Psychosocial processes of recovery among alcoholics and their families: implications for clinicians and program evaluators.

This paper provides an overview of a program of research that has focused on the role of extratreatment factors in the process of recovery and relapse among treated alcoholic patients and their families. Consistent with a systems perspective, patients who controlled their drinking showed improvements in nondrinking aspects of their functioning and members of their families showed improved adjustment as well. Moreover, the posttreatment functioning of these recovered families was comparable to that of a matched nonalcoholic community group. In contrast, relapsed alcoholics and their family members suffered from multidimensional impairments. Extratreatment factors such as environmental stressors, coping responses, and social resources had as much influence on the recovery process as did patients' treatment experiences. New procedures to assess these extratreatment factors are described and methods by which clinicians and researchers can use the resulting information to improve treatment outcome and the specificity of program evaluations are discussed.