RECOVERY IN ALCOHOLICS WHO SEEK TREATMENT

The Effectiveness of Recovery In Alcoholics Who Seek Professional Treatment

Table of contents

I. Introduction3

Statement of problem3

Statement of purpose4

Statement of hypotheses6

Limitations6

Assumptions8

Operational definitions8

II. Review of Related Literature9

III. Methodology14

Participants14

Instruments and analysis14

Experimental design15

Procedure18

IV. Conclusion22

References28

I. Introduction

Statement of problem

There is growing evidence that individuals with alcohol use disorders who participate in professional treatment and/or Alcoholics Anonymous (AA) for extended intervals experience better alcohol-related outcomes (Connors et al., 2001 and Jerrell and Ridgely, 1999). However, we know very little about the processes of self-selection and social causation that underlie these findings, nor about how these processes may differ for professional treatment versus AA. Self-selection and social causation are concepts used primarily in psychiatric epidemiology to try to explain how aspects of personal functioning may contribute to the selection of specific social contexts (such as how depression or alcohol abuse results in a lack of social resources), and, in turn, how such social contexts may lead to personal dysfunction (such as how a lack of social resources may result in more severe depression or alcohol abuse) (for an example, see Moos et al., 1998).

As used here, self-selection refers to the process whereby the severity of individuals' alcohol use disorders influences their participation in professional treatment and AA. Social causation refers to the influence of professional treatment and AA on alcohol-related outcomes. More severe alcohol-related problems may be associated with a more extended initial episode of treatment, which, in turn, may lead to more improvement. Then, in a need-based feedback cycle, more impaired individuals may re-enter and remain in treatment; accordingly, extended treatment episodes may no longer be associated with better outcomes.

However, a more socially based process might characterize AA. The pattern for an initial episode is likely to be comparable to that for treatment: more impaired individuals participate in AA for more extended intervals, which are associated with better outcomes. Subsequently, contrary to the process that occurs in treatment, individuals with better initial outcomes may be more accepted and involved in AA groups and thus continue to participate and to experience better outcomes. Continued participation in treatment is likely to be in response to more alcohol-related impairment, whereas continued participation in AA may reflect social cohesion and bonding processes.

Statement of purpose

This study examined the influence of self-selection, as reflected in alcohol-related functioning, on the duration of professional treatment and Alcoholics Anonymous (AA), and the influence of social causation, as reflected in the duration of treatment and AA, on alcohol-related outcomes. A sample of alcoholic individuals was surveyed at baseline and 1, 3, and 8 years later. At each point, participants completed an inventory that assessed participation in treatment and AA since the last assessment and alcohol-related functioning.

There were divergent processes of self-selection and social causation with respect to the duration of participation in professional treatment and AA. Individuals with more severe alcohol-related problems obtained longer episodes of professional treatment, but this self-selection process was much less evident for AA.

Longer participation in professional treatment in the first year predicted better alcohol-related outcomes; however, the ...