NCSB Journal Summer 2026

“Whether by dropping drinking and using buddies, or making new clean and sober friends, a change in social networks is key for long-term relapse prevention. Why? Because we are social creatures, and we tend to model our behavior on those around us.”

the ways in which they benefitted differed. For both groups, enhanced self-efficacy (albeit dif ferent subtypes of self-efficacy) played a key role. Among women, AA helped by boosting their confidence in their ability to cope with negative affect without drinking (known as “ negative affect self-efficacy”) and by reducing depression symptoms. That same measure was negligible among men. Rather, among men, AA helped by changing men’s social networks and by boosting their confidence in their ability to cope with high-risk social situations where alcohol was present without drinking ( absti nence social self-efficacy)—a negligible measure among women. The magnitude of these differences by gen der was stark and highlights the different types of relapse risk factors: for men, the biggest risk for relapse seems to involve direct and indirect alcohol cue exposure in social contexts; for women, it is the experience of negative affect. Slicing the data yet another way, a further analysis compared young adults (18–29 years old) to older adults (30+ years old). As we saw with the addiction-severity and gender cohorts, young adults derived the same degree of relapse prevention benefit as older adults, but once again, the ways that this occurred differed in nature and magnitude across the two groups. The most striking way that AA helped young adults recover was by helping them drop drinking/using buddies. The data shows this singular mechanism is twice as impactful for young adults as it is for their older adult counterparts. On the other hand, AA helped older adults by helping them adopt sober friends (as opposed to dropping drinking buddies). Whereas AA was not found to work through this mechanism for young adults. The exact reason for this difference remains unclear and warrants further study. One plausible explanation is the relative dearth of young adults in AA, making it harder for this cohort to make sober friends. One thing you may have noticed is that whichever way the data is sliced (addiction severity, gender, age), studies consistently show that a change in social networks is a key mech

anism for behavior change across groups. Whether by dropping drinking and using bud dies, or making new clean and sober friends, a change in social networks is key for long-term relapse prevention. Why? Because we are social creatures, and we tend to model our behavior on those around us. Take this example. A social experiment featured on the National Geographic show Brain Games investigated peer pressure and human conformity by staging a waiting room scenario where actors were instructed to stand up every time a beep sounded, without any apparent reason. 7 The real patient, unaware of the experiment, initially hesitates but begins mimicking the group behavior after just a few beeps. This conformity persists even after the actors leave, with the woman continuing to stand at each beep while alone in the waiting room. When new (also unaware) patients enter, they also begin to conform to this behavior, even after being offered no viable reason for doing so when one patient asks about it. This experiment demonstrates the powerful influence of social conformity, where individuals adopt group behaviors (even without understanding the reason), driven by a desire to fit in and avoid social exclusion. This phenomenon is linked to social learning, as a way of becoming socially integrated. It is a major reason why ongoing peer support is crucial for sustained long-term recovery, because we learn from the lived experience of sober role models. One very small but profound study stands out in my mind from Dr. Kelly’s talk because it ties into this concept of social network/peer support and goes to the heart of what we do at the LAP. Twenty clients were selected from an outpatient alcoholism treatment program and randomly assigned to one of two groups. Half were assigned to a control group that received a standard referral procedure which involved giving the client information about AA, encouraging the client to attend meetings, and providing information with the time, date, and location of weekly meetings. The other half were assigned to an experimental group that received a “warm handoff,” which involved a

phone call to a local AA member in which the member briefly talked to the client about the AA meeting, offered to meet the client before the meeting, offered to give the client a ride to the meeting, and called the client the night of the meeting to remind them of it and encourage them to come. The results of the study showed that 100% of the experimental group attended AA within one week of referral and continued to attend, whereas none of the control group ever attended. Researchers concluded that a warm handoff is significantly more effective than a standard referral. As Dr. Kelly relayed this study, it reinforced for me our best practice of having our LAP counselors visit lawyers in detox or inpatient treatment, offering a warm handoff to them upon discharge—serving not only as a warm handoff to the Lawyer Assistance Program itself, but also eventually to facilitate a warm handoff to a sober LAP volunteer. In healthcare it is called “continuity of care,” which is the consistent and coordinated management of a patient’s health over time achieved by ensuring seamless communication and collaboration between healthcare providers, settings, and the patient themselves. This approach means patients are supported by the same core healthcare team as much as possible, with a unified strategy for ongoing care across various transitions in the healthcare system. We have plenty of evidence that lawyers are at less risk of relapse if they are involved with the Lawyer Assistance Program in the early years of sobriety as they work towards sustained remission of five-plus years. I was also reminded of one of our active LAP volunteers who penned the story Being a Lawyer Saved My Life . 8 In it, he shares that he went to a few AA meetings but felt out of place. He stopped going and drank again despite a growing list of serious consequences. It was only when he was paired with a sober LAP volunteer, who took him to an AA meeting, that he suddenly felt comfortable there. He observes, “Like so many active alcoholics, I would not allow myself to open up to and become part of a recovery fellowship of which

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