How do you know if your treatment of problem drinking is successful?

The particular importance of examining the issue of the effectiveness of treatment for problem drinking is based on: (a) the history of a separation of science and practice in the alcohol field; (b) an era of increased accountability for the results of clinical practice. Consideration of the complexities involved in deciding whether treatment makes a difference is followed by an examination of the relative merits of empirical and non-empirical evaluative approaches. Barriers to using knowledge effectively (therapist and cultural) are identified along with the use of knowledge destruction tactics. It is concluded that the most realistic alternative is an empirical approach that uses a wide range of methodologies to bridge the scientist-practitioner divide. (C) 1998 John Wiley & Sons, Ltd.