Date of Award

1992

Document Type

Thesis

Degree Name

Master of Science

First Advisor

Betty LeMasters

Second Advisor

Carolyn Scott

Third Advisor

William Watson

Abstract

This thesis will focus on the development of the chemical dependency treatment field, including an overview of the historical growth of mental health and chemical dependency treatment, and its recent change from a growing to a declining field. It will also examine various theories in the treatment of mental illness and, specifically, chemical dependency, in a historic context, and placing these theories into a unified system of viewing illness in general. Finally, this thesis will explain the growth, then decline, in the field as a result of political, social, and financial developments, and show how these extra clinical influences are justified by various clinical theories.

Mental illness, and chemical dependency as a category of mental illness, has been viewed in a variety of ways throughout history. The pattern is not, however, an evolutionary pattern of increasing scientific knowledge leading to increasingly effective and sophisticated methods of viewing and treating chemical dependency. It is, rather, a history of various extra clinical influences which produce particular world views. Those, in tum, influence our diagnostic and therapeutic systems. These views, moreover, do not replace each other on an historic continuum, but exist simultaneously, and are used as justification for a wide variety of diagnostic and clinical activity depending on the needs and desires of the clinicians and researchers.

During the recent past, in the United States, the Chemical Dependency treatment field experienced tremendous growth, beginning with the nineteen thirties and forties, with the scientific work on the disease concept and growing acceptance of the notion of chemical dependency as a disease, coupled with the growth and success of Alcoholics Anonymous, and continuing with the growth of occupational drug and alcohol programs and the increasing availability of insurance dollars to support treatment for this illness.

Presently, however, with an increasing concern by those sectors of the society who pay for health care costs that these resources are limited, the growth of the treatment industry has halted and been reversed. This has led to a revision of the disease concept to fit the new economic reality, and a return to older diagnostic and therapeutic models, which justify the lessened societal resources allotted to treatment.

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