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A Quiet Revolution

<p>Reading this text for private practitioners on the treatment of alcohol and drug problems prompted me to reflect on the dramatic changes in the field over the last 25 years. As a then psychology intern, I learned about an ongoing paradigm shift (Pattison, Sobell, & Sobell, 1977) in the conceptualization of alcohol problems. At that time, the prevailing wisdom assumed uniformity among alcoholics, that they were different from nonalcoholics, and that they were victims of an inevitably progressive disease for which abstinence was the only goal and Alcoholics Anonymous the only solution. Providing psychotherapy was thought to be ineffectual and, perhaps, even harmful. A year later, I was speaking in New York about the behavioral treatment of problem drinkers (Noel, Sobell, Cellucci, Nirenberg, & Sobell 1982). A distinguished gentleman from a nearby treatment center came up afterwards and said, “I really enjoyed your talk, but I work in the field of alcoholism.” I realized the significance then of how the field would be defined. He was arguing that problem drinking had little to do with alcoholism and related services. It was another nine years before the influential Institute of Medicine (1990) report, Broadening the Base of Treatment for http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png PsycCRITIQUES PsycCRITIQUES®

A Quiet Revolution

Abstract

<p>Reading this text for private practitioners on the treatment of alcohol and drug problems prompted me to reflect on the dramatic changes in the field over the last 25 years. As a then psychology intern, I learned about an ongoing paradigm shift (Pattison, Sobell, & Sobell, 1977) in the conceptualization of alcohol problems. At that time, the prevailing wisdom assumed uniformity among alcoholics, that they were different from nonalcoholics, and that they were victims of an inevitably progressive disease for which abstinence was the only goal and Alcoholics Anonymous the only solution. Providing psychotherapy was thought to be ineffectual and, perhaps, even harmful. A year later, I was speaking in New York about the behavioral treatment of problem drinkers (Noel, Sobell, Cellucci, Nirenberg, & Sobell 1982). A distinguished gentleman from a nearby treatment center came up afterwards and said, “I really enjoyed your talk, but I work in the field of alcoholism.” I realized the significance then of how the field would be defined. He was arguing that problem drinking had little to do with alcoholism and related services. It was another nine years before the influential Institute of Medicine (1990) report, Broadening the Base of Treatment for
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