Evaluation of Psychotherapy with Alcoholics; A Critical Review

Abstract

A review of 49 studies published in the United States and Canada from 1952 through 1963 which reported evaluation of psychotherapy with alcoholics was undertaken. These studies fail to live up to their potential for contributing to knowledge in the field because of a failure to meet many methodological requirements for the conduct of evaluative research. Requirements which should be considered in the planning of such research are as follows: 1. Use of controls: The majority of studies used an inadequate design, that of employing the patient as his own control. A few employed another treatment group as a control condition but almost invariably failed to meet the constraint of matching groups or of random assignment of patients to various treatments. The key variable, motivation for treatment, was not controlled for in any study, although two sets of investigations made serious attempts to do so. 2. Subject selection procedures: Although a certain degree of bias is inherent in evaluative research, many of the studies showed severe but easily remediable deficiencies in sampling procedures. In only a few instances were explicit sampling constraints employed to methodological advantage. 3. Selection and definition of criterion variables: The behavior most frequently evaluated was change in drinking pattern, with the ideal goal of abstinence. The question is raised as to whether changes in drinking behavior are measurable, and whether decrease or cessation of drinking is a relevant…