Details

Subject(s)

• Alcoholism—Treatment [Browse]
• Alcoholics—Rehabilitation [Browse]

Related name

• Institute of Medicine (U.S.). Committee for the Study of Treatment and Rehabilitation Services for Alcoholism and Alcohol Abuse [Browse]
• National Institute on Alcohol Abuse and Alcoholism (U.S.) [Browse]

Series

• Publication (National Research Council (U.S.)) ; no. 4038. [More in this series]
• [Publication ; 4038]

Notes

• "Committee for the Study of Treatment and Rehabilitation Services for Alcoholism and Alcohol Abuse"--P. v.
• "Contract no. ADM-281-87-003 with the National Institute on Alcohol Abuse and Alcoholism of the Department of Health and Human Services"--T.p. verso.

Bibliographic references

Includes bibliographical references.

Language note

English

Contents

• Broadening the Base of Treatment for Alcohol Problems
• Copyright
• Contents
• Introduction and Summary
• The Study Process
• A Summary of the Text
• Our Vision
• Some Fundamental Questions
• Aspects of Treatment
• Special Populations in Treatment
• Aspects of Financing
• Guiding the Ongoing Effort
• REFERENCES
• 1 Our Vision
• A Brief History of Treatment
• Broadening the Base
• Toward Treatment Systems
• Advice to the Reader
• 2 What Is Being Treated?
• The Alcohol Problems Perspective
• Other Perspectives
• Alcoholism
• Alcohol Dependence Syndrome
• A Terminological "Map"
• The Heterogeneity of Alcohol Problems
• Heterogeneity of Presentation
• Heterogeneity of Course
• Heterogeneity of Etiology
• Implications of Heterogeneity for Treatment
• Summary and Conclusions
• 3 What Is Treatment?
• Refining the Definition of Treatment for Alcohol Problems
• Defining the Expanded Continuum of Care
• Defining the Elements of Treatment in the Continuum of Care
• Treatment Philosophy or Orientation
• Treatment Stages
• Stage 1: Acute Intervention
• Stage 2: Rehabilitation
• Stage 3: Maintenance
• Treatment Settings
• Treatment Modalities
• 4 Who Provides Treatment?
• Describing the System to Treat Persons with Alcohol Problems
• Treatment of Alcohol Problems in the Nonspecialist Community Sectors
• Treatment in the Specialist Alcohol Problems Sector
• A State Perspective on Treatment Providers
• A Federal Perspective
• A National Perspective
• Treatment Personnel
• 5 Does Treatment Work?
• Reframing the Question
• Answering the Reframed Question: Methods
• The Randomized Controlled Trial
• The Role of Quality Assurance
• Other Methods
• Answering the Reframed Question: Results.
• 6 Is Treatment Necessary?
• Improvement in Alcohol Problems Without Formal Treatment
• Deterioration in Alcohol Problems with Formal Treatment
• Coerced Treatment for Alcohol Problems
• Implications for Treatment
• Treatment Based on Knowledge of Improvement Without Treatment
• 7 Is Treatment Available?
• Distribution of Resources for Alcohol Problems Treatment
• The National Drug and Alcoholism Treatment Unit Survey
• The Distribution of Treatment Capacity
• Expenditure Data
• American Hospital Association Annual Survey of Hospitals
• Relationship Between Treatment Availability and the Prevalence of Alcohol Problems
• 8 Who Pays for Treatment?
• Who Are the Payers?
• Who Pays for Treatment in Specialty Programs?
• Sources of Funding in Public-Sector Specialty Programs
• Sources of Funding in Private Sector Specialty Programs
• Who Pays for Treatment of All Health Care?
• What Does Treatment of Alcohol Problems Cost?
• 9 The Community Role: Identification, Brief Intervention, and Referral
• An Orientation to the Community Role in Treatment
• A Paradox and Its Implications
• Identifying People with Alcohol Problems
• Brief Intervention
• Efficacy of Brief Interventions
• Varieties of Brief Intervention
• The Target of Brief Intervention
• The Goal of Brief Intervention
• Referral
• Implementing the Community Role
• Settings
• Personnel
• Effects and Costs
• Conclusions and Recommendations
• 10 Assessment
• What Is Assessment?
• The Purposes of Assessment for Alcohol Problems
• Characterizing the Problem
• Characterizing the Individual
• Characterizing the Treatment Population
• Planning Treatment for the Individual.
• Guiding Treatment for the Population
• The Structure of Comprehensive Assessment
• Sequential Assessment
• Multidimensional Assessment
• The Content of Comprehensive Assessment
• Content of Screening
• Content of the Problem Assessment
• Content of Personal Assessment
• Desirable Qualities of Assessment Content
• The Administration of Assessment
• Obtaining Valid Assessment Data: Problems in Providing Information
• Obtaining Valid Assessment Data: Problems in Gathering Information
• Methods of Obtaining Assessment Information
• 11 Matching
• Studies of Matching in the Treatment of Alcohol Problems
• Examples of Matching Programs
• Specification of Treatment
• Specification of Matching Guidelines
• Therapist Selection
• Patient Selection
• Problem-Oriented Selection
• Theory-driven Selection
• Research-driven Selection
• Data-driven Selection
• Some Treatment Controversies as Matching Problems
• Appendix: Excerpts From The Cleveland Admission, Discharge and Transfer Criteria
• Overview of Adult Admission Criteria
• Diagnosis
• Levels of Care
• Placement Criteria Consideration
• Dimensions for Making Placement Decisions
• LEVEL I: MUTUAL/SELF-HELP
• A. Brief Description of Treatment Level
• B. Programmatic Description
• C. Brief Description of Typical Patient
• D. Dimensional Admission Criteria
• LEVEL II: LOW INTENSITY OUTPATIENT TREATMENT
• LEVEL V: MEDICALLY SUPERVISED INTENSIVE INPATIENT TREATMENT
• D. Dimensional Admission Criteria.
• ADULT DISCHARGE &
• TRANSFER CRITERIA
• Introduction
• Exceptions to Transfer Criteria
• Transfer to a Higher Level of Care
• Transfer to a Lower Level of Care
• 12 Determining Outcome
• The Rationale for Outcome Determination
• Some Examples of Systematic Outcome Determination
• A Major Caveat
• Implementing Outcome Monitoring
• Setting the Stage for Outcome Monitoring
• The Content of Outcome Monitoring
• The Process of Outcome Monitoring
• The Locus of Responsibility for Outcome Monitoring
• The Funding of Outcome Determination
• 13 Implementing the Vision: Toward Treatment Systems
• Assuring Continuity of Care
• Feedback of Outcome Information
• An Audit of the Systems Approach
• Description of the Table
• Evaluation of the Systems Approach
• 14 The Treatment of Special Populations: Overview and Definitions
• Defining Special Populations: A Historical Perspective
• The Research Perspective on Special Populations
• 15 Populations Defined by Structural Characteristics
• Women
• Adolescents
• The Elderly
• American Indians
• Asian Americans and Pacific Islanders
• Blacks
• Hispanics
• 16 Populations Defined by Functional Characteristics
• Drinking Drivers
• Dual-Diagnosis Psychiatric Patients
• Homeless Persons: The New Public Inebriates
• College Students
• Children of Alcoholics
• 17 The Treatment of Special Populations: Conclusions and Recommendations
• 18 The Evolution of Financing Policy
• Development of a National Policy.
• The Establishment of the National Institute on Alcohol Abuse and Alcoholism
• Using Federal Grants to Increase Treatment Resources
• Efforts to Increase Public and Private Health Insurance
• The Current Situation
• The Shifting Leadership Role
• State and Local Government Activities
• Federal Government Activities
• Private Health Insurance Activities
• Mandated Private Health Insurance
• Changes in Health Care Financing Policy: The Recent Emphasis on Cost Containment
• Health Maintenance Organizations
• Preferred Provider and Managed Care Arrangements
• State Agencies
• The Current Funding Environment
• The Need for Better Data on Funding and the Costs of Treatment
• 19 Cost-Effectiveness
• Studies of Costs and Cost Offsets
• Cost-Benefit and Cost-Effectiveness Analysis
• Matching and Cost-Effectiveness
• 20 Paying for the Treatment System
• Financing the Current Treatment System
• Criteria for Evaluating Coverage Appropriateness
• Optimal Conventional Coverage
• Paying for the Current Treatment System
• Financing the Ideal Treatment System
• Financing the Vision: Paying for Specialized Treatment Services for the Poor and the Uninsured
• 21 Leadership
• Our Vision: The Committee's Recommendations
• Opportunities for Leadership
• The Leadership Opportunity for Congress
• The Leadership Opportunity for the States
• The Leadership Opportunity for Employers and Private Insurers
• The Leadership Opportunity for Treatment Providers
• The Leadership Opportunity for the Professions and Training Programs
• The Leadership Opportunity for the National Institute on Alcohol Abuse and Alcoholism
• The Leadership Opportunity for Voluntary and Community Organizations
• The Challenge for the Future
• REFERENCES.
• Acknowledgments.

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ISBN

• 1-280-21433-3
• 9786610214334
• 0-309-56838-2

OCLC

• 645436818
• 923269812

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