Family–oriented treatment for people with alcohol problems in Ireland: a comparison of the effectiveness of residential and community–based programmes

Abstract

Using a naturalistic design involving consecutive referrals self–selected for family–oriented treatment, forty–two participants from a residential programme and twenty–five participants from a community–based programme were assessed on a range of alcohol–use and psychosocial measures before treatment. A proportion of these cases were assessed after treatment and at six months’follow–up. At six months’ follow–up 79 per cent of both the residential and community groups were either abstinent or drinking moderately. However, more members of the residential group (75 per cent) were abstinent at follow–up compared with the community group (36 per cent). In contrast, more members of the community group were moderate drinkers (43 per cent) at follow–up compared with the residential group (4 per cent). At six months’ follow–up, compared with the community group, more members of the residential group showed a clinically significant reduction in recent negative consequences of drinking and psychological adjustment problems. Both groups made significant mean gains on indices of alcohol abuse and psychosocial adjustment but there were important intergroup differences. The residential group showed a greater mean reduction in recent negative consequences from drinking but the community group showed a greater mean reduction in the percentage of days’ heavy drinking.

A Systematic Review of Family-Based Interventions Targeting Alcohol Misuse and Their Potential to Reduce Alcohol-Related Harm in Indigenous Communities

“…Second, reference lists from reviews of family-based approaches targeting alcohol (n = 44), identifi ed by Step 1, were hand-searched for relevant studies not yet identifi ed. This process identifi ed seven relevant studies (Doyle et al, 2003;Dutcher et al, 2009;Fals-Stewart et al, 2005;Howells and Orford, 2006;Latimer et al, 2003;Rychtarik and McGillicuddy, 2005;and Walitzer and Dermen, 2004).…”

“…The delivery mode for interventions targeting problem drinkers and their family members included individual sessions (Boyd-Ball, 2003;Liddle et al, 2009;Nattala et al, 2010;O'Farrell et al, 2008;Slesnick and Prestopnik, 2009;Vedel et al, 2008), individual sessions with concurrent group and/or family/couples sessions (Doyle et al, 2003;Esposito-Smythers et al, 2006;Fals-Stewart et al, 2005;Slesnick and Prestopnik, 2009), group sessions with concurrent family/couples sessions (Doyle et al, 2003;Latimer et al, 2003), family/couples sessions (Fals-Stewart et al, 2005;Nattala et al, 2010;Slesnick and Prestopnik, 2009;Vedel et al, 2008), or group sessions (Fals-Stewart et al, 2005;Latimer et al, 2003;Liddle et al, 2009;Walitzer and Dermen, 2004). Interventions targeting problem drinkers and their family members were delivered in tertiary health care settings (Boyd-Ball, 2003;Doyle et al, 2003;Esposito-Smythers et al, 2006;Fals-Stewart et al, 2005;Latimer et al, 2003;Liddle et al, 2009;Nattala et al, 2010;O'Farrell et al, 2008;Vedel et al, 2008); a research center (Walitzer and Dermen, 2004); and within a home, an offi ce, or a runaway shelter (Slesnick and Prestopnik, 2009). The delivery mode for interventions targeting family members of problem drinkers included individual sessions (Copello et al, 2009;Dutcher et al, 2009;…”

“…Across interventions for problem drinkers and their family members, problem drinking youth (Boyd-Ball, 2003;Esposito-Smythers et al, 2006;Latimer et al, 2003;Liddle et al, 2009;Slesnick and Prestopnik, 2009) or adults (Doyle et al, 2003;Fals-Stewart et al, 2005;Nattala et al, 2010;O'Farrell et al, 2008;Vedel et al, 2008;Walitzer and Dermen, 2004) were targeted. Types of family members targeted in the treatment of problem drinkers included parents (Esposito-Smythers et al, 2006;Latimer et al, 2003;Liddle et al, 2009) or other family members (Boyd-Ball, 2003;Slesnick and Prestopnik, 2009) for adolescent problem drinkers, and spouse (Fals-Stewart et al, 2005;Vedel et al, 2008;Walitzer and Dermen, 2004) or other family members (Doyle et al, 2003;Nattala et al, 2010;O'Farrell et al, 2008) for adult problem drinkers. Interventions for family members only targeted a spouse (de los Angeles Cruz-Almanza et al, 2006;Hansson et al, 2004;Howells and Orford, 2006;Rychtarik and McGillicuddy, 2005) or other family members (Copello et al, 2009;Dutcher et al, 2009;Hansson et al, 2006;Landau et al, 2004) of a problem drinker.…”

The Evaluation of Family Functioning by the Family Assessment Device: A Systematic Review of Studies in Adult Clinical Populations

“…Among the 12 studies in which the FAD did not detect significant changes in family functioning, three studies examined interventions addressed only to patients (Browne et al, 2002;Doyle et al, 2003;LaFrance et al, 2010), one study examined an intervention involving only family members (Brown et al, 1999), two studies examined interventions addressed to both patients and at least one family member (Creamer et al, 1999(Creamer et al, , 2006Valdez et al, 2011), and three studies focused on the impact of different rehabilitation settings in family functioning (Anderson et al, 2000;Evans & Hendricks, 2001;Evans et al, 1998). Among those studies, in three studies the FAD has been administered only to patients (Browne et al, 2002;Doyle et al, 2003 et al, 2010), in six studies only to at least one family member (Brown et al, 1999;Evans & Hendricks, 2001;Evans et al, 1998;Geurtsen et al, 2011;Kissane et al, 2006;Kreutzer et al, 2009), and in three studies to both patients and at least one family member (Anderson et al, 2000;Creamer et al, 1999Creamer et al, , 2006Valdez et al, 2011).…”

Thematic review of family therapy journals in 2003

“…Transporting empirically supported treatments into routine practice settings is in its infancy in North America. However, on this side of the Atlantic, evaluations of community-based programmes, with many of the features listed above, have yielded positive findings (Doyle et al, 2003;Yandoli et al, 2002).…”