MATCHING TREATMENT TO ALCOHOLISM SUBTYPES

In the field of alcoholism treatment, as in mental health treatment more generally, no one treatment model is equally effective for all patients and problem types. A review of the literature in both alcohol treatment and in psychotherapy research suggests some relationships in common between treatment efficacy and patient coping style, drinking patterns, and family dynamics. This literature suggests that ''internalizing'' alcoholics, whose drinking tends to be steady and to be functionally interwoven with family dynamics, will benefit more from family-systems oriented treatments than from symptom- or individual focused treatments. Conversely, ''externalizing'' alcoholics may derive more benefit from symptom-focused cognitive and behavioral treatments than from family systems treatment. We describe an ongoing research project designed to test these hypotheses and the development of treatment manuals that may increase differential treatment efficacy.