ABSTINENCE OR CONTROLLED DRINKING IN CLINICAL-PRACTICE - INDICATIONS AT INITIAL ASSESSMENT

Previous research has suggested two leading hypotheses concerning which excessive drinkers can re-establish control: one based upon level of dependence, the other upon the client''s personal persuasion. Using initial assessment data from 46 clients of a clinical psychology alcohol problems service (30 men, 16 women), an attempt was made to operationalise the concepts of dependence and personal persuasion using a variety of indicators of each. Although SADQ scores and Rand definite alcoholism were in general agreement, there were a number of borderline instances and cases of disagreement, and neither was in good agreement with estimates of problem duration, nor with reports of recent or earlier attainment of abstinence or contol. Indicators of personal persuasion were more consistent. Those with dependence indicators for abstinence tended to prefer abstinence as a goal, but there were many departures from this pattern particularly for women. It is concluded that in clinical practice it will be very difficult to make a clear cut recommendation about treatment goal at initial assessment except in a few cases.