McKay J R, Longabaugh R, Beattie M C, Maisto S A, Noel N E
Department of Psychiatry, University of Pennsylvania, Philadelphia 19104.
J Subst Abuse. 1993;5(1):45-59. doi: 10.1016/0899-3289(93)90122-r.
This report examines functioning in the families of alcoholics undergoing outpatient treatment. Alcoholic patients were randomly assigned to two social-learning-based alcoholism treatments, one of which contained a conjoint therapy component. Patients (Pts) and significant others (SOs) provided ratings of family functioning before treatment and at a 6-month follow-up. According to the perceptions of both Pts and SOs, there were significant improvements in family functioning in a number of areas at posttreatment. Contrary to what was expected, however, the improvements were not greater in the conjoint condition. The usefulness of alcoholics' level of autonomy as a matching variable also was explored. According to the perceptions of both Pts and SOs, posttreatment family functioning was better when low-autonomy alcoholics were treated without other family members. There also was evidence that conjoint treatment was more effective with high-autonomy alcoholics and their families, although it was less convincing and limited to the SOs' perceptions. Implications for alcoholism treatment and the limitations of the findings are discussed.
本报告考察了接受门诊治疗的酗酒者家庭的功能状况。酗酒患者被随机分配到两种基于社会学习的酗酒治疗方案中，其中一种包含联合治疗成分。患者（Pts）及其重要他人（SOs）在治疗前和6个月随访时对家庭功能进行了评分。根据患者和重要他人的看法，治疗后家庭功能在多个方面有显著改善。然而，与预期相反，联合治疗组的改善并不更大。还探讨了酗酒者的自主水平作为匹配变量的有用性。根据患者和重要他人的看法，低自主性酗酒者在没有其他家庭成员参与的情况下接受治疗时，治疗后家庭功能更好。也有证据表明，联合治疗对高自主性酗酒者及其家庭更有效，尽管这一证据不太有说服力且仅限于重要他人的看法。文中讨论了对酗酒治疗的启示以及研究结果的局限性。
