Evaluation of Treatment Methods in Chronic Alcoholism

Baekeland, Frederick

doi:10.1007/978-1-4613-4199-4_10

Cited by 32 publications

(7 citation statements)

References 219 publications

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“…Defense mechanisms tended to be more marked among clients streamed into the out-patient and primary care programmes. In general, the out-patient clients tended to have more favourable prognostic indicators (Baekeland, 1977), such as social stability and lower level ofalcoholic involvement. Differences existed among clients streamed into alternative treatment programmes.…”

Section: Measures Of Psychopathology: the Importantmentioning

confidence: 91%

“…These differ ences are not surprising since social stability is an important consideration when assigning clients to out patient care. Research indicates that a reasonable level of community support is necessary to sustain treatment on an out-patient basis (Baekeland, 1977). There were no systematic age or sex differences across programmes.…”

Section: Demograph Icmentioning

confidence: 99%

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Comparison of Clients Assigned to In-patient and Out-patient Treatment for Alcoholism and Drug Addiction

Skinner¹

1981

Br J Psychiatry

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This study examined characteristics of 296 alcohol and/or drug abuse clients assigned to either (1) in-patient programmes, (2) out-patient programmers, or (3) a lower cost primary care alternative. Multivariate analysis indicated that clients admitted for in-patient care reported greater alcohol consumption and associated problems, fewer community supports and more severe symptoms such as depression and anxiety. They tended to be more frank about their problems while defence mechanisms were more apparent in clients admitted to out-patient and primary care programmers. In general, out-patients ahd more favourable prognostic indicators, such as higher social stability and lower level of alcoholic involvement. The differences among treatment programmers were along quantitative dimensions of problem severity. In particular, the alcohol dependence syndrome was a major discriminating dimension.

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Section: Measures Of Psychopathology: the Importantmentioning

confidence: 91%

Section: Demograph Icmentioning

confidence: 99%

Comparison of Clients Assigned to In-patient and Out-patient Treatment for Alcoholism and Drug Addiction

Skinner¹

1981

Br J Psychiatry

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“…In some recent reviews (Baekeland et al, 1975;Costello, 1975aCostello, , 1975b, a case has been made for the superiority of broad-spectrum programs which combine inpatient and outpatient care, stress aggressive outreach, involvement of collaterals, adjunctive use of Antabuse, and behavior therapy, but the empirical evidence is not convincing-in one review of 23 outcome studies, seven of eight comparisons were not statistically reliable (Costello, 1975b)-and the very combining of different approaches suggests that there are no differences between them. In this connection, Baekeland (1977) and Baekeland et al (1975) argued that Alcoholics Anonymous, too, has no higher outcome rates than have other treatments. Armor et al (1976), after adjusting outcomes for client characteristics, found no major effects for treatment type or setting across eight Alcohol Treatment Centers.…”

Section: Modification Of Drinking Behavior (Abstinence or Decrease In...mentioning

confidence: 99%

“…An increasing body of evidence indicates that controlled drinking (variously referred to as normal, social, moderate, or attenuated drinking) is an appropriate objective for treatment of alcoholics (Armor et al,, 1976;Emrick, 1974;Lloyd & Salzberg, 1975;Nathan & Briddell, 1977;Pattison, 1976;Pomerleau, Pertschuk, & Stinnett, 1976;Popham & Schmidt;Sobell & Sobell, 1973. As Baekeland (1977) pointed out, there is considerable reluctance among many clinicians to accept this evidence because of adherence to a physiological loss-of-control theory of alcoholism; controlled drinking as a treatment goal is also objected to on grounds that it may be unsafe for many alcoholics and is premature in our present state of knowledge (Fox, 1976). Lloyd and Salzberg (1975), reviewing the literature on the topic, found little to support a physical model of loss of control but a fair amount of evidence for controlled drinking.…”

Section: Controlled Drinkingmentioning

confidence: 99%

“…Nathan and Briddell (1977) recommend a thorough behavioral assessment in order to arrive at individualized treatment goals, including the functions drinking serves in the client's life, pretreatment consumption behavior, social supports, prior treatment experience, and client expectations. Also, further work on validation of controlled drinking as an index of improvement needs to be done, with multifactorial measures of outcome (Baekeland, 1977;Baekeland et al, 1975).…”

Section: Controlled Drinkingmentioning

confidence: 99%

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Issues in the evaluation of alcoholism treatment.

Blane¹

1977

Professional Psychology

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Outcomes of treatment for alcoholism parallel those reported for psychotherapy generally: improvement 62%-68%, deterioration 6%-10%, and "spontaneous" remission 1 %-33%. Several client characteristics and the amount of treatment are related to improvement, other treatment features are not, and therapist effects and client-treatment-therapist interactions have not been studied. Measurement problems and individual variation in drinking behavior tend to inflate improvement. Controlled drinking not only is an appropriate treatment goal for some alcoholics but also has implications for prevention of alcoholism. Future evaluation research should focus on client-therapist interactions related to entering and remaining in treatment, social climate, cost-benefit analyses, and staffing patterns.Evaluation of treatment for alcoholism has a long, if methodologically undistinguished, history. As early as 1942, Voegtlin and Lemere reviewed studies published between 1909 and 1941 that evaluated any form of treatment for alcoholics and concluded, among other things, that no one form of treatment appeared to be more efficacious than any other, but they questioned the quality of much of the literature. Reviewing evaluations of psychotherapy with alcoholics appearing between 1952and 1963, Hill and Blane (1967 refused to summarize findings about treatment outcome because the results might have been misleading, given the ineptness of the evaluations. Instead, they confined themselves to a discussion of the minimal requirements that outcome studies must meet, noting that only 2 of 49 studies reviewed met accepted standards of evaluation research with regard to design, measurement, analysis, and reporting of results; nearly all the rest took the form of gross retrospective surveys that employed superficial, unreliable, and unvalidated measures and inadequate follow-up procedures.More recent studies and reviews reveal desirable advances in methodological sophistication, notably present in research design, measurement of outcome, and statistical analyses. Emrick (1975) reported that in 72 of 384 studies patients were randomly assigned to treatments or were matched on critical variables; over 90% of these studies have appeared since 1965. More precision in the measurement of drinking behavior, a key outcome variable, has been introduced by using self-report techniques adapted from surveys of drinking behavior in the general population (Cahalan, Cisin, &

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Lithium in the Treatment of Other Psychiatric and Nonpsychiatric Disorders

Schou¹

1979

Arch Gen Psychiatry

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Evaluation of Treatment Methods in Chronic Alcoholism

Cited by 32 publications

References 219 publications

Comparison of Clients Assigned to In-patient and Out-patient Treatment for Alcoholism and Drug Addiction

Comparison of Clients Assigned to In-patient and Out-patient Treatment for Alcoholism and Drug Addiction

Issues in the evaluation of alcoholism treatment.

Lithium in the Treatment of Other Psychiatric and Nonpsychiatric Disorders

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