Age-specific versus mainstream approaches to the treatment of elderly alcoholics: Addiction counselor perceptions of efficacy.

Abstract

America is aging, older alcoholic numbers rise. Disagreement has long existed as to whether elderly should be treated within traditional programs or in special age-specific modalities. Few studies measure variables selected to show either need or efficacy of elderly specific programs. This study was designed to answer the question: What is the perception of certified alcohol and other drug abuse counselors regarding the best way to treat the elderly, mainstream or elderly specific? The study is based on a bias that addiction counselors have been delivering services to elderly for years in both program types and offer valuable perceptions on the question of treatment effectiveness. A random sample of 788 counselors from a nationwide population of over 25,000 was persistently solicited to participate in a survey addressing the treatment of alcoholics 55 years and older. The most common education level was a master degree; length of experience 9-15 years; age 46. The study analyzed data from the 574 returns, a 72.8% response rate, of a lengthy questionnaire previously validated by gerontology and alcoholism experts. Items selected as variables were clustered into three domains which indicated tendencies toward (a) choice of either traditional or special age-specific programming as most effective, (b) cognizance of elderly and alcohol treatment issues, and (c) willingness to counsel the elderly. On the main research question, according to domain scores, there was no statistical significance in counselor-perceived efficacy of either mainstream or elderly specific treatment of elderly alcoholics. The literature body also is ambiguous on the question. Amount of education predicted degree of gerontology knowledge. Greater gerontological acumen predicted preference (perceived greater effectiveness) for elderly specific programming. Females had more gerontologic knowledge than males. Gender predicted willingness to counsel the elderly; males were more willing than females. Counselor training should include more gerontology studies. Foci and loci for future research were identified with suggestions for treatment planning. Appendices include the questionnaire, item response frequencies, and an extensive annotated bibliography specifically devoted to elderly alcoholic treatment issues.