Treatment of alcohol problems.

This paper gives an overview of the variety of approaches that have been used in the treatment of alcohol problems. There is good evidence that approaches directed at improving social and marital relationships, self-control and stress management are effective. There is at present little to suggest that aversion therapies, confrontational interventions, educational lectures or films and group psychodynamic therapy are effective, nor is there good evidence yet that use of psychotropic medications is effective. However, it may be that therapies that have not proved effective with the broad range of individuals with alcohol problems might prove effective with selected cases. Future research should place more emphasis on determining the kinds of alcohol problems that are likely to respond to different kinds of treatments directed at different kinds of goals and by different kinds of practitioners. The base of treatment should be broadened to include the large numbers of individuals with alcohol problems but who could not be considered as alcohol-dependent. This would have to involve a wide range of primary care and generic workers and include use of brief interventions.