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 ≈ 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.