Outcomes in alcoholism treatment
A broad review of alcoholism studies spanning the past 35 years indicating considerable progress--increasing numbers of individuals have been identified and treated for alcohol abuse and alcoholism. Many viewpoints in the current debate over treatment goals and outcome measures are outlined and recent conceptual and empirical advances in the assessment of treatment outcomes are presented. Outcome criteria have implications far beyond classifying successes and failures; they imply assumptions about how alcoholism is defined, the etiology of the disorder, how well a certain treatment works, and the diagnostic criteria for who should be called an alcoholic. A multiple-outcome approach is used in reviewing treatment outcomes--abstention, level of consumption if nonabstainer, behavioral impairment resulting from alcohol abuse, marital stability, job stability, and earnings. Studies on the differential effects of treatment include variations in treatment setting, treatment type, and amount and duration of treatment. Natural remission from alcoholism, given no treatment, is also considered.