Treatment and Rehabilitation of the Chronic Alcoholic

Treatment Methods.- Summary.- References.- 4 Engaging the Alcoholic in Treatment and Keeping Him There.- Detection of the Alcoholic.- High-Risk Groups.- Factors Hindering Identification.- Methods of Identification.- Engaging the Patient at the Referral Stage.- Referral Failures: Extent and Causes.- Remedies.- Keeping the Alcoholic in Treatment.- Dropping Out of Treatment: Extent and Causes.- Remedies.- References.- 5 Toward a Social Model: An Assessment of Social Factors Which Influence Problem Drinking and Its Treatment.- Biological Model.- Psychological Model.- The Origins and Perspectives of a Social Model.- Social Systems Theory and Its Role in the Social Model.- Supracultural Orientation.- Specific-Culture Orientation.- Substructural Orientation.- Social Etiological Factors in Drinking Behavior.- Religious Aspects.- Social Class Influences.- Family Influences.- Ethnic Aspects.- Age, Sex, and Urbanization.- Treatment Approaches.- Alcoholics Anonymous.- Therapeutic Communities.- Halfway Houses.- Group Therapy.- Activity Groups.- Family Therapy.- The Social Learning Approach.- Education Approaches.- Conclusion.- References.- 6 Group Psychotherapy in Alcoholism.- Alcoholics Anonymous.- The Psychology of A. A.- A.A. as a Group.- A.A. as a Therapeutic Network.- A Survey of Group Therapy with Alcoholics.- Conjoint and Family Groups.- Summary.- References.- 7 Family Therapy in Alcoholism.- Family Therapy as a Treatment Modality.- The Family as a System.- The Concept of Homeostasis.- The Concept of the "Identified Patient" or "Scapegoat".- Communication Patterns.- Behavioral Context.- Boundaries.- Family Therapy in Alcoholism.- Phase I: Early Interest in Family Issues and Alcoholism.- Phase II: The Alcoholic Marriage.- Phase III: Concurrent Therapy for Alcoholics and Spouses.- Phase IV: The Adaptation of Family Theory to Alcoholism Therapy.- Phase V: Conjoint Therapy with the Alcoholic Family.- Phase VI: Multiple-Couples and Multiple-Family Group Therapy Approaches.- Al-Anon Family Groups.- Discussion.- References.- 8 Behavioral Assessment and Treatment of Alcoholism.- Behavioral Theories of Alcoholism.- Behavioral Assessment Techniques.- Behavioral Assessment in the Laboratory.- Behavioral Assessment in the Natural Environment.- Behavioral Assessment: Overall Evaluation.- Behavioral Treatment Approaches.- Goals of Treatment.- Modifying the Drinking Response: Aversive Conditioning.- Modifying the Drinking Response: Operant Methods.- Modifying the Drinking Response: Blood Alcohol Level Discrimination Training.- Modifying Associated Behavioral Problems: Systematic Desensitization.- Modifying the Drinking Response and Associated Behavioral Problems: Broad-Spectrum and Multifaceted Therapies.- Modifying the Natural Environment: Community-Reinforcement Counseling and Contingency Management.- Behavioral Treatment in Perspective.- References.- 9 The Role of the Halfway House in the Rehabilitation of Alcoholics.- Halfway Houses.- Origins of Halfway Houses.- A Definition of Halfway Houses.- One Example: The Compass Club.- Major Characteristics of Halfway Houses.- Some Types of Halfway Houses.- Residents.- Patterns of Dependence.- Alcoholics: White-Collar, Blue-Collar, and Skid Row.- Reaction, Impairment, and Resources.- Halfway Houses and their Clientele.- Rehabilitation.- A Definition of Rehabilitation.- Indices of Rehabilitation.- The Social Conditions of Rehabilitation.- Research Findings on Rehabilitation Outcomes.- A Theory of Rehabilitation.- Strains of Group Membership.- Authority and the Halfway House.- Social Types: Ways of Coping with Halfway House Authority.- Ex-Resident Social Roles.- Halfway House Social Types and Ex-Resident Social Roles.- Some Hypotheses on Social Types and Ex-Resident Social Roles.- Types of Halfway Houses and Halfway House Social Types.- Summary and Conclusions.- References.- 10 Evaluation of Treatment Methods in Chronic Alcoholism.- Treatment Goals and Outcome.- Treatment Length.- Spontaneous Improvement, or What Happens to the Untreated Alcoholic?.- Inpatient Treatment.- Effectiveness of Inpatient Treatment.- Patient and Treatment.- Treatment Length and Outcome.- The Effectiveness of Inpatient Psychotherapy.- Hospital versus Outpatient Treatment.- How Necessary Is Aftercare?.- Outpatient Treatment.- Dropping Out of Treatment.- Basic Issues of Outpatient Treatment.- Alcoholics Anonymous (A.A.).- General Considerations.- A.A. Population Characteristics.- Predictors of Success in A.A.- The Effectiveness of A.A..- A.A. Attendance as a Predictor of Success in Other Settings.- Behavioristically Oriented Psychotherapy.- General Considerations.- Aversive Conditioning.- Systmatic Desensitization.- Operant Conditioning.- Drug Treatment.- Implicit Assumptions.- Negative Results in Drug Studies with Alcoholics.- Outcome in Drug Studies.- Summary and Conclusions.- References.- 11 Factors in the Development of Alcoholics Anonymous (A.A.).- Introduction: Crisis for a Hungover Doctor.- The Growth and Size of A.A.- In English-Speaking Lands.- A.A. Growth Worldwide.- The Development of A.A. and Its Structure.- Earliest A.A. Origins.- From"The Big Book" to the G. S. Conference (1938-1955).- Developments Since 1965.- Evaluations of A.A. Effectiveness.- Survey Method.- Representativeness of the Sample.- Findings of the A.A. Board Surveys.- The Literature on A.A.- Material Published by A.A.- Bibliographies.- Significant Early Publications in Mass Media.- Professional, Scientific, and Technical Publications.- Criticisms of A.A.- References.- 12 Role of the Recovered Alcoholic in the Treatment of Alcoholism.- Definitions.- Scope of Chapter.- Roles of the Recovered Alcoholic, Past and Present.- Independent Lay Therapists and Group Programs.- Religious Programs.- Independent Facilities.- Medically and Psychiatrically Sponsored Programs.- Industrial Programs.- Antipoverty Programs.- Courts and Correctional Facilities.- Public Education and Information Agencies.- The Alcoholism Counselor as Member of a Treatment Team.- Unique Advantages of the Recovered Alcoholic as Counselor.- Motivation of Counselors.- Selection of Candidates to Be Counselors.- Training.- Job Responsibility.- Problems Unique to the Recovered Alcoholic as Counselor.- Remuneration and Status.- Thoughts on the Future of Recovered Alcoholics as Counselors.- References.- 13 Training for Professionals and Nonprofessionals in Alcoholism.- Significant Components of Training.- Objectives.- Target Groups.- Settings.- Teaching Methods and Models.- Subject Matter.- Examples of Programs.- Research Program.- University Program.- Community Leaders Program.- Paraprofessionals Program.- Evaluation.- Guidelines for Designing a Training Program.- Conclusion.- References.- 14 Public Health Treatment Programs in Alcoholism.- Alcohol Problems in the United States.- The Rise of Organizational Interest in the Problem of Alcoholism.- Social Involvement with Problems of Alcoholism.- Changing Legal Patterns in the Public Approach to Alcoholism.- Involvement of the Federal Government in Alcoholism Problems.- Patterns of Alcohol Use and Abuse within Communities.- The Scope of Public Health Problems Involved in Alcoholism.- Community Alcoholism Treatment Services.- Using Available Agencies: The Experience of Industry.- A Model Alcoholism Treatment Program.- Prevention of Alcoholism.- Summary.- References.