As of 2000, there is no conclusive evidence to show that one single method of treatment is consistently more successful than another (Project MATCH). One of the largest (U.S.) clinical experiments—sponsored by the National Institute on Alcohol Abuse and Alcoholism—shows that of the three major treatments studied (cognitive-behavioral therapy [CBT], twelve-step facilitation [TSF], and motivational enhancement therapy [MET]), none emerged the clear ''winner.''

A group of 952 outpatients (some still drinking) and 774 patients (previously receiving residential/ day hospital treatment) participated in the study, that spanned over twelve weeks. The two groups were each divided into three separate groups, each group receiving one of the three treatments.

Particpants were polled immediately after treatment and again every three months for a year in an effort to document their subsequent progress. Patients of all three treatments exemplified good and sustained results. In all, only 10 percent of the participants dropped out of the study itself; two-thirds finished the treatment(s). The percentage of days abstinent (PDA) rose in all three groups by 60 percent (from 20 to 80 percent), and suffered only minimal decline in the next year.

Controlled drinking (CD) is one of a number of approaches with an important role to play in alcoholism treatment. CD, as well as abstinence, is an appropriate goal for the majority of problem drinkers who are not alcohol-dependent (though there is no proven scientific method to determine who can and who cannot stop drinking after one or two drinks). In addition, while controlled drinking becomes less likely the more severe the degree of alcoholism, other factors—such as age, values, and beliefs about oneself, one's drinking, and the possibility of controlled drinking—also play a role, sometimes the dominant role, in determining successful outcome type. Finally, reduced drinking is often the focus of a harm-reduction approach, where the likely alternative is not abstinence but continued alcoholism.

(SEE ALSO: Alcohol; Disease Concept of Alcoholism and Drug Abuse; Relapse Prevention; Treatment)


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