A minority of alcohol dependent persons ever enters specialized treatment units and there is little information on why they are admitted. This study of 50 consecutive clients revealed that admission occurred in the presence of a recent psychosocial crisis in an otherwise protracted disorder. Motivation for treatment was difficult to assess. The decision to admit for inpatient rather than outpatient treatment tended to be influenced by the distressed state of the client or the degree of disturbance created in relation to the crisis. The complex issues of crisis, motivation and treatment compliance are reviewed.