An experimental investigation of the influence of aftercare on alcoholic relapse.

Abstract

SummaryOne hundred and fifty‐five subjects who had completed a 4‐week residential treatment programme for alcoholism were assigned to one of three aftercare groups: (1) mandatory aftercare in which subjects were contracted to attend four aftercare sessions during the initial 3 months following discharge; (2) voluntary aftercare in which aftercare participation was entirely at the clients' discretion; and (3) no aftercare in which clients were dissuaded from attending aftercare until their fourth month following discharge from inpatient treatment. No differences between groups were found with respect to relapse rate, satisfaction with lifestyle and trait anxiety. In addition, subjects who did not attend aftercare at the treatment centre were not found to make greater use of alternate sources of aftercare (i.e. Alcoholics Anonymous (AA), physicians and other treatment resources). Despite the fact that aftercare participation was not found to be related to outcome, an apparent demand for aftercare was evidenced. In that regard, 66% of the subjects in the Voluntary Group requested aftercare.It is suggested that the results of this study are consistent with the body of literature which contends that there is no advantage to extended therapy in the treatment of alcoholism. Furthermore, the possibility is raised that previous research efforts that have found a positive relationship between aftercare and outcome may have been confounded ty the issue of ‘patient compliance’ with the terms of treatment. That is, subjects who comply with the terms of treatment tend towards better outcomes irrespective of whether the terms of treatment call for aftercare or not. In conclusion, the authors recommend greater individualized aftercare planning for alcoholics and suggest a greater emphasis on ‘processing relapses’.