Excessive drinking behavior, family pathology and social deterioration are variables frequently discussed in the literature on alcoholism. Many of the studies which have examined the inter-relationships among the three have reported inconsistent and often contradictory findings. Studies by Pfeffer and Berger;l Gerard, Saenger, and Wile;2 and a paper by Pattison et aL3 present evidence for a consistent relationship between these variables. More recently, Pattison4 has begun to qualify this conclusion. Hill and Blane,5 applying statistical techniques to data presented by Rossi, Stach and Bradley conclude that they can find no evidence that improvement in drinking behavior is associated with improved adjustment in most areas. Regardless of the findings, however, most of these studies have started out with the implicit assumption that if a change in drinking behavior is related to a change in family pathology and social deterioration, the temporal sequence, or cause-effect direction is from drinking behavior to other areas.This paper reports the results of a project which was based on an alternative implicit assumption : that, for a married alcoholic, the question of temporal sequence is irrelevant. The relationship between excessive drinking behaviour and family pathology seems to be one of mutual reinforcement.6 While this would not have been denied in most of the studies cited above, they generally do not give sufficient recognition to the independent importance of the family situation.? Given this implicit assumption, Marriage Council of Philadelphiat undertook to counsel maritally conflicted alcoholics and their non-alcoholic spouses in the belief that alleviation of the marital problems might have an effect upon the drinking behavior. Therefore, the "therapy" is focused on the marital conflict (family pathology) , with consideration of a drinking problem taking place only in the context of the overt and covert roles it plays in that conflict. If an c'improvement" in this secondary area can be associated with a lessening of family pathology, support will be indicated for the indirect approach to the treatment of alcoholism. 3
SummaryWe have described the project on which this follow‐up is based. We have indicated some of the problems we have had to overcome in implementing a single follow‐up for the several distinct phases of 10 years of counseling alcoholics and their non‐alcoholic spouses. We have described the procedures, results and problems of our follow‐up attempts. In critically evaluating the problems we met and the ways in which we have coped with them, we have also indicated directions others might take to minimize such difficulties.
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