The natural history of alcoholism versus treatment effectiveness: methodological problems

A majority study of alcoholism treatment concluded that results of treatment were no better than the natural history of untreated alcoholism. This conclusion cannot be considered valid because of methodological problems which render the treated and untreated samples incomparable. The latter methodological problems include age cohort differences between the untreated and treated samples, and differences in socioeconomic status. Other issues confounding the original conclusion are inadequacy of the minimal treatment provided. Major reviews of alcoholism treatment and recent outcome studies indicate that treatment optimism is warranted in contrast to the view that treatment renders no advantage over "natural" outcome.