Assessing Youth Participation in AA-Related Helping: Validity of the Service to Others in Sobriety (SOS) Questionnaire in an Adolescent Sample


Address correspondence to Dr. Pagano, Division of Child Psychiatry, Department of Psychiatry, Case Western Reserve University School of Medicine, WO Walker Building, 10524 Euclid Ave., Cleveland, OH 44106. E-mail:


Background and Objectives

The positive outcomes derived from participation in Alcoholics Anonymous-related helping (AAH) found among adults has spurred study of AAH among minors with addiction. AAH includes acts of good citizenship in AA, formal service positions, public outreach, and transmitting personal experience to another fellow sufferer. Addiction research with adolescents is hindered by few validated assessments of 12-step activity among minors. This study provides psychometric findings of the “Service to Others in Sobriety (SOS)” questionnaire as completed by youths.


Multi-informant data was collected prospectively from youth self-reports, clinician-rated assessments, biomarkers, and medical chart records for youths (N = 195) after residential treatment.


Few youths (7%) did not participate in any AAH during treatment. Results indicated the SOS as a unidimensional scale with adequate psychometric properties, including inter-informant reliability (r = .5), internal consistency (alpha = .90), and convergent validity (rs = −.3 to .3). Programmatic AAH activities distinguished abstinent youths in a random half-sample, and replicated on the other half-sample. The SOS cut-point of 40 indicated high AAH participation.

Conclusions and Significance

The SOS appears to be a valid measure of AAH, suggesting clinical utility for enhancing treatment and identifying service opportunities salient to sobriety. (Am J Addict 2013;22:60-66)