Although there is some evidence that inpatient and outpatient alcohol rehabilitation may be equally effective for middle class individuals, this work had not been extended to alcoholics low in social resources and stability. Further, studies of alcohol rehabilitation have been concerned with the effectiveness of a program or a modality and have thus far directed little attention to the effectiveness of specific treatment elements. Finally, the patient-treatment matching studies conducted have been promising, but have been limited in the scope of the variables included. The proposed research will attempt to accomplish two objectives in determining the relative efficacy and costs of inpatient and day-hospital alcohol rehabilitation: 1) examine four common treatment elements associated with most rehabilitation programs (group therapy, alcohol education, AA, recreational therapy), 2) develop optimal patient-treatment matches which will result in increased treatment effectiveness and reduced costs. This 4-year project compares the relative effectiveness and costs of inpatient and day-hospital alcohol rehabilitation for alcohol dependent individuals with low social stability and resources. Five hundred alcoholics seeking rehabilitation will be randomly assigned to one of the two forms of treatment. Baseline evaluation will include measures of alcoholism severity, psychiatric diagnoses and psychopathology, social stability/resources, familial alcoholism, biochemical indices of medical status. Measures of the treatment process will be obtained by standardizing and recording treatment received, assessing patients' perceptions of the treatment environment, and rating progress made toward achieving the objectives of the four major treatment elements. Follow-up evaluation, which will include most of the baseline measures, will be completed at six and twelve months post treatment evaluation. Multivariate statistics will be employed to examine the data.
| Strohmetz, D B; Alterman, A I; Walter, D (1990) Subject selection bias in alcoholics volunteering for a treatment study. Alcohol Clin Exp Res 14:736-8 |
