Ahead of its time: 40 years after the advice versus treatment family study.

Griffith Edwards' proposal for the alcohol 'treatment versus advice' study--also known as 'the family study'--illustrates how ahead of his time he was. The sample consisted of 100 married men who attended with their wives for a comprehensive assessment. Those randomized to 'advice' were told that the responsibility for attaining the goal of abstinence lay in the patient's hands, supported by his wife, that no further intervention was indicated, but that the research social worker would 'keep a watching brief' by visiting the home every 4 weeks for 12 months. Across multiple outcome measures there was no evidence that 'treatment'--considerable in amount by modern standards--was better than advice. Conversely, marital variables such as wives' alcohol-related hardship were significantly predictive of the outcome of the drinking problem. The study was arguably one of the principal sources of the whole 'brief treatments'/'brief interventions' movement which gathered momentum from then on and which, arguably, has itself become the conventional wisdom. The findings questioned the very nature of the addiction change process, suggesting that non-specific factors might be the more important, an issue that still remains unresolved. It is less clear that the study has left such a mark in terms of the development of a family and social model of addiction treatment and change. For example, it continues to be a struggle to help treatment organizations to become more family-inclusive.