Problem Areas Identified Among COPA Clients
The present research adopted an exploratory approach to investigating the factors associated with substance abuse in a clinical sample of older substance abusers (without comparison to other populations). As described previously, the noncomparative approach has a number of advantages-principal among them is that the approach is more likely to identify critical dimensions as well as various subtypes of the target population. Previous research has only begun the process of describing alcohol problems among older people. It is apparent that increasingly focused descriptive research is required in order to mount meaningful large scale comparative studies. The COPA evaluation offers some unique advantages in this endeavor. First, many of the previous noncomparative studies did not collect data systematically, and the findings were more reflective of clinical insight than of objective data analyses. The COPA evaluation included systematic objective data collection, in addition to a less objective approach using a case study method. Second, samples in previous studies, using treatment populations from traditional addictions treatment programs or from mental health or psychiatric populations, were likely to be biased since older people rarely attend traditional addictions treatment. Therefore, those who do attend traditional addictions treatment programs are likely not representative of the population of older people who have alcohol problems. The COPA Project is different from traditional addictions treatment programs in two important ways: (1) it uses outreach methods, and (2) it does not require that the person being helped acknowledge that he or she has an alcohol problem. Many of the people treated by the
program would not have attended traditional programs;1 therefore, the elderly seen by COPA are probably more representative of the population who have alcohol problems than are clients in traditional addictions treatment programs.