[Medico-psycho-social rehabilitation of alcoholics: a multidisciplinary approach].

In heavy problem drinkers with loss of control and severe disruptive behavioral disorders, the general practitioner cannot offer a comprehensive program coping with all the disturbed parameters: those of the individual, the family, the friends, the working and leisure time environment. In these situations a multidisciplinary team approach is very helpful. A close collaboration between physician, nurse, social worker and psychologist enables the team to implement the comprehensive program in a more efficient way and with the active participation of the patient, his family and social environment. In this paper the author deals with the inner structure of the team model. Today there is a shifting from the traditional "paternalistic team model" (i.e. medical leadership) toward a more democratic team structure as a result of emancipatory pressures from the social work profession. The author presents a critical view of extreme emancipatory tendencies aiming at abolishing the disease concept of alcoholism and the team members professional identity as well as the role differences between therapist and client. The professional rehabilitation model is compared with the Alcoholics Anonymous self help model, and possibilities and limits of an interdisciplinary cooperation between the two approaches are stressed.