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Aftercare in Alcoholism Treatment

A Review
Chapter
Part of the Applied Clinical Psychology book series (ABBI, volume 13)

Abstract

Successful treatment of a chronic condition, such as alcohol dependence, often involves extended rehabilitation. As such, the goal of rehabilitation is to move the patient back into normalized interpersonal and community life. Alcohol dependence, like other addictive behaviors, poses a special challenge to the treatment community. Treatment programs are successful in helping patients achieve sobriety, but are often less successful in helping patients maintain sobriety. Alcohol dependence has a rate of recidivism second only to schizophrenia (National Institute of Mental Health, 1973) and has a high rate of relapse following treatment (Hunt, Barnett, & Branch, 1971; Litman, Eiser, & Taylor, 1979). This suggests that inpatient treatment may be necessary but not sufficient for full recovery. In fact, Hunt, Barnett, and Branch’s (1971) data indicate that patients are at great risk for relapse in the first month following inpatient discharge.

Keywords

Alcohol Dependence Inpatient Treatment Community Mental Health Center Alcohol Treatment Drinking Status 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. Ahles, T. A., Schlundt, D. G., Prue, P. M., & Rychtarik, R. G. (1983). Impact of aftercare arrangements on the maintenance of treatment success in abusive drinkers. Addictive Behaviors, 8, 53–58.PubMedCrossRefGoogle Scholar
  2. Baekelund, F. (1977). Evaluation of treatment methods in chronic alcoholism. In B. Kissin & H. Begleiter (Eds.), The biology of alcoholism: Treatment and rehabilitation of the chronic alcoholic (pp. 385–440 ). New York: Plenum Press.Google Scholar
  3. Caddy, G. R., Addington, H. J., & Trenschel, W. R. (1985). A comparative evaluation of aftercare technologies in the management of alcohol dependence. Unpublished manuscript, Nova University, Department of Psychology, Fort Lauderdale, FL.Google Scholar
  4. Chvapil, M., Hymes, H., & Delamstro, D. (1978). Outpatient aftercare as a factor in treatment outcome; A pilot study. Journal of Studies on Alcohol, 39, 540–554.PubMedGoogle Scholar
  5. Costello, R. M. (1975). Alcoholism treatment evaluation: In search of methods II. Collation of two-year follow-up studies. International Journal of the Addictions, 10, 857–867.PubMedGoogle Scholar
  6. Costello, R. M. (1980). Alcoholism aftercare and outcome: Cross-lagged and path analyses. British Journal of Addiction, 75, 149–153.CrossRefGoogle Scholar
  7. Cronkite, R. C., & Moos, R. H. (1980). Determinants of post treatment functioning of alcoholic patients: A conceptual framework. Journal of Consulting and Clinical Psychology, 48, 305–316.PubMedCrossRefGoogle Scholar
  8. Davidson, A. F. (1976). An evaluation of the treatment and aftercare of a hundred alcoholics. British Journal of Addiction, 71, 217–224.CrossRefGoogle Scholar
  9. Donovan, D. M., & Chaney, E. F. (1985). Alcoholic relapse prevention and intervention: Models and methods. In G. A. Marlatt & J. R. Gordon (Eds.), Relapse prevention: Maintenance strategies in the treatment of addictive behaviors (pp. 351–416 ). New York: Guilford Press.Google Scholar
  10. Dubourg, G. O. (1969). Aftercare for alcoholics: A follow-up study. British Journal of Addiction, 64, 155–163.CrossRefGoogle Scholar
  11. Emrick, C. D., & Hansen, J. (1983). Assertions regarding the effectiveness of treatment for alcoholism: Fact or fantasy? American Psychologist, 38, 1078–1088.PubMedCrossRefGoogle Scholar
  12. Erwin, J. E., & Hunter, J. J. (1984). Prediction of attrition in alcoholic aftercare by scores on the EFT & two Piagetian tasks. Journal of Consulting and Clinical Psychology, 52, 354– 358.PubMedCrossRefGoogle Scholar
  13. Finney, J. W., Moos, R. H., & Mewborn, C. R. (1980). Posttreatment experiences and treatment outcome of alcoholic patients six months and two years after hospitalization. Journal of Consulting and Clinical Psychology, 48, 17–29.PubMedCrossRefGoogle Scholar
  14. Finney, J. W., Moos, R. H., & Chan, D., (1981). Length of stay and program component effects in the treatment of alcoholism: A comparison of two techniques for process analysis. Journal of Consulting and Clinical Psychology, 49, 120–131.PubMedCrossRefGoogle Scholar
  15. Harmon, S. K., Latinga, L. J., & Costello, R. M. (1982). Aftercare in chemical dependence treatment. Bulletin of the Society of Psychologists in Substance Abuse, 1, 107–110.Google Scholar
  16. Hunt, W. A., Barnett, L. W., & Branch, L. G. (1971). Relapse rates in addiction programs. Journal of Clinical Psychology, 27, 455–456.PubMedCrossRefGoogle Scholar
  17. Intagliata, J. (1976). A telephone follow-up procedure for increasing the effectiveness of a treatment program for alcoholics. Journal of Studies on Alcohol, 37, 1330–1335.PubMedGoogle Scholar
  18. Joint Commission on Accreditation of Hospitals (1974). Accreditation Manual for Alcoholism Programs. Chicago, IL: Author.Google Scholar
  19. Katz, A., Morgan, M. Y., & Sherlock, S. (1981). Alcoholism treatment in a medical setting. Journal of Studies on Alcohol, 39, 136–143.Google Scholar
  20. Kirk, S. A., & Masi, J. (1978). Aftercare for alcoholics: Services of community mental health centers. Journal of Studies on Alcohol, 39, 345–547.Google Scholar
  21. Litman, G. K., & Oppenheim, A. N. (n.d.). A model for alcoholism survival. Unpublished manuscript, Addiction Research Unit, Institute of Psychiatry, Maudsley Hospital, London, England.Google Scholar
  22. Litman, G. K., Eiser, J. R., Rawson, N. S., & Oppenheim, A. N. (1979). Differences in relapse précipitants and coping behavior between alcoholic relapsers and survivors. Behaviour Research and Therapy, 17, 89–94.PubMedCrossRefGoogle Scholar
  23. Litman, G. K., Eiser, J. R., & Taylor, C. (1979). Dependence, relapse, and extinction: A theoretical critique and behavioral examination. Journal of Clinical Psychology, 35, 192–199.PubMedCrossRefGoogle Scholar
  24. Maisto, S. A., & McCollam, J. B. (1980). The use of multiple measures of life health to assess alcohol treatment outcome: A review and critique. In L. C. Sobell, M. B. Sobell, & E. Ward (Eds.), Evaluating alcohol and drug abuse treatment effectiveness (pp. 15–76 ). New York: Pergamon Press.Google Scholar
  25. McLachlan, J. F. C. (1972). Benefit from group psychotherapy as a function of patient therapist match on a conceptual level. Psychotherapy Theory Research and Practice, 9, 317–323.CrossRefGoogle Scholar
  26. McLachlan, J. F. C. (1974). Therapy strategies, personality orientation and recovery from alcoholism. Canadian Psychiatric Association Journal, 19, 25–30.PubMedGoogle Scholar
  27. Marlatt, G. A., & Gordon, J. R. (1980). Determinants of relapse: Implications for the maintenance of behavior change. In P. O. Davidson & S. M. Davidson (Eds.), Behavioral medicine: Changing health lifestyles (pp. 410–452 ). New York: Brunner/Mazel.Google Scholar
  28. Moos, R. (1974). Ward Atmosphere Scale Manual. Palo Alto: Consulting Psychologists Press.Google Scholar
  29. Nathan, P. E,, & Lansky, D. (1978). Common methodological problems in research on the addictions. Journal of Consulting and Clinical Psychology, 46, 713–726.PubMedCrossRefGoogle Scholar
  30. National Institute of Mental Health. (1973). Utilization of Mental Health facilities by persons diagnosed with alcohol disorders (DHEW Publication no. HSM 73–9114 ). Washington, DC: U.S. Government Printing Office.Google Scholar
  31. Page, R. D., & Schaub, L. H. (1979). Efficacy of 3 vs 5 week alcohol treatment program. International Journal of the Addictions, 14, 697–714.PubMedGoogle Scholar
  32. Panepinto, W., Galanter, M., Bender, S. H., & Strochlic, M. (1980). Alcoholics transition from ward to clinic: Group orientation improves retention. Journal of Studies on Alcohol, 41, 940–945.PubMedGoogle Scholar
  33. Pittman, D. J., & Tate, R. L. (1969). A comparison of two treatment programs for alcoholics. Quarterly Journal of Studies on Alcohol, 30, 888–899.PubMedGoogle Scholar
  34. Pokorny, A., Miller, B., & Cleveland, S. (1968). Response to treatment of alcoholism: A follow-up study. Quarterly Journal of Studies on Alcohol, 29, 364–381.PubMedGoogle Scholar
  35. Pokorny, A., Miller, B., Kanas, T., & Vallès, J. (1973). Effectiveness of extended aftercare in the treatment of alcoholism. Quarterly Journal of Studies on Alcohol, 34, 435– 443.PubMedGoogle Scholar
  36. Pratt, T. C., Linn, M. W., Carmichael, J. S., & Webb, N. L. (1977). The alcoholic’s perception of the ward as a predictor of aftercare attendance. Journal of Clinical Psychology, 33, 915–918.PubMedCrossRefGoogle Scholar
  37. Prochaska, J. O., & DiClemente, C. C. (1983). States and processes of self-change of smoking: Toward an integrative model of change. Journal of Consulting and Clinical Psychology, 51, 390–395.PubMedCrossRefGoogle Scholar
  38. Prue, D. M., Keane, T. M., Cornell, J. E., & Foy, D. W. (1979). An analysis of distance variables that affect aftercare attendance. Community Mental Health Journal, 15, 149– 154.PubMedCrossRefGoogle Scholar
  39. Ritson, B. (1969). Involvement in treatment and its relation to outcome amongst alcoholics. British Journal of Addiction, 64, 23–29.CrossRefGoogle Scholar
  40. Seigel, C., Alexander, M. J., & Lin, S. (1984). Severe alcoholism in the Mental Health sector: II. Effects of service utilization on readmission. Journal of Studies on Alcohol, 45, 510–516.Google Scholar
  41. Tuchfeld, B. S. (1981). Spontaneous remission in alcoholics: Empirical observations and theoretical implications. Journal of Studies on Alcohol, 42, 626–641.PubMedGoogle Scholar
  42. Van Dijk, W. K., & Van Dijk-Koffeman, A. (1973). A follow-up study of 211 treated male alcoholics. British Journal of Addiction, 68, 3–24.CrossRefGoogle Scholar
  43. Vannicelli, M. (1978). Impact of aftercare in the treatment of alcoholics: A cross-lagged panel analysis. Journal of Studies on Alcohol, 39, 1875–1886.PubMedGoogle Scholar
  44. Walker, R. D., Donovan, D. M., Kivlahan, D. R., & O’Leary, M. R. (1983). Length of stay, neuropsychological performance and aftercare: Influences on alcohol treatment outcome. Journal of Consulting and Clinical Psychology, 51, 900–911.PubMedCrossRefGoogle Scholar
  45. World Health Organization. (1955). Report on the alcoholism subcommittee (Technical Report, series No. 42 ). Geneva: Author.Google Scholar

Copyright information

© Plenum Press, New York 1986

Authors and Affiliations

  1. 1.Department of PsychologyUniversity of WashingtonSeattleUSA
  2. 2.Health Services Research and DevelopmentSeattle Veterans Administration Medical CenterSeattleUSA
  3. 3.Department of Psychiatry and Behavioral SciencesUniversity of WashingtonSeattleUSA
  4. 4.Alcohol Dependence Treatment ProgramSeattle Veterans Administration Medical CenterSeattleUSA

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