Alcoholism is a major public health problem that affects families as well as individuals. Alcoholism treatments have typically focused upon the drinking behaviors of the identified patient and only secondarily have attempted to alter patterns of family interactions. Literature of the past decade, however, has suggested for some subtypes of alcoholics, drinking may reflect and be perpetuated by a disturbance of the family system. Two alcoholics subtypes are most relevant to this issue. The first subtype consists od internalizing or neurotiform drinkers whose drinking may be supported by the family system. Among these alcoholics, drinking may reduce family tension and divert attention away from family problems. The second subtype consists of externalizing or characterological alcoholics, whose drinking behaviors represent a pattern of impulsive behavior that supercedes the influence of the family system. This latter subtype represents an individual problem and, unlike the former, drinking tends to disrupt interpersonal relationships rather than attenuate their intensity. On the basis of these characterizations, it is hypothesized that differential rates of effectiveness will be observed among these two subtypes of alcoholics when behavioral focused and family systems-focused treatments are compared. The current projects represents a revision of a previous submission, the focus of which is to test two treatment models on patients representing these two subtypes of alcoholics. Changes and additions are indicated by bold type.
