works Cited ............................................................................................................................... 197 Appendix A: The 12 Steps & 12 Traditions of Overeaters Anonymous ................................... 208 Appendix B: Overeaters Anonymous Tools of Recovery ......................................................... 209 Appendix C: Memo on Participation of Alcoholics Anonymous Members in Research and Other Non-A.A. Surveys ......................................................................................................... 210 Appendix D: Comparison of Sample with OA Fellowship ....................................................... 212 Appendix E: Interviewee Characteristics .................................................................................. 213 Appendix F: Participant Survey ................................................................................................ 214 Appendix G: Meeting Observation Form .................................................................................. 232 Appendix H: Semi-Structured Stratified Random Sample Interview Protocol.......................... 233 iii LIST OF FIGURES Figure Number Page 5.1 Age Distribution of Sample….............................................................................. 121 5.2 Time Spent Sponsoring ....................................................................................... 126 iv LIST OF TABLES Table Number Page 2.1 Meeting Characteristics ………………………………………………............................. 14 2.2 Stratified Random Sample for Interviews ……………………………………................. 19 3.1 Length of Attendance ……………………………………………………….................... 37 3.2 Length of Attendance: Pacific Northwest City vs. OA Fellowship …………................... 37 3.3 Top Step Worked ………………………………………………………........................... 38 3.4 Fellowship ..............……………………………………………………............................ 38 3.5 Member Identifications ...................................................................................................... 40 3.6 Correlations Between Various Eating Disorders and OA Identification ........................... 42 3.7 Correlations: Very Strong Identification and Its Predictors…..………….......................... 43 3.8 Predicting Very Strong Identification as an OA Member ……………….......................... 46 4.1 Correlations: Current Service and Its Predictors ................................................................ 81 4.2 Predictors of Current Service Position ............................................................................... 81 5.1 Education Levels .............................................................................................................. 122 5.2 Household Income............................................................................................................. 122 5.3 Severity of Food Problems ............................................................................................... 123 5.4 Top Step Worked............................................................................................................... 124 5.5 Frequency of Using Program Tools ...................................................................................124 5.6 Frequency of Being Sponsored and Sponsoring Others ....................................................125 5.7 Length of OA Attendance ................................................................................................. 127 5.8 Fellowship ......................................................................................................................... 130 5.9 Index of Recovery ............................................................................................................. 132 v 5.10 Predictors of Index of Recovery......................................................................................
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