This paper presents clinical data from a research study designed to examine the relation between alcohol consumption and interactional behavior in "alcoholic couples". The central innovative feature of the study was the simultaneous admission to an inpatient setting of up to three couples, one or both members of which was alcoholic. The in-patient experience was part of an intensive, six-week, multiple-couples, group-therapy program. During hospitalization couples were encouraged to reproduce as closely as possible their usual drinking patterns and interactional behavior. Therapists utilized observations of interactional behavior during intoxication and sobriety to formulate central interactional and psychological issues for each couple. The authors utilized these same observations to develop the interactional model of alcoholism in families that is presented in detail in this paper. This model is an extension of earlier work delimiting an interactional theory of alcoholism based on general systems concepts.

The Eagleville Hospital and Rehabilitation Center Family Study Program is described, presenting an overview of the Family Research Study and the problem areas inherent in coordinating research with a new treatment program; an analysis of the sample of drug abusers, their families, and their course in family treatment is discussed. The Community School Program is included as a demonstration of the potential for effective primary prevention. Areas of promise for future development are reviewed as they provide direction for further clinical and research work with the family and drug abuse.

The authors propose that substance use and abuse may be understood and effectively treated when the individual user or abuser is viewed in the context of his family or stable living group. This viewpoint attributes an important role in the maintenance of individual substance abuse to interactional processes within the family system. The theoretical assumptions implied by this viewpoint are discussed. A selective literature review examines the available evidence, from both experimental and clinical-descriptive studies, that is relevant to this proposal. The next step toward a more systematic investigation of these ideas is outlined, including testable hypotheses, methodological issues and problems, and potentially useful techniques.

No abstract

The following report describes the results of a national study of the role of family therapy in the drug abuse field. Characteristics of agencies that work with families are described, as well as the demographic characteristics and psychological problems of the clients most apt to be treated in family therapy. The study also looks at the role and structure of family therapy in the ecological system of the treatment institutions. A profile of the family therapists who are responsible for providing services to families is presented. An attempt was made to assess agencies' level of development with regard to family therapy by using an instrument, The Progress Index for Family Therapy Programs. Generally, findings indicated that there is considerable variation in expertise. More extensive training in family therapy techniques was of major concern, particularly among clinics with a heroin addict population.