Summary - Successful treatment of alcoholics cannot be achieved without the active family participation. Alcoholic often presents wrongly his and his family's behaviour and family happenings in order to present himself in a more positive light. Therefore, family therapy is also a kind of confrontation of an alcoholic with his family. The aim of our investigation was to find out the cause-and-effect relation between the occurrence and the evolution of alcoholism and personal factors, demographic factors, economic factors and earlier treatment.
Key words: Alcoholism; Family therapy
In our environment, there was no traditional basis for family therapy, but after the opening of Center for Investigation and Prevention of Alcoholism (today Reference Center of the Ministry of Health for Alcoholism in Sestre milosrdnice University Hospital) we began to practice family therapy of the alcoholics.1'4 From the very beginning it was obvious that the successful treatment cannot be achieved without the active family participation. Therefore we insist that the family is present already at the time of the initial interview as well as at the admittance to the therapeutic community and at this time, the date of the family meeting is determined. In this phase, the alcoholic and his family often offer resistance, mainly because of their fear and reluctance to face some personal difficulties.5,6 After analyzing the reasons of resistance the positive pressure is applied to the alcoholic in order to force him to persuade his family to attend the meetings. Alcoholic often presents wrongly his and his family's behaviour and family happenings in order to present himself in a more positive light. Therefore, family therapy is also a kind of confrontation of alcoholic and his family.7'9
In the entire program of therapeutic communities of the day hospitals and the in-patient clinic, the patient's family takes part generally 10-15 times, in partial hospitalization lasting for 3 months 3 times weekly and finally during the 5 years in the clubs of treated alcoholics. It is clear that the family needs to be present at discharge of its members from the hospital and is expected to report about the up-to then treatment experience. Intensive education is also a part of treatment and alcoholic and his family have to undergo the exam 3 weeks after beginning of treatment.1,5,10
Family therapy is practiced in groups consisting of physician, social worker, nurse, special teacher, and psychologist. All groups work within a system of therapeutic communities which have daily meetings in order to discuss the problems that emerged during the last 24 hours. The specifics feature of our therapeutic communities is to introduce the family. The goal is not only to receive more exact information concerning life of alcoholic's family, but also to enable confrontation of different perception of their problems.1,5,10
The discussion that follows after family introduction enables the family to be openminded in understanding their problems and provides a full emotional support for overcoming their problems. Family members in therapeutic communities can more clearly identify and understand the alcohol induced problems and the need for treatment and perspective rehabilitation.
The work with families is determined also by the families themselves: it is not the same if they are motivated, resigned, or offering resistance. According to these characteristics, the families can be divided in passive, active, pessimistic or with delayed action.11-15
Passive families don't participate in treatment neither verbally nor emotionally. Though they basically agree that alcoholism is an illness that disturbs the familial relationship, at the same time, they feel it as their fate. These families resist to face the problems and change their behaviour and even deny alcoholism as an illness. Active families take part in the treatment with full emotional and rational capacity, are ready to change their behaviour and fully support their member. …