Alcoholism is a common form of addiction. Although alcohol is widely available, it is generally considered a harmful substance even when taken in regular small doses.

The 2016 UK guidelines in regard to alcohol state that there is no safe drinking level. Click here to read more.

Alcoholics Anonymous (AA) is a well known organisation helping people with drinking problems and is available in many countries. The SOS questionnaire helps to measure if there is room for improvement in the way people are giving services to alcoholics in AA settings.

Use of the “Service to Others in Sobriety” questionnaire (Pagano and colleagues, 2009, 2010, 2013) can shape the ways in which alcoholics, clinicians, administrators, and researchers think about helping behavior during recovery. The tool is easy to administer, as respondents are able to complete the assessment in less than 5 minutes. This comprehensive tool assesses activities which are relevant to alcoholics at various levels of recovery. The “SOS” tool can be used to assess the degree to which a client is engaging in helping behavior, as a score below 40 indicates room for improvement.

A significant, negative relationship was found between the SOS score and covert narcissistic behavior, which is theorized to be one of the main roots of alcoholism. Thus, altruistic behaviors measured by the SOS tool can prove to be very beneficial to alcoholics in recovery.

You can measure narcism with two different scales on PsyToolkit: The Narcissism Inventory or the Hypersensitive Narcissism Scale.

According to the 2010 paper by Pagano et al. scores between 40 and 60 indicate a high level of Alcoholics Anonymous-related helping (AAH):

"" A cut-off score of 40 or higher was found to provide the highest average of sensitivity and specificity (SN = .81; SP = .66), the highest Phi coefficient (φ = .3), and the highest degree of concordance (k = .3). Using this cut-off score to indicate high AAH, 27% of subjects engaged in high AAH during treatment, similar to the rate observed among adults (28%). ""

In sum, use of the “Service to Others in Sobriety” instrument can inform treatment planning, clinical decisions, group interventions, and the ways in which alcoholics, clinicians, administrators, and researchers think about helping.

The questionnaire is not limited by education, gender, race, socioeconomic class, severity of substance use, transportation accessibility, place of residence, or level of meeting attendance. The “Service to Others in Sobriety” assesses formal service positions in 12-step programs, such as public outreach, as well as non-formal forms of AA-related helping, such as reaching out to a fellow sufferer. Service activities assessed are relevant to the daily lives of newcomers and old-timers (in alcoholism support groups) alike, do not require special training, and, with one exception (being a sponsor), are independent of length of time sober.

A significant, negative relationship was found between the SOS and covert narcissistic behaviors. Self-absorption is one theorized root of alcoholism, the solution to which requires getting out of oneself through service of the AA (Alcoholics Anonymous).

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The SOS be used for research, but you need to acknowledge the authors and their research paper(s) when writing about it (Pagano et al., 2009, 2010, 2013).


This is a simple scale question.

The survey code for PsyToolkit

Copy and paste this code to your PsyToolkit account if you want to use the scale in your own online research project
scale: sosfreq
- never
- rarely
- sometimes
- often
- always

l: sos
t: scale sosfreq
o: width 50%
q: How often in the past month did you...
- Take calls or spent time with a sponsee?
- Guide an alcoholic/addict through the 12-Steps?
- Hold a service position in a 12-Step program?
- Say something positive to an alcoholic/addict?
- Listen to an alcoholic/addict?
- Say hello to a newcomer?
- Reach out to an alcoholic/addict having a hard time?
- Share a personal story with an alcoholic/addict?
- Read program literature to an alcoholic/addict?
- Encourage an alcoholic/addict to go to a meeting?
- Donate money to Alcoholics Anonymous or Narcotics Anonymous?
- Put away chairs after a meeting?

l: sos_score
t: set
- sum $sos

l: feedback
t: info
q: A score on the Service to Others in Sobriety (SOS) Questionnaire
can range from 12 to 60 points.<br>
Your score on this questionnaire is {$sos_score}.<br>
In case you are involved giving services to people with alcohol
problems in the context of AA or NA programmes, a score below 40 points indicates room for improvement.<br>


  • Pagano, M.E., Krentzman, A.R., Onder, C.C., Baryak, J.L., Murphy, J.L., Zywiak, W.H., & Stout, R. L. (2010). Service to Others in Sobriety (SOS). Alcohol Treatment Quarterly, 28, 111-127. Read this paper online for free.

  • Pagano, M. E., Krentzman, A. R., Onder, C. C., Baryak, J. L., Zywiak, W. H., & Stout, R. L. (2009). Assessment of service to others in sobriety (SOS). Alcoholism-clinical and experimental research, 33, 194A-194A.

  • Pagano, M. E., Kelly, J. F., Scur, M. D., Ionescu, R. A., Stout, R. L., & Post, S. G. (2013). Assessing Youth Participation in AA-Related Helping: Validity of the Service to Others in Sobriety (SOS) Questionnaire in an Adolescent Sample. American Journal on Addictions, 22, 60-66.