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Objective. To examine the effects of telephone prompting on attendance for the start of treatment and retention in treatment in a specialist alcohol clinic. Method. The study setting was a specialist alcohol treatment clinic. Participants were 172 clients attending as out-patients. An ABABAB design was used with planned alternating conditions, respectively, with or without a telephone prompt the day before the client was due to attend, over a succession of six consecutive 4-week periods. Results. Clients who were prompted were more likely to start treatment and attend further treatment sessions than clients who were not prompted. Conclusions. Telephone prompting is a simple and effective way to improve attendance for the start of treatment and retention in alcohol treatment. [ABSTRACT FROM AUTHOR]

A historical summary is given of the clinical application of assessment and treatment procedures emanating from the new model of problem drinking that was emerging in the 1970s contemporaneously with the opening of the Windsor Clinic in Liverpool. Learning from the sometimes unexpected long-term outcomes of treated clients has provided invaluable feedback for this service. Controlled drinking is a goal choice selected by most clients at treatment entry but is a long-term successful drinking status found less commonly than abstinence. A sample of 10 clients who have been successful in maintaining controlled drinking after treatment for an average of 5 years is described. Common strategies that these individuals have adopted – including an initial period of abstinence, maintaining regular attendance at the agency, alcohol consumption levels considerably less than recommended limits and avoiding distilled spirits and solitary drinking – appear to be important. [ABSTRACT FROM AUTHOR]

Objective. To investigate the use of a minimal intervention as a preparation for treatment of alcohol dependency. Method. A randomized-controlled trial with 361 treatment seekers in an alcohol treatment unit in Northwest England. Study variables included recent alcohol intake, participants' views of their drinking problem, and several self-report scale scores. Experimental group participants received an advance leaflet containing advice on reducing alcohol intake. Results. At follow-up participants in the leaflet group were more likely to view their drinking problem as a learnt behaviour. There was a non-significant tendency for more of the leaflet group to attend for assessment by comparison with controls. Significant improvements occurred over time in readiness to change (recognition subscale), self efficacy and dependency, independent of group allocation. Conclusions. The tendency toward increased attendance rates should be confirmed in a larger sample. Findings have potential implications for the usage of treatment preparatory material. [ABSTRACT FROM AUTHOR]

Abstract Because of the need to maximise treatment adherence and minimise costs, the duration of treatment for alcohol problems should not be longer than is necessary to achieve clinical benefit. The present authors have previously demonstrated the effectiveness of a 10-week outpatient treatment programme. In this paper, they evaluate the effects of reducing the length of the programme to 6 weeks by comparing the outcomes to those of the original programme. One hundred and twenty-four patients were followed up 11 months after choosing the revised 6-week programme. Eighty-eight patients (71%) were successfully contacted. Data collected included alcohol-related problems, use of other services, drinking patterns throughout the follow-up period and details of alcohol intake for the week prior to interview. Reducing the programme length significantly increased the number of patients completing the programme at no cost to clinical effectiveness. [ABSTRACT FROM AUTHOR]

Describes treatment outcome following admission to behaviorally oriented residential treatment and investigates the prognostic influence of a number of variables and their interactions on outcome in such a treatment setting. Definition of successful or equivocal outcome and failure; Analysis of sociodemographic factors in predicting outcome.

Annual increases in indices which reflect the extent of alcohol and drug abuse in society result in a considerable cost to industry. Nurses as a professional group have not generally been identified as having a significantly high incidence of staff with problems of alcohol or drug abuse. although there is some evidence that they are more likely than other workers to attend treatment agencies. The role of nurse management in the early recognition and handling of problems can be vital and training material has been developed to encourage appropriate involvement. A brief description and preliminary evaluation of management training is given. Guidelines and policies which clarify the roles of management. trade unions, occupational health and specialist treatment agencies should facilitate the rehabilitation of the nurse with a drink or drug problem and, in doing so. have potential economic as well as personal benefit to the parties involved. [ABSTRACT FROM AUTHOR]

When empowered to select either a residential or a day care treatment programme for problem drinking, more patients favour the latter option. Those completing the full programme, which was similar in content in both settings, were followed up at ≈ 9 months after initial engagement in treatment. Attrition was a major problem, particularly in the day-patient sample. Of the 103 patients who began each programme, 91 completed the residential option but only 23 completed all sessions in the day-patient course. Day-care completers tended to have less severe alcohol-related problems than in-patient completers. They were also older, had experienced fewer episodes of alcohol-related admissions in the past and were less likely to show biochemical evidence of alcohol-related physical damage. Both groups showed positive changes in drinking intake, drink-related problems, the use of adjunct services and the self-ratings of improvement throughout the follow-up period. Outcome in the day programme completers group was, however, generally better than that shown by the in-patients. The results should be interpreted with caution owing to the significant inter-group differences at the start of treatment and the considerably higher non-attendance and attrition rates for the day-care programme. A cognitive-behavioural in-patient programme for alcohol dependent patients can be provided in a day-care setting. For some patients, this option is both attractive and effective. [ABSTRACT FROM AUTHOR]

The current study aimed to investigate the range of influences on people's decisions to seek alcohol treatment and develop a model of treatment-seeking based on participants' accounts. Understanding these influences could inform clinical practice and aid development of effective motivational interventions for the majority of people with alcohol problems who avoid or delay seeking treatment. Individual, semi-structured interviews were conducted with 30 participants who had been referred to an NHS alcohol treatment unit. To ensure, a broad range of treatment-seekers was investigated; participants were recruited according to the principles of maximum variation sampling whereby we interviewed participants at varying stages of engagement. Verbatim transcripts of the interviews were analysed within a thematic analytic framework. Contrary to expectations participants had not worked up gradually to seek help. Rather, participants described the decision to seek treatment as sudden and prompted by events that mirrored the extent of their drinking. Participants described their response to these mirroring events as both passive and autonomous. Furthermore, a window of opportunity was initiated by these events, during which participants were responsive to suggestions to make changes to their drinking and practitioners could influence the treatment-seeking process. This evidence is inconsistent with influential models of treatment-seeking behaviour. It suggests an alternative view that treatment-seeking is externally influenced and the result of a step-wise rather than gradual process. The findings indicate how practitioners might encourage treatment-seeking, particularly for participants who may not appear ready to change. [ABSTRACT FROM AUTHOR]

Previous research has suggested that alcohol dependency may be associated with particular cognitive schemas. The objective of this study was to examine the severity of reported maladaptive schemas, and of anxiety and depression levels of an alcohol dependent group prior to and following a period of abstinence, and in comparison with a non-clinical sample. A total of 100 participants, comprising an alcohol dependent clinical (ADC) group ( n = 50) and a non-clinical group ( n = 50), were recruited. Data were collected on demographic characteristics, drinking patterns, severity of alcohol dependence, depression, anxiety, and maladaptive schemas. ADC participants reported higher levels of depression and anxiety than did the non-clinical group immediately before a period of abstinence. The groups differed significantly on 6 of 15 schema beliefs. Following a brief (3-week) period of abstinence and participation in a psycho-educational program, the ADC group demonstrated significant improvements in relation to depression, anxiety, and 13 out of 15 maladaptive schema beliefs. Further research is required to understand the association and potential relevance of particular schemas to alcohol dependency. [ABSTRACT FROM AUTHOR]