Moderation Management

Domain V · Systemic, relational, group & community · Audrey Kishline · 1994 · Ann Arbor, Michigan, USA

What it is

Moderation Management (MM) is a secular, peer-run mutual-help organisation, not a therapy a clinician delivers. Its current Opening Statement calls MM groups "not treatment or therapy" and welcomes anyone concerned about their drinking. Audrey Kishline founded it in 1994 in Ann Arbor, Michigan, and…

Format

• MM has no clinical phases or session count. Its core structure is the Nine Steps, which still appear in MM's current meeting materials, used at the member's own pace alongside ongoing meetings. MM also offers a seven-step Steps of Change guide that orders similar tasks differently (B16). Below, the…
• Goal: attend meetings or online groups and learn the programme.

Who practises it, and how they are trained or regulated

• Version followed: MM's Nine Steps, Meeting Ground Rules, moderate-drinker profile and Limits as MM currently publishes them on its Meeting Materials page and its Moderate Drinking Guidelines page (moderation.org, October 2026; the guidelines page was last modified August 2026). In substance these match the 1999–2000 version set out by Rotgers & Kishline (International Journal of Self Help & Self Care), which…
• How change happens, in MM's model. MM treats problem drinking as a learned habit rather than a permanent disease, so it can be unlearned through self-management. The method draws on cognitive-behavioural moderation training: Miller & Muñoz's behavioural self-control training and Sanchez-Craig's DrinkWise. The sequence is:
• What this guide covers. It is written for a clinician who assesses whether MM fits a client, refers and prepares the client, uses MM's steps and tools within individual treatment, or helps start an MM meeting. MM's 1999–2000 literature allowed professionals to start or lead meetings, with control left to the participants. MM's current site describes meetings as facilitated by an experienced member and routes…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve fasting, a special diet or 'detox'? Have you discussed this with your doctor?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• How do you and the practitioner understand what is happening, in spiritual or cultural terms? Is that a source of comfort, worry, or both?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• a review that doesn't use records.
• criteria being renegotiated after the fact.
• the client treating the ceilings as a daily allowance.
• gaps in the records, which often hide over-limit days.
• personal limits set at MM's maximum. Suggest starting lower.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.