Pre-treatment change in psychotherapy with adult children of problem drinkers: The significance of leaving home

In a qualitative diary study of four adult children of problem drinkers in psychotherapy, it transpired that all four clients had experienced significant changes before they entered psychotherapy. This study first addresses the issue of how pre-treatment change may be conceptualised in psychological theory and research. Five ways of understanding pre-treatment change are presented. Data from the case studies are then presented, highlighting how these clients experienced a diminishing sense of self-control in relation to leaving the home they cohabited with their alcoholic parent. The dynamics of how leaving home affects the clients are analysed. It is suggested that change experienced in relation to leaving home is significant to the decision to enter therapy. The fit between the data and the theories of pre-treatment change is discussed.