ABSTRACT
In most parts of the world enormous changes are occurring in the organization and financing of health care services. Cost containment has become all important. There is an increasing expectation by funders that alcohol services must show identifiable benefits or positive outcomes. Politicians are calling for improvement to the quality of health care while continuing the commitment to reducing health care costs. Most alcohol counsellors are conscientious, dedicated and hardworking. The historical development of services has been generally abstinence based, providing for clients at the action stage. An implication of the stages of change model is that treatment and prevention are not always separate activities. In the alcohol service field, most of the publicly funded programmes have traditionally served a low-income client group, many in receipt of Social Security benefits.
