The development and evaluation of a programme for the treatment of alcohol dependence

This thesis describes the development and the research evaluation of an alcohol treatment programme and was undertaken within the period 1990-1997. An independent healthcare organisation (St Andrew's Hospital) provides the setting for the study. The first chapter is concerned with placing the above development within an historical context, both in terms of a national/international treatment perspective and in terms of developments within the healthcare system. Chapter 2 focuses on the planning and implementation of change within the above unit, with particular reference to the development of an evidence-based treatment programme and the strategies used to ensure the successful management of change. The third chapter is concerned with examining the methodological and philosophical issues pertinent to the evaluation of outcome success for addiction treatment.;The findings from the major outcome study of the comparative merits of two treatment programmes are discussed in Chapter 4. The cost effectiveness of the two treatments is also assessed. Two further papers are concerned with the intake and process variables that may relate to treatment outcome. Chapter 5 examines the topic of dynamic and static predictors of outcome. Two studies deal respectively with staff and peer predictors of treatment success and of cognitive/subjective variables (self-efficacy and outcome expectations) as they relate to outcome. The final chapter (6) examines the implication for clinical practice and service development of the above work