In this congressionally mandated study, an expert committee of the Institute of Medicine takes a close look at where treatment for people with alcohol problems seems to be headed, and provides its best advice on how to get there. Careful consideration is given to how the creative growth of treatment can best be encouraged while keeping costs within reasonable limits. Particular attention is devoted to the importance of developing therapeutic approaches that are sensitive to the special needs of the many diverse groups represented among those who have developed problems related to their use of "man's oldest friend and oldest enemy." This book is the most comprehensive examination of alcohol treatment to date.

Alcohol Problems in the United States: Twenty Years of Treatment Perspective presents an overview of trends in the treatment of alcohol problems over a 20-year period from three vantage points: broader treatment perspectives, experienced views from the field, and personal perspectives. Some of the field's foremost experts, including Alcoholics Anonymous historian Dr. Ernest Kurtz and Dr. Robert Sparks, who chaired the committee that authored the Institute of Medicine’s highly influential study, “Broadening the Base of Treatment for Alcohol Problems,” provide practical information on the vital treatment issues you deal with every day. By detailing treatment histories of the recent past, contributors offer a look at likely future trends that will help keep your treatment methods up to date. Treatment topics addressed in Alcohol Problems in the United States: Twenty Years of Treatment Perspective include: alcoholism as a disease alcohol dependence and mental illness the role of spirituality the growth and decline of treatment programs at the Mayo Clinic and Timberlawn Hospital and the special treatment needs of women, youths, African Americans, Native Americans, the Latino community, and the incarcerated. Alcohol Problems in the United States: Twenty Years of Treatment Perspective chronicles the story of alcohol treatment from historical and personal perspectives, offering the opportunity to anticipate future trends in the many challenges associated with alcohol problems. The book is an essential resource for professional alcoholism counselors, social workers, psychologists, physicians, clergy, nurses, employee assistance professionals, and anyone who provides care and service to those struggling with alcohol.

The last three decades have seen an explosion of social, psychological and clinical research to identify effective strategies to prevent and treat alcohol-related problems. This “Essential Handbook” contains an updated selection of reviews of “what works” drawn from the critically acclaimed International Handbook of Alcohol Dependence and Problems. Selected specifically for health and other professionals, who need to provide effective responses in their work, these authoritative, science-based reviews are a distillation of the more practical elements, designed to save time for the busy practitioner.

This book is the first complete guide to implementing the Community Reinforcement Approach (CRA), an empirically based, highly effective cognitive-behavioral program for treating alcohol problems. CRA acknowledges the powerful role of environmental contingencies in encouraging or discouraging drinking, and attempts to rearrange these contingencies so that a non-drinking lifestyle is more rewarding than a drinking one. Unique in its breadth, the approach utilizes social, recreational, familial, and vocational strategies to aid clients in the recovery process. This authoritative manual is a hands-on guide to applying these therapeutic procedures. The authors present a step-by-step guide to each component of the treatment plan, many of which have been shown to be effective forms of treatment in themselves. Topics include behavioral skills training, social and recreational counseling, marital therapy, motivational enhancement, job counseling, and relapse prevention. Each chapter provides detailed instructions for conducting a procedure, describes what difficulties to expect, and presents strategies for overcoming them. Sample dialogues between clients and therapists, annotated by the authors, further illuminate the treatment process. The book concludes with a chapter that both addresses the common mistakes made when implementing CRA, and emphasizes the flexibility and benefits of this total treatment plan. This book is an invaluable resource for a wide range of practitioners including psychologists, psychiatrists, substance abuse counselors, and social workers.

It sounds simple: Women who drink while pregnant may give birth to children with defects, so women should not drink during pregnancy. Yet in the 20 years since it was first described in the medical literature, fetal alcohol syndrome (FAS) has proved to be a stubborn problem, with consequences as serious as those of the more widely publicized "crack babies." This volume discusses FAS and other possibly alcohol-related effects from two broad perspectives: diagnosis and surveillance, and prevention and treatment. In addition, it includes several real-life vignettes of FAS children. The committee examines fundamental concepts for setting diagnostic criteria in general, reviews and updates the diagnostic criteria for FAS and related conditions, and explores current research findings and problems associated with FAS epidemiology and surveillance. In addition, the book describes an integrated multidisciplinary approach to research on the prevention and treatment of FAS. The committee Discusses levels of preventive intervention. Reviews available data about women and alcohol abuse and treatment among pregnant women. Explores the psychological and behavioral consequences of FAS at different ages. Examines the current state of knowledge about medical and therapeutic interventions, education efforts, and family support programs. This volume will be of special interest to physicians, nurses, mental health practitioners, school and public health officials, policymakers, researchers, educators, and anyone else involved in serving families and children, especially in high risk populations.