Treatment of strategies in an urban Indian alcoholism program.

her complicated because of difficulty in defining the nature, or even the size, of the problem. Research literature concerning the definition, etiology, dynamics, assessment and treatment of alcoholism among American Indians is abundant but of unequal quaL ity and questionable usefulness. No single agency or organization collects or has access to information on alcohol use among native peoples. Only on the Pine Ridge and Makah Reservations has an epidemiological survey of an entire tribal population been made regarding mental health and alcoholism (1). The native peoples of North America are a heterogeneous population with diverse cultures, attitudes and religious persuasions in which alcohol has a number of uses and meanings. In response to this diversity, as well as to the overwhelming need in local Indian communities, over a hundred new Indian-run alcoholism treatment programs have developed since the American Indian SelfDetermination Act of 1975. Few of these programs have reported their treatment approaches or have investigated the effectiveness of tribal-specific treatment of Indian problem drinkers. This paper examines the relationship between treatment approaches used in the Seattle Indian Alcoholism Program and treatment outcome. The program was established by the local Seattle Indian community and is recognized by both Indian and nonIndian community alcoholism treatment agencies as a successful program. This survey may aid other alcoholism treatment programs that are attempting to provide treatment, education and support to Indian alcoholics.