Types of Treatment: Treatment Trends

Some research has indicated that intensive outpatient alcohol/drug treatment is as effective between inpatient treatment. Ritson (1968) found no significant difference in effectiveness between inpatient and outpatient alcoholism treatment programs and questioned the routine hospitalization of alcoholics.

Due to the high cost of inpatient treatment, the trend in the 1990s was to refer more patients to outpatient treatment. Instead of the expensive, traditional, hospital-based 28 day inpatient chemical dependency treatment program, the alternative is intensive outpatient programs for 30-180 days. This is a more appropriate recovery period because it allows support during the time when the recovering alcoholic/addict is most vulnerable to relapse. It also minimizes the costly aspects of inpatient hospitalization.

Managed care is the trend today. Inpatient treatment programs are becoming part of a managed care network in order to survive. Approximately 40 percent inpatient alcohol/drug treatment programs have gone out of business or have been consumed by managed care operations. Certainly, the preferred trend for managed care of alcohol/drug problems is outpatient counseling to minimize cost. As a result, the entire fields of alcohol/drug recovery, mental health, and treatment of co-occurring disorders have been affected by managed care. In his workshops “Brief Targeted Strategic Therapy for Relapse Prevention,” Terence T Gorski (1996) emphasizes treatment that is brief (up to 20 sessions), targeted (What is the problem?), strategic (What am I going to do about it? Step-by-step plan), and outcome focused.

In the 1990’s, there was a major focus on cognitive-behavioral therapies, solution-focused therapy, motivational interviewing, and other techniques that allow for brief, targeted therapies.

Arnold Washton, in his introduction to the book Psychotherapy and Substance Abuse (1995), comments on solution-focused, brief therapy:

“along the way we have discovered that regardless of what the problems are, the solutions to them seem to be so similar and yet so mundane; to do what will be good for clients and their families, such as talking to each other, being open and honest with each other, doing kind deeds, working hard, developing healthy habits, and looking for ways to change tomorrow by creating a vision of what they want.”

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