Treatment setting and treatment outcome in alcohol dependency: residential and day-care options compared

When empowered to select either a residential or a day care treatment programme for problem drinking, more patients favour the latter option. Those completing the full programme, which was similar in content in both settings, were followed up at approximately 9 months after initial engagement in treatment. Attrition was a major problem, particularly in the day-patient sample. Of the 103 patients who began each programme, 91 completed the residential option but only 23 completed all sessions in the day-patient course. Day-care completers tended to have less severe alcohol-related problems than in-patient completers. They were also older, had experienced fewer episodes of alcohol-related admissions in the past and were less likely to show biochemical evidence of alcohol-related physical damage. Both groups showed positive changes in drinking intake, drink-related problems, the use of adjunct services and the self-ratings of improvement throughout the follow-up period. Outcome in the day programme completers group was, however, generally better than that shown by the in-patients. The results should be interpreted with caution owing to the significant inter-group differences at the start of treatment and the considerably higher non-attendance and attrition rates for the day-care programme. A cognitive-behavioural in-patient programme for alcohol dependent patients can be provided in a day-care setting. For some patients, this option is both attractive and effective.