Throughout the nineteenth and twentieth centuries alcoholism was seen largely as a vice of the poor and its treatment rested almost entirely with the missions and the workhouse. The theory that alcoholism is a disease that can affect anyone regardless of social position is by no means universally accepted even today. Although in the last twenty-five years there has been a rapid increase in the number of public institutions for the treatment of alcoholics, the possibility remains that class status still influences the diagnosis and care they receive.

This study observes a sample of patients of a public clinic, from their source of referral for treatment to termination of therapy, to determine the influences of class position on the therapy used in each case. The findings indicate that specific treatments are assigned along class lines. The authors of this study offer a number of necessary recommendations which ask for a more rational link between therapy and diagnosis than is currently evident in clinical practice.

This is an extremely important and topical study, the findings of which are applicable beyond the treatment of alcoholism to the treatment of all behavioural disorders.

Wolfgang Schmidt was a researcher at the Addiction Research Foundation in Toronto.

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REGINALD G. SMART is Research Scientist (psychology) at the Alcoholism and Drug Addiction Research Foundation and teaches psychology at York University.

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MARCIA K. MOSS is Senior Research Assistant in the Research Department of the Alcoholism and Drug Addiction Research Foundation.

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