CRITICAL OVERVIEW OF EVALUATIONS OF ALCOHOLISM-TREATMENT

Most alcoholism treatment evaluations do not use adequate evaluation research designs or an adequate array of outcome measures whose reliability and validity have been established. Data about the durability of treatment effects are also missing. As a result, many evaluation study findings are open to question. Measures of alcohol addiction, general morbidity, and mortality are proposed as essential in evaluating treatment effects, along with the more usual reports of work and criminal history. Estimates of quantity and frequency of alcohol consumption are deemed preferable to current categorizations of alcohol consumption after treatment into moderate or heavy drinking. A large proportion of alcoholics who seek treatment seem to do well even when they do not continue in it. The type of treatment provided does not seem to improve chances of success. Lifestyle and community factors are probably influencing outcomes of treatment; however, these have not been taken into account in most studies. Attempts to improve treatment program management by evaluation studies hold promise. Review by professional standards, management by exception, and cost effectiveness studies have been undertaken in isolated instances. Several cost effectiveness indicators for state alcoholism and treatment programs are proposed for use with available data. Copyright © 1979, Wiley Blackwell. All rights reserved