In the 1970s family doctors, social workers, researchers and administrators had been aware of the inadequacy of the response to drinking problems for some time. However, there had been no systematic examination of why such agents felt negatively about drinkers and disinclined to respond to them. Originally published in 1978, this book develops a radical new perspective on the prevalence and causes of drinking problems, combining reviews of historical and contemporary literature with the authors' own research studies. This perspective is then linked to the need for an integrated response from both medical and social services, with a particular accent on the need for a community response. By focusing on the relationship between helper and helped a solution is sought to the question which has troubled the field for many years: why are agents like family doctors and social workers so inadequate in recognising and responding to people with drinking problems? The crucial aspects within the therapeutic relationship are pinpointed and experimental studies are described which show how training, casework, supervision and the redeployment of expertise can help improve recognition rates and responses to individual drinkers. This book thus expresses the need for major changes both in our attitudes and understanding of people with drinking problems and the difficulties of agents who try to help them. It should still be of historical interest to social scientists and those involved in helping people with drinking problems.

Studies have suggested that differences in the effectiveness of therapists may be related to the therapist's ability to maintain a facilitative stance in the face of client resistance or hostility. The current study, examined a sample of audiotaped sessions from Hyams, Cartwright, and Spratley's (1996) study of engagement in an alcohol treatment service in an attempt to see whether the therapists' effectiveness at engaging clients in treatment was related to client-therapist interaction in assessment interviews. It was hypothesized that there would be (1) more overall negative interpersonal behaviour (2) more negative interpersonal behaviour by the therapist and (3) more negative interpersonal complementarity in interviews where the client failed to engage. Structural Analysis of Social Behaviour was used to assess the interpersonal behaviour of clients and therapists in three case comparisons, each of which focused on an engage and a non-engage case provided by one of three participating therapists. An additional series of follow-up qualitative case studies was carried out on the interviews where the client failed to engage. The results were mixed, with the qualitative analyses providing more support for the hypotheses than the quantitative analysis. It was concluded that problematic interpersonal processes might be harder to gauge in assessment sessions than later on in therapy and methodological recommendations were made for enhancing the likelihood of detecting problematic processes in future studies.

Studies have suggested that differences in the effectiveness of therapists may be related to the therapist's ability to maintain a facilitative stance in the face of client resistance or hostility. The current study, examined a sample of audiotaped sessions from Hyams, Cartwright, and Spratley's (1996) study of engagement in an alcohol treatment service in an attempt to see whether the therapists' effectiveness at engaging clients in treatment was related to client-therapist interaction in assessment interviews. It was hypothesized that there would be (1) more overall negative interpersonal behaviour (2) more negative interpersonal behaviour by the therapist and (3) more negative interpersonal complementarity in interviews where the client failed to engage. Structural Analysis of Social Behaviour was used to assess the interpersonal behaviour of clients and therapists in three case comparisons, each of which focused on an engage and a non-engage case provided by one of three participating therapists. An additional series of follow-up qualitative case studies was carried out on the interviews where the client failed to engage. The results were mixed, with the qualitative analyses providing more support for the hypotheses than the quantitative analysis. It was concluded that problematic interpersonal processes might be harder to gauge in assessment sessions than later on in therapy and methodological recommendations were made for enhancing the likelihood of detecting problematic processes in future studies.

There remains considerable debate about a theoretically interpretable subscale structure for the Inventory of Interpersonal Problems (IIP). In this paper items are extracted from the IIP to form a 40-item shortened version (the IIP-40) comprising eight subscales, each of five items, which conform to the eight octant positions within Birtchnell's interpersonal octagon: a version of interpersonal theory. The inter-item reliability of the subscale structure is found to be acceptable when tested against a sample of 150 pre-assessment for psychotherapy IIP completions within the Centre for the Study of Psychotherapy (CSP), University of Kent. The face validity is established through acceptable inter-rater reliability scores in an experiment using blind raters. Subscale scores are shown for patients within CSP and are found to be significantly different between genders in the octant positions of Upper Close and Neutral Distant. High scores in the octant position of Upper Distant is found to be a significant predictor of therapeutic drop-out. The results for gender and therapeutic engagement are consistent with other published work in the interpersonal theory field.

For over 20 years it has been assumed, that the interviewers level of therapeutic commitment does have a major impact on a clients tendency to engage in treatment. Using a modified version of the Alcohol Problems and Perception Questionnaire (AAPPQ) we examine this contention. The evidence suggests strong associations between the interviewers therapeutic commitment, their assessment of the clients ''stage of change'', the clients experience of the interviewer's interpersonal warmth and their tendency to engage in treatment.