Involvement of support networks in treatment

Alcohol dependence and abuse are biopsychosocially determined and ameliorated. However, social factors involved in effecting treatment outcomes continue to be understudied as a context in which psychological and biological factors are researched and also as a treatment focus in their own right. Yet the client's social setting and relationships during and after treatment are more important forces in the recovery process than formally defined alcohol treatment interventions. Though this has been so historically, it is even more likely now in managed care environments where treatments are highly circumscribed. This suggests that treatment interventions refocus toward targeting changes in the patient's social environment. Treatments involving spouses and families of the patient's social networks it has been shown, are incrementally effective. A high priority for research is to identify the set of conditions under which the wider social network can also be effective. Early results are promising though not well understood. The next generation of network therapies will focus on testing the conditions under which various components of the patient's social network are important in affecting patient outcomes. As with other therapies, an important focus for research is on identifying the active ingredients in these treatments that bring about favorable change in patients generally or that enhance the outcomes of the subset of patients particularly amenable to network interventions (patient-treatment "matching"). Recommended priorities for future research in network interventions are identified.