Reluctant referrals: The effectiveness of legal coercion in outpatient treatment for problem drinkers

Roger G. Dunham, Armand L. Mauss

Research output: Contribution to journalArticlepeer-review

24 Scopus citations


An annoying paradox which has been facing policy-makers and practitioners alike in their efforts to deal with public problem drinkers is that of recognizing the condition of alcohol-related offenders as both a misdemeanor and a disease. This paradox is discussed in terms of a legal model and a therapeutic model for responding to alcohol-related problems. A multivariate covariance model is used to compare the effectiveness of treatment for problem drinkers coerced into treatment by the courts and problem drinkers voluntarily initiating treatment, while statistically controlling for pre-treatment group differences. With regards to effectiveness, and the role played by an element of coercion in effectiveness, type of referral did have an important independent impact upon treatment outcome. An element of coercion involved in that referral did not subvert the goals of the therapeutic model; indeed, it rendered successful treatment outcome considerably more likely than with strictly voluntary self-referral. Finally, coercion proved somewhat more effective where the penalties for non-compliance were the more certain, not necessarily the more severe.

Original languageEnglish (US)
Pages (from-to)5-20
Number of pages16
JournalJournal of Drug Issues
Issue number1
StatePublished - Jan 1982

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Health(social science)
  • Public Health, Environmental and Occupational Health
  • Psychiatry and Mental health


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