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September 1976

About Alcoholism - Alcoholism Information, Research and Treatment

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A "cafeteria plan" for alcoholism treatment, through which clients choose an individualized rehabilitation course from a variety of modalities, allows facilities to provide services to more people with greater success than by use of a single therapeutic approach, according to a University of North Carolina researcher.

Dr. John A. Ewing, the plan's author, observed that treatment programs often reflect a single philosophy or approach, in spite of research findings that no one modality is effective with all alcoholic patients. Until more is known about matching patients with specific treatment, programs must offer a comprehensive selection of options, he said.

The "cafeteria plan" divides types of service into three groups: Group A, including support groups and education, medication, Alcoholics Anonymous, family therapy, and insight therapies; Group B, including behavior therapies and patient clubs; and Group C, including encounter groups, occupational therapy, rehabilitation programs, and psychodrama. Dr. Ewing suggested that each patient be allowed to see all the treatment options and, in consultation with the clinic staff, select those which seem most suitable at the time. "Menu" changes are permitted at the patient's initiative, and the total program for each patient is reevaluated every three months.

Dr. Ewing stated that clinics which offer "cafeteria plan" programs report fewer dropouts, better attendance, more interest, more family involvement, and better overall results.

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