Moderation Management: Difference between revisions

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{{Short description|Mutual support group for people with alcohol problems}}

{{Infobox organization

| name = Moderation Management

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| homepage = {{URL|www.moderation.org}}

}}

'''Moderation Management''' ('''MM''') is a [[secular]] [[non-profit]] organization providing peer-run non-coercive [[support group]]s for anyone who would like to reduce their [[Alcoholicalcohol beverage(drug)|alcohol consumption]] consumption. MM was founded in 1994 to create an alternative to [[Alcoholics Anonymous]] and similar [[addiction recovery groups]] for non-dependent problem drinkers who do not necessarily want to stop drinking, but want to moderate their amount of alcohol consumed to reduce its detrimental consequences.

==History==

{{See also|Bystander effect#Larry Froistad|Murder of Amanda Froistad|l1=Bystander effect: Larry Froistad|l2=Murder of Amanda Froistad}}

Moderation Management was founded by Audrey Kishline, a problem drinker, who did not identify with the [[disease theory of alcoholism]] finding that it eroded her [[self-confidence]]. Kishline found that she could moderate her drinking with the help of [[cognitive behavioral therapy]] principles and in 1994 created Moderation Management as an organization for non-dependent problem drinkers to help maintain moderate alcohol use. MM maintains, however, that it is not for all problem drinkers; that there are some drinkers for whom abstinence will be the only solution.<ref name="HUMPHREYS2004">{{Cite book|last=Humphreys |first=Keith |title=Circles of Recovery: Self-Help Organizations for Addictions |year=2004 |publisher=[[Cambridge University Press]] |isbn=978-0-521-79277-6 |chapter=Chapter 2: An international tour of addiction-related mutual-help organizations: Moderation Management |pages=70–73}}</ref>

Kishline had asked many [[Mental health professional|professionals]] for advice while she was establishing the fellowship, including psychologist [[Jeffrey Schaler]], who wrote the foreword for the first edition of the book, ''Moderate Drinking,'' used in the organization and served on the original board of [[trustee]]s for MM.<ref name="SCHALER1994">{{Cite book|last=Schaler |first=Jeffrey A. |title=Moderate Drinking: The New Option for Problem Drinkers |chapter=Foreword |publisher=See Sharp Press |editor=Kishline, Audrey |year=1994 |edition=First |chapter-url=http://www.schaler.net/Kishlineforeword.htm}}</ref> Schaler split ways with MM over two issues. The first being failure of MM's leadership to condemn member Larry Froistad after he [[Murder of Amanda Froistad|confessed to murdering his daughter]] on an MM support group [[Electronic mailing list|email list]]. The second being a disagreement with MM as to whether there was a medical distinction between problem drinkers and [[alcoholism|alcoholics]]. Schaler's foreword was replaced with one by historian Ernest Kurtz in subsequent editions.<ref name="SCHALER2000">{{Cite book|last=Schaler |first=Jeffrey A. |title=Addiction Is a Choice |publisher=[[Open Court Publishing]] |___location=[[Chicago, Illinois]] |date=January 2000 |chapter=Chapter 10: Moderation Management and Murder |pages=107–114 |chapter-url=http://www.schaler.net/mmurder.htm |isbn=978-0-8126-9403-1}}</ref>

In January 2000 Kishline posted a message to an official MM [[email list]] stating that she had concluded her best drinking goal was abstinence and that she would begin attending [[Alcoholics Anonymous]], [[SMART Recovery]] and [[Women For Sobriety]] meetings while continuing to support MM for others.<ref name="KISHLINE2000">{{cite mailing list | url = http://www.doctordeluca.com/Documents/KishlineToldMM.htm | title = Announcement from Audrey | mailinglist = Moderation Management | date = 2000-01-20 | last = Kishline |first = Audrey |archive-date=2001-03-06 |archive-url=https://web.archive.org/web/20010306062247/http://www.doctordeluca.com/Documents/KishlineToldMM.htm}}</ref> In March 2000, while drunk,<ref>{{Cite news|last=Girvan|first=Amy|date=March 2015|publisher=[[The Guardian]]|title=The next AA? Welcome to Moderation Management, where abstinence from alcohol isn't the answer|url=https://www.theguardian.com/society/2015/mar/16/the-next-aa-moderation-management-abstinence-alcohol-isnt-the-answer|accessdate=2017-12-29|quote=After starting MM, Kishline left the group, realizing that she could not moderate her drinking after all. She returned to AA, then fell off the wagon, drunk-driving in March 2000 and killing a man and his 12-year-old daughter.}}</ref> she drove her truck the wrong way down a highway, and hit another vehicle head-on killing its two passengers (a father and his twelve-year-old daughter). MM continued to grow during Kishline's time in prison.<ref name="HUMPHREYS2004"/> She was released in August 2003 after serving 3½ years of her 4½ year sentence.<ref name="Walker2015">{{cite journal|title=Remembering Audrey Kishline, the Founder of Moderation Management |last1=Walker |first1=Regina |journal=The Fix |date=2015-01-07 |url=https://www.thefix.com/content/remembering-audrey-kishline |access-date=2019-02-28 |archive-date=2015-09-29 |archive-url=https://web.archive.org/web/20150929065244/http://www.thefix.com/content/remembering-audrey-kishline}}</ref><ref name="KishlineMaloy2007">{{cite book|author1=Audrey Kishline|author2=Sheryl Maloy|title=Face to Face: A Deadly Drunk Driver, a Grieving Young Mother, and Their Astonishing True Story of Tragedy and Forgiveness|url=https://books.google.com/books?id=B7ezTUTnoWYC|year=2007|publisher=Meredith Books|isbn=978-0-696-23514-6|oclc=144226098}}</ref>

Kishline continued to drink once released from prison.<ref name="Walker2015"/> Soon after she divorced from her husband and struggled to find work in part due to her felony conviction.<ref name="Walker2015"/> She developed a friendship with the wife and mother of the victims of her drunk driving accident, and together they authored a book together on their relationship.<ref name="Walker2015"/><ref name="KishlineMaloy2007"/> She died at the age of 59 on December 19th, 2014. Her death was said to have been a suicide by two mental health professionals, but this was not confirmed by her family.<ref name="Walker2015"/>

==Methodology==

MMModeration allowsManagement membersis toa setbehavioral change program that helps individuals reduce their ownalcohol drinkingintake goalsrather asthan theyquit feeldrinking appropriateentirely.<ref name="HUMPHREYS2004"/> MM encourages membersparticipants to follow particular drinking guidelines, limits, goal setting techniques, and a nine-step [[Cognitive behavioral therapy|cognitive-behavioral]] change program.<ref name="SOLOMON2005">{{Cite book|title=AA: Not the Only Way |last=Solomon |first=Melanie |isbn=978-0-9762479-9-9 |year=2005 |publisher=Capalo Press |chapter=Part Three: Moderation Management |pages=39–41}}</ref>

The MM limits and guidelines were derived from the work of Dr. Martha Sanchez-Craig.<ref name="SANCHEZCRAIG2005">{{Cite journal|last=Sanchez-Craig |first=Martha |title=Empirically based guidelines for moderate drinking: 1-year results from three studies with problem drinkers |journal=American Journal of Public Health |volume=85 |issue=6 |pages=823–828 |author2=Wilkinson, D. Adrian |author3=Davila, Rafaela |year=1995 |pmid=7762717 |doi=10.2105/AJPH.85.6.823 |pmc=1615483}}</ref> MM membersparticipants are encouraged, but do not need to follow, the suggested guidelines, limits and steps. MM does not view non-dependent problem drinkers as [[alcoholism|alcoholics]], but rather people with a bad, but controllable, [[Habit (psychology)|habit]]. MM does not state that [[Surrender (spirituality and psychology)|surrender]] or [[spirituality]] is needed to end or control the habit.<ref name="ROTGERS2000">{{Cite journal|last=Rotgers |first=Frederick |author2=Kishline, Audrey |title=Moderation Management: A support group for persons who want to reduce their drinking, but not necessarily abstain |journal=International Journal of Self- Help and Self Care |year=1999–2000 |pages=145–158 |volume=1 |issue=2 |doi=10.2190/8909-FFH3-44BA-HKVN}}</ref> MM literature makes a similar distinction to Alcoholics Anonymous literature that there are problem drinkers who can return to controlled drinking and alcoholics who can not.<ref name="HUMPHREYS2003">{{Cite journal|last=Humphreys |first=Keith |title=Alcohol & drug abuse: A research-based analysis of the Moderation Management controversy |journal=Psychiatric Services |volume=54 |date=May 2003 |pages=621–622 |pmid=12719491 |doi=10.1176/appi.ps.54.5.621 |issue=5}}</ref>

MM groups are intended to give membersparticipants a chance to identifyconnect with other problem drinkers and learn from the successes and failures of each other. Face-to-face meetingsMeetings last about an hour, whereasand online meetingsmost are ongoingonline. "Crosstalk,"Face-to-face membersmeetings interrupting each otherstarted to providere-emerge feedback during meetings, is allowedpost-pandemic. [[Mental health professional]]s are allowed to help start MM meetings, but ultimate control must be left to the participants.<ref name="ROTGERS2000"/><ref name="KLAW2000A">{{Cite journal|last=Klaw |first=Elena |author2=Humphreys, Keith |title=Life stories of Moderation Management mutual help group members |journal=Contemporary Drug Problems |volume=27 |issue=4 |year=2000 |pages=779–803|doi=10.1177/009145090002700404 |s2cid=141724352 }}</ref> A [[content analysis]] of online MM meetings found the most common types of communication by membersparticipants were [[self-disclosure]], provision of information and advice, and provision of emotional support. Similar studies of depression and eating disorder support groups have found the same patterns.<ref name="KLAW2000B">{{Cite journal|last=Klaw |first=Elena |author2=Huebsch, Penny Dearmin |author3=Humphreys, Keith |title=Communication patterns in an on-line mutual help group for problem drinkers |journal=Journal of Community Psychology |volume=28 |year=2000 |pages=535–546 |issue=5 |doi=10.1002/1520-6629(200009)28:5<535::AID-JCOP7>3.0.CO;2-0}}</ref>

==Membership==

In a 2001 survey of Moderation Management, most MM members are [[White people|white]] (96%), employed (81%), educated (72% have at least a college education) and on average are more secular than the rest of the population (32% identify as [[atheism|atheists]] or [[agnosticism|agnostics]], only 16% regularly attend religious services). MM attracts an equal number of men and women (49% are female); depending on the kinds of meetings attended, between 11.9% and 33.8% of membersparticipants were under 35 years of age.<ref name="HUMPHREYS2001"/>

MM members mostly describe themselves as being non-dependent problem drinkers. In general, MM members report having a mild history of substance-abuse problems before joining, with 40% having consumed four or fewer drinks per drinking day and less than 10% experienced serious withdrawal symptoms or comorbid drug abuse.<ref name="HUMPHREYS2001">{{Cite journal|last=Humphreys |first=Keith |author2=Klaw, Elena |title=Can targeting non-dependent problem drinkers and providing internet-based services expand access to assistance for alcohol problems?: A study of the Moderation Management self-help/mutual aid organization |journal=Journal of Studies on Alcohol |volume=62 |date=July 2001 |pages=528–532 |issn=0096-882X |issue=4 |pmid=11513231|doi=10.15288/jsa.2001.62.528 }}</ref>

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==Effectiveness==

A 2009 study saw that subjects using just Moderation Management to reduce their drinking went from having only about one day a week abstinent from alcohol to having 1.5 days a week abstinent (e.g., they would drink six days one week and five days another week).<ref>{{cite journal|pmc=2739257|year=2009|last1=Hester|first1=R. K.|title=A web application for moderation training: Initial results of a randomized clinical trial|journal=Journal of Substance Abuse Treatment|volume=37|issue=3|pages=266–276|last2=Delaney|first2=H. D.|last3=Campbell|first3=W.|last4=Handmaker|first4=N.|pmid=19339137|doi=10.1016/j.jsat.2009.03.001}} It should be noted that theThe study reported that using MM along with an online drink tracker increased the number of days abstinent from alcohol to three or four days a week</ref>

A 2012 paper argues that, while there is little scientific analysis of MM's efficacy, mutual support groups such as ''Moderation Management'' could be effective.<ref>{{cite journal|last1=Lembke|first1=Anna|author-link=Anna Lembke|last2=Humphreys|first2=Keith|year=2012|title=Moderation Management: A Mutual-Help Organization for Problem Drinkers Who Are Not Alcohol-Dependent|journal=Journal of Groups in Addiction & Recovery|volume=7|issue=2–4|pages=130–141|doi=10.1080/1556035X.2012.705657|s2cid=145299928}}</ref>

==History==

{{See also|Bystander effect#Larry Froistad|Murder of Amanda Froistad|l1=Bystander effect: Larry Froistad|l2=Murder of Amanda Froistad}}

Moderation Management was founded by Audrey Kishline, a problem drinker, who did not identify with the [[disease theory of alcoholism]], finding that it eroded her [[self-confidence]]. Kishline found that she could moderate her drinking with the help of [[cognitive behavioral therapy]] principles and in 1994 created Moderation Management as an organization for non-dependent problem drinkers to help maintain moderate alcohol use. MM maintains, however, that it is not for all problem drinkers; that there are some drinkers for whom abstinence will be the only solution.<ref name="HUMPHREYS2004">{{Cite book|last=Humphreys |first=Keith |title=Circles of Recovery: Self-Help Organizations for Addictions |year=2004 |publisher=[[Cambridge University Press]] |isbn=978-0-521-79277-6 |chapter=Chapter 2: An international tour of addiction-related mutual-help organizations: Moderation Management |pages=70–73}}</ref>

Kishline had asked many [[Mental health professional|professionals]] for advice while she was establishing the fellowship, including psychologist [[Jeffrey Schaler]], who wrote the foreword for the first edition of the book, ''Moderate Drinking,'' used in the organization and served on the original board of [[trustee]]s for MM.<ref name="SCHALER1994">{{Cite book|last=Schaler |first=Jeffrey A. |title=Moderate Drinking: The New Option for Problem Drinkers |chapter=Foreword |publisher=See Sharp Press |editor=Kishline, Audrey |year=1994 |edition=First |chapter-url=http://www.schaler.net/Kishlineforeword.htm}}</ref> Schaler split ways with MM over two issues. The first being failure of MM's leadership to condemn member Larry Froistad after he [[Murder of Amanda Froistad|confessed to murdering his daughter]] on an MM support group [[Electronic mailing list|email list]]. The second being a disagreement with MM as to whether there was a medical distinction between problem drinkers and [[alcoholism|alcoholics]]. Schaler's foreword was replaced with one by historian Ernest Kurtz in subsequent editions.<ref name="SCHALER2000">{{Cite book|last=Schaler |first=Jeffrey A. |title=Addiction Is a Choice |publisher=[[Open Court Publishing]] |___location=[[Chicago, Illinois]] |date=January 2000 |chapter=Chapter 10: Moderation Management and Murder |pages=107–114 |chapter-url=http://www.schaler.net/mmurder.htm |isbn=978-0-8126-9403-1}}</ref>

In January 2000, Kishline posted a message to an official MM [[email list]] stating that she had concluded her best drinking goal was abstinence and that she would begin attending [[Alcoholics Anonymous]], [[SMART Recovery]] and [[Women Forfor Sobriety]] meetings while continuing to support MM for others.<ref name="KISHLINE2000">{{cite mailing list | url = http://www.doctordeluca.com/Documents/KishlineToldMM.htm | title = Announcement from Audrey | mailinglistmailing-list = Moderation Management | date = 2000-01-20 | last = Kishline |first = Audrey |archive-date=2001-03-06 |archive-url=https://web.archive.org/web/20010306062247/http://www.doctordeluca.com/Documents/KishlineToldMM.htm}}</ref> In March 2000, while drunk,<ref>{{Cite news|last=Girvan|first=Amy|date=March 2015|publisherwork=[[The Guardian]]|title=The next AA? Welcome to Moderation Management, where abstinence from alcohol isn't the answer|url=https://www.theguardian.com/society/2015/mar/16/the-next-aa-moderation-management-abstinence-alcohol-isnt-the-answer|accessdate=2017-12-29|quote=After starting MM, Kishline left the group, realizing that she could not moderate her drinking after all. She returned to AA, then fell off the wagon, drunk-driving in March 2000 and killing a man and his 12-year-old daughter.}}</ref> she drove her truck the wrong way down a highway, and hit another vehicle head-on killing its two passengers (a father and his twelve12-year-old daughter). MM continued to grow during Kishline's time in prison.<ref name="HUMPHREYS2004"/> She was released in August 2003 after serving 3½ years of her 4½ year sentence.<ref name="Walker2015">{{cite journal|title=Remembering Audrey Kishline, the Founder of Moderation Management |last1=Walker |first1=Regina |journal=The Fix |date=2015-01-07 |url=https://www.thefix.com/content/remembering-audrey-kishline |access-date=2019-02-28 |archive-date=2015-09-29 |archive-url=https://web.archive.org/web/20150929065244/http://www.thefix.com/content/remembering-audrey-kishline}}</ref><ref name="KishlineMaloy2007">{{cite book|author1=Audrey Kishline|author2=Sheryl Maloy|title=Face to Face: A Deadly Drunk Driver, a Grieving Young Mother, and Their Astonishing True Story of Tragedy and Forgiveness|url=https://books.google.com/books?id=B7ezTUTnoWYC|year=2007|publisher=Meredith Books|isbn=978-0-696-23514-6|oclc=144226098}}</ref>

Kishline continued to drink once released from prison.<ref name="Walker2015"/> Soon after, she divorced from her husband and struggled to find work, in part due to her felony conviction.<ref name="Walker2015"/> She developed a friendship with the wife and mother of the victims of her drunk driving accidentcrash, and together they authored a book together on their relationship.<ref name="Walker2015"/><ref name="KishlineMaloy2007"/> She died of suicide at the age of 59 on December 19th19, 2014.<ref Hername="Walker2015"/><ref>{{cite web|url=http://www.thefix.com/content/update-death-audrey-kishline|archive-url=https://web.archive.org/web/20150924084436/http://www.thefix.com/content/update-death-audrey-kishline|archive-date=September was said to have been a suicide by two mental health professionals24, but2015|title=Exclusive: thisNew wasDetails notEmerge confirmedAbout byAudrey herKishline's family.Death|last=Walker|first=Regina|url-status=dead}}</ref name="Walker2015"/>

==Literature==

* {{Cite book |last=Kishline |first=Audrey |title=Moderate Drinking: The Moderation Management (TM) Guide for People Who Want to Reduce Their Drinking |isbn=978-0-517-88656-4 |date=December 1995 |publisher=[[Three Rivers Press]] |oclc=33947025 |url=https://archive.org/details/moderatedrinking00kish_0 }}

* {{Cite book |last=Rotgers |first=Frederick |author2=[[Marc Kern|Kern, Marc F.]] |author2-link=Marc Kern |author3=Hoeltzel, Rudy |title=Responsible Drinking: A Moderation Management Approach for Problem Drinkers |publisher=[[New Harbinger Publications]] |date=September 2002 |isbn=978-1-57224-294-4 |oclc=55204532 |url=https://archive.org/details/responsibledrink00rotg }}

==See also==

{{div col|colwidth=22em}}

{{Col-begin}}

{{Col-2}}

*[[Addiction recovery groups]]

*[[Alcoholism]]

*[[Cognitive behaviorbehavioral therapy]]

*[[Drug addiction]]

{{Col-2}}

*[[LifeRing Secular Recovery]]

*[[Rational Recovery]]

*[[SMART Recovery]]

{{Col-div col end}}

==References==