The Alcoholism Treatment Quarterly (ATQ), since its inception has focused on substance use disorders (SUDs), primarily alcohol, with diagnosis treatment and recovery as primary areas of concentration. This issue of the ATQ maintains this focus as these areas of concentration are explored from the perspectives of diagnosis, treatment, and recovery. The international dimensions of SUDs are highlighted in this issue with contributions from Iran, Malaysia, Denmark, the United Kingdom, and Sweden.
Alcoholics Anonymous (AA) and other 12-Step programs are the mainstay of recovery for persons and families experiencing alcohol and other drug problems. The importance of AA as an agent of recovery is emphasized in the opening articles of this issue. Sanders explores the tension within Alcoholics Anonymous’ (AA) “singleness of purpose” for women who may be dealing with some other medication dependencies in addition to alcohol. Women in AA tend not to reveal these other dependencies. Kuerbis and Tonnigan investigate how the perceived social dynamics in AA meetings affect attendance, exposure to spiritual practices, and the extent to which these practices are mobilized beyond AA participation. Distinct social dynamics within particular groups are decisive in achieving group cohesion which factors into longer sobriety.
The use of substances in coping with sexual abuse by survivors and their support providers is examined by Ullman and colleagues. Both may use alcohol as part of a survival strategy. This article highlights the need for a safe place to address all the issues involved. Smith and colleagues look at social support and gender correlates with risk of relapse in collegiate programs. The findings show increased risk for relapse in men with increased social support whereas women with increased social support have lowered risk of relapse. This suggests the necessity of establishing appropriate levels of support.
Hogan and Nielsen, in the following articles, explore dynamics at work in inpatient and outpatient settings. The Hogan study attributes the failure of participants to complete an inpatient detoxification program in the United Kingdom to lack of engagement, criminal involvement, and the use of other drugs in addition to alcohol. The Nielsen study in Denmark illustrates the superiority of actuarial matching of clients to treatment options over a motivational matching assessment by clinicians. Improvement in the actuarial cohort is seen in terms of better outcomes measured by alcohol consumption and increased sobriety.
The concluding articles address the psychological and social issues in determining treatment outcomes. In a Swedish study, Stalheim and colleagues look at the origin of psychotic experiences in nonpsychiatric participants with alcohol use disorders in relationship to childhood trauma. Lua and colleagues in a Malaysian study examine the psychosocial profiles of people in an Islamic-based program of recovery, with particular interest in levels of religiousness, purpose of life, anger, and depression. Their findings suggest that moderate expression of psychosocial difficulties may be attributed to religious factors. The ability of Cognitive-Behavior Therapy to improve measures or self-perception and self-efficacy are explored by Roudposhtia and colleagues in a methadone maintenance population.
The variety and diversity of treatment and recovery are captured in this issue of the ATQ. As always, it is our hope that these articles will be helpful in promoting a more effective response to the complex issues involved in the treatment and maintenance of recovery in persons and families experiencing SUDs.