Research on alcoholism treatment outcome is expanding at an ever-increasing rate. Periodic reviews are needed to take stock of what has been accomplished in the past and to point to productive directions for future research. This application proposes to continue a comprehensive, quantitative review of the alcoholism treatment outcome research literature. The proposed syntheses will have three foci: (a) the relative effectiveness of different treatment modalities; (b) the effects of potential prognostic indicators (i.e., patient characteristics assessed at treatment intake as they relate to posttreatment functioning); and (c) patient-treatment interaction effects (i.e. whether different types of patients experience better outcomes in different types of treatment). Each of these foci is of interest in its own right and all are related in that they provide information relevant to the issue of patient-treatment matching. The proposed project will add to an existing dataset so that it will be possible to describe the nature of alcoholism treatment research over a 29-year period and the extent to which it reflects various components of methodological quality (e.g. rigorous research design). It also will be possible to determine whether the methodological quality of alcoholism treatment outcome studies has been increasing over time. In addition, the review will provide evidence on the extent to which research has been underpowered. The proposed work will break new ground in research synthesis techniques with respect to estimating the effectiveness of treatment. Because the body of comparative treatment research in the alcohol field contains no consistent, standard treatment or control condition, a traditional meta-analysis with between-group effect sizes is neither applicable nor meaningful. Consequently, alternative approaches will be used to estimate the magnitude of effects of different treatment modalities. In developing and applying alternative techniques, we will build on our previous efforts to (a) do focused comparisons of alternative treatment modalities; (b) adjust box-score indices of treatment effectiveness by taking into account the """"""""strength of the competition"""""""" against which different modalities have been pitted; and (c) model abstinence and """"""""success"""""""" (abstinence plus nonproblem drinking) rates across studies. However, we propose to apply these approaches using between-and within-treatment-group effects sizes instead of box-score effectiveness indices, and in addition to simple rates of abstinence and """"""""success.""""""""
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