Family-member involvement to initiate and promote treatment of problem drinkers.

The present study evaluated a method of teaching distressed family members of problem drinkers how to minimize their own distress, reduce the drinking, increase the motivation of the alcoholic to obtain formal treatment and assist in the treatment program. Twelve concerned family members were given either community-reinforcement counseling or a traditional type of counseling (control group). The reinforcement counseling resulted in more alcoholic persons obtaining treatment than did the traditional type and a greater reduction in drinking before the formal treatment was obtained; drinking was reduced further during the joint treatment of the family members and problem drinkers. These results suggest that the drinking of unmotivated alcoholic persons can be reduced by counseling concerned family members in the use of appropriate reinforcement procedures and can lead to the initiation of formal treatment.

Alcoholism treatment by disulfiram and community reinforcement therapy.

Traditional disulfiram treatment has often been ineffective because of a failure to maintain usage. The present study with 43 alcoholics compared: (1) a traditional disulfiram treatment, (2) a socially motivated Disulfiram Assurance program and (3) a Disulfiram Assurance program combined with reinforcement therapy. About five sessions were given for each program. At the 6-month follow-up, the traditional treatment clients were drinking on most days and no longer taking the medication. The Disulfiram Assurance treatment resulted in almost total sobriety for married or (cohabitating) clients but had little benefit for the single ones. The combined program produced near-total sobriety for the single and married clients. These results indicate a promising integration of chemical, psychological and social treatment of alcoholism.

The use of systematic encouragement and community access procedures to increase attendance at Alcoholic Anonymous and Al-Anon meetings.

A difficulty in the treatment of alcoholism is that many alcoholics referred to treatment programs never reach the referral destination, or if they do, they seldom remain involved in those programs. The present study attempted to increase participation in Alcoholics Anonymous and Al-Anon meetings. Twenty clients were selected from an outpatient mental health alcoholism treatment program and randomly assigned to either a standard referral procedure which involved giving the client information about Alcoholics Anonymous or Al-Anon; encouraging the client to attend; and providing information concerning time, date, and location of weekly meetings; or to a systematic encouragement and community access procedure which involved a phone call being made in the counseling session to a local Alcoholics Anonymous or Al-Anon member in which the member briefly talked to the client about the meeting, offered to give a ride to the client and to meet the client before the meeting and having the Alcoholics Anonymous or Al-Anon member call the client the night of the meeting to remind them of it and to encourage them to come. The results of this study showed that 100% of the experimental group attended Alcoholics Anonymous or Al-Anon within 1 week of referral and continued to attend, whereas none of the control group ever attended. The results of this study suggest that the systematic encouragement and community assess procedure are significantly more effective than standard referral systems.