The treatment of alcoholism has had a unique historical development in the United States. This study provides a chronology of how the problem of alcoholism was defined and handled during various time periods in United States history. The process that evolved resulted in an abstinence based, comprehensive, multidisciplinary approach to the treatment of alcoholism as a primary disease based on the principles of Alcoholics Anonymous. This treatment modality, that developed outside of established medicine, is currently used by the majority of treatment providers. Seven individuals who have been actively involved in alcoholism treatment were interviewed. In addition to archival research, biographies and autobiographies were examined to gain a broad perspective. Because alcoholism is both a collective and an individual problem an effort was made to include a microsociological frame of reference within a broad sociological view. Alcoholism, or inebriety, was first perceived as a legal and moral problem. By the end of the 19th century, inebriety was recognized as an illness differing from mental illness, and separate asylums were established for its treatment. Alcoholism is currently accepted and treated as a primary disease by the majority of social institutions, but the legal and moral implications remain. National Prohibition in the early part of the 20th century targeted alcohol instead of the alcoholic delaying any progress toward treatment which was made in the 19th century. The advent of Alcoholics Anonymous brought the first widely accepted hope for alcoholics. The treatment process that developed utilized the principles of Alcoholics Anonymous in a setting of shared recovery which has been difficult to quantify. In 1970 the allocation of federal funds for treatment and research brought the involvement of new disciplines creating both conflicts and possibilities. Alcoholism recovery has elucidated the connection of mind, body, and spirit.

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Because of the prevalence of substance abuse in America and the association between this issue and common problems brought to the family therapist, it is important that family therapists be trained to diagnose and either treat or refer substance abusing clients and their families. This study gathered information from the Directors of Master's level family therapy programs accredited by AAMFT about the content and format of training that students in their programs receive preparing them to work with substance abusing families. Twenty of the 22 programs were represented by completed questionnaires. Five programs were reported as having a required substance abuse course; four, a popular elective. Three respondents reported plans to increase their coverage of the topic in their curricula. The average of the responses for prevalence of substance abuse as a central issue in practicum cases was 30%. Although about 75% of the respondents believed that their graduates were ready to diagnose and refer these cases, only 25% believed that these same students were ready to treat substance abuse cases. Data showed that 40% of the respondents believed it advisable for AAMFT to require a separate course on substance abuse. Comments from those opposed to such a requirement noted the crowdedness of existing curricula, the importance of academic freedom, and the abundance of other topics to be covered. / Master of Science