Broadening the Base of Treatment for Alcohol Problems (1990) / Chapter Skim
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Chapter 16--Populations defined by functional characteristics
Chapter 16--Populations defined by functional characteristics
Pages 381-398
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From page 381... ...
For some of these functionally defined special populations (e.g., drinking drivers and skid row public inebriates) , specialized agencies have developed and form a discrete subsystem within the specialist alcohol treatment sector described in Chapter 4.
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From page 382... ...
Additional differentiation has taken place, such as the development of long-term individually oriented counseling programs and more intensive residential treatment programs targeted at multiple offenders (Mann et al., 1983; Wells-Parker et al., 1986; McCarty and Argeriou, 1988~. From 1971 until 1982 NIAAA sponsored a categorical grant program to serve drinking drivers; the program ended with the advent of the block grant.
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From page 383... ...
On the one hand, they encourage offenders to enter treatment. On the other hand, by allowing the offender to avoid or circumvent what appear to be particularly effective deterrent licensing sanctions, the programs may actually be counterproductive.
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From page 384... ...
The most elaborate drinking driver classification system yet proposed for differential treatment planning includes seven groups or subtypes (Steer et al., 1979~. Using four indexes of alcohol impairment, records for a pool of 1,500 male DWI arrestees that had been seen in NIAAA-funded treatment programs were cluster analyzed.
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From page 385... ...
They rejected the conceptualization that alcohol problems were merely a symptom of an underlying psychiatric condition requiring psychoanalytically oriented dynamic psychotherapy or psychopharmacological treatment. Initially, many of the recovering alcoholics who were involved in developing what was then the "news Minnesota model intensive residential and hospital-based treatment programs and specialist halfway houses avoided any relationships with psychiatrists and the specialty mental health system.
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From page 386... ...
As with other special populations, many of the available studies on dual-diagnosis patients have focused on epidemiological and diagnostic considerations-that is, on determining how many of the persons seen in various community and treatment settings have concomitant DSM-III diagnoses of alcohol dependence and "another psychiatric disorder, including dependence on other drugs (Hesselbrook et al., 1985; H
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From page 387... ...
The detoxification center had merely replaced the drunk tank as a Revolving door." The explanation given for the failure to see dramatic change in public inebriety was the inadequacy of the resources committed to meeting the extensive needs for health care, supportive living arrangements, gradual but consistent engagement in treatment by meeting survival needs as well as treating the drinking behavior (Blumberg et al., 1973; Finn, 1985~. Gradually, agencies serving public inebriates began to develop the added social support, health care, and vocational counseling services required to supplement the specific treatment modalities they offered to reduce problem drinking (e.g., Moos et al., 1978~.
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From page 388... ...
The specific configuration of services needed, the possibility that different configurations are necessary for different subgroups, and the effectiveness of involuntary commitment have not been empirically tested despite the almost 20 years of identification of the public inebriate and skid row alcoholic as a special population. College Students Recently, college students as a subgroup of adolescents have become identified as a new special population.
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From page 389... ...
Opposition to "responsible drinking" as a goal for underage drinkers has been stated by several national groups, including the National Council on Alcoholism and the National Institute on Alcohol Abuse and Alcoholism. Second, college students have flexible class and work schedules and are under minimal supervision while on campus.
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From page 390... ...
They are, however, heterogeneous on the other key variables that have served to identify special populations (gender, race and ethnicitr, social class, living situation, personality type) , and this heterogeneity must be considered in program planning
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From page 391... ...
Other colleges and universities have already established primary prevention programs, and a few have established their own special population treatment programs (e.g., Rutgers)
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From page 392... ...
The recommendations from those meetings were to include codependency status as part of the national uniform minimal data set. In the private sector, the area is sufficiently established that there are specific codependency treatment programs and codependency units in alcohol programs (Cermak, 1984, 1986~.
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From page 393... ...
Despite the importance that has been attached to the defining characteristics of a special population in developing treatment strategies based on clinical experience and theories about the etiology and maintenance of alcohol problems within each population, there have been few studies that test the differential effectiveness of these approaches. The conclusion that there is an inexcusable lack of systematic research on the application of specific treatment approaches holds for those special populations defined by functional characteristics as well as for those defined by structural characteristics.
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From page 394... ...
1977. Summary, Conclusions, and Recommendations of the Final Report on Problem Drinking Driver Programs Funded by NIAAA Prepared for the National Institute on Alcohol Abuse and Alcoholism.
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From page 395... ...
Prepared for the National Highway Traffic Safety Administration. Publication DOT HS 806-274.
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From page 396... ...
1988. Alcohol-related problems, marital disruption and depressive symptoms among adult children of alcohol abusem in the United States.
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From page 397... ...
Prepared for the IOM Committee for the Study of Treatment and Rehabilitation Services for Alcoholism and Alcohol Abuse, June. Russell, M., C
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From page 398... ...
1988. Substance use disorders and college students: Inpatient treatment Issues -- A model of practice.
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