This paper provides a general overview of the literature on adult children of alcoholics (ACOAs). Among the topics discussed are adjustment issues and treatments for the problems faced by this group. Family therapy emphasizing Bowenian theory is heavily emphasized; the review ends with a critical review of Bowenian theory as well as a delineation of some of the elements it is missing regarding treatment of the issues confronting adult children of alcoholics.
Adult children of alcoholics can be defined as those individuals who grew up in a household where one or both parents met the American Psychiatric Association's (DSM IV, 1994) criteria for alcohol dependence or alcohol addiction. According to Maulen and Faust (1992) literally one-quarter of the people in the world grow up in such households and in some countries the prevalence rates are far higher.
Maulen and Fast (1992) propose that the psychological consequences of being reared in an alcoholic household are so pervasive and systematic that adult children of alcoholics might be considered to be a new diagnostic group. This call for a diagnostic definition is based, according to the authors, on certain fairly reliable findings observed for ACOAs. These findings are that:
(1) ACOAs have a three- to four-fold greater risk of developing a dependence themselves than the general population. (2) ACOAs are more likely to marry partners who are also dependent, and have an above-average propensity toward separation and divorce.
(3) ACOAs tend to have adopted a specific role within the family they come from (e.g., whipping boy, family hero or fool.)
However, not all researchers/theorists agree that ACOAs need to be considered as a special population. For example, Mahon and Kempler (1995) conducted a study to examine whether ACOAs comprise a special client population that might require specific therapeutic factors.
Subjects in the study consisted of 92 group me...