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Summary

Proposals that future services for the alcoholic client should be based in the community are likely to be obstructed by the negative therapeutic attitudes of the majority of community agents. In seeking to explain such attitudes, this paper considers the relationship between a measure of an overall therapeutic attitude towards the alcoholic client and four independent variables. These are: experience with alcoholic clients; support from colleagues when working with such clients; training in alcohol and alcohol related problems; and self-esteem. Data collected on three occasions from students attending the Summer Schools on Alcoholism are analysed cross-sectionally and longitudinally. The analysis suggests that support and experience are independently related to overall therapeutic attitudes, explaining a large proportion of the variance. The effects of training and self-esteem appear to be contingent upon the agent's level of support and experience.

Different levels of the independent variables are seen to explain the differences in therapeutic attitudes of different groups of agents. In particular, it is demonstrated that agents who specialise in working with drinkers have more positive attitudes than those who do not, because they have greater access to these independent variables.

The implication of the findings far the development of community services are considered, and related to the action research experiments of the Maudsley Alcohol Pilot Project.