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Kuhn2 "The Structure of Scientific Revolutions" !-+ 01"
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1970 ;2 d>6! @i f , Postscript ! D; "9Q ) Gordon,
(1983 <; ' E, 5 f-; b9 <; Qj < %-
6 % -= 5! D Ob6 % ' 0E< kQ4i Q4 Q1
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5> <5
@ `!i1 c " "Social Work Revolution! <;
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!EiQ Inductive approach 5N !< ' b 6H6 2E4i
w9 .Logical Positivism !< fi1 5< 'iQ ' c
;?9 ;= c @ H9 ;i kE?! . b1 5 d6jx,P
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.(Review" (Fischer, 1973
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5P.
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=
H - -i Deductive Approach 5mQi D1, z6,!c6
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.
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4
! "The Disease Concept of Alcoholism " "@c 52b ! <;
!?,; !2!< dc1 2 -6.-
b E Jellinek d ; ' P, HN:
`' : i H, t !9y1 -i dc 8 &! E 5 6
1 = H1 ).(Jellinik, 1960
.1 :(Alpha Alcoholism) 6
b i t !Q i< 0E< 5H6, 6!2 !
i 1@H,t= %-6 5m@c.
.2 :(Beta Alcoholism) 1
b i t 4, 5< d t 5H6i 5HP !>Eb i
t ' ! ! Q9> H 2" 5m@c .1 5i
\ !2 ! 9 5< 1@H,t= %-6 5m@c.
.3 = ):(Gamma Alcoholism
!Qb i "! , t 5i !"cb i < 5 @
`! .c d+b i t \ i 5< -P
@ `! c&! . = 5i8 1 ' 5H6@c
8 E61!4H %-, ' @c 5 = 5i< .-,m!H <5
5m@c '9 b6i c 5 %- E6 %- !QP ' = .g'
!& % <] %-41 = 5i@ 5< %c= fb m <; @c .
%-41 = 5i 4E, @c ` !- i '9 c Q
yc ` '9E6 !4H ' %-H6,Q i1 y 1`!.
.4 ):(Delta Alcoholism
!+i < 5 1 ;1+' D 1 9 = . 5i 8
= 5i 5i %-41@ c1 %c 5 5< -,1!+! d
m < -@c . 5i ' = 5i zc4H @5< %c
Qi!+ %-41 z< 4E,t 5m@c .9 x4
b i t i QH,@c < %H 5 < D 5`=
f>=i Ob QHi@ ` ',Q ! @H,t -?1 dP
, \ 5m !4@c 6 Ob`!.
.5 H1 ):(Epsilon Alcoholism
b = d, t +, Jellinek E H1 ;,9
c = . 5iH1 1!+ ' <! 4E i %-ic,c @ f!y
@c <] %-,>@Q <& 5 gi& Q!< 5-i !+ c+1 %- !+1.
" :, 5i@c ! y1! D1 d9 % @2E %- xiOb
! d9 5:5
dQ= 9! ot:
8 Ob!
1 9 @c @ 5 kE! x> i
@ 5 --`<! <9 5 %- d .X ! Ob- 5m`Q '
dQE@c %HP X 1 O' cm b' {E 5
!< 1 d>6 !+ d ' z6,6 4.
9! ob,t t1:
8 Ob! H
1 9! @ !< (1) 5 <E b! Blackouts
=>! ` d 5@ <! !+ 1 Q! (2) !+ (3) 6!P
@c (4) @ @c ' !c6 <> |Q d! O!c69 8 @c(5)
+ x,b1i H kN !jb @ = P, @ f !y@c.
< 5 Ob! 9 5iQ 9 ?, ;H6,< Q !mc,]1 ;E t '
@c.
o! 9@!:
< 5 Ob! 9c ' 5HP@c @2 '
!4 E6; ' !+ w@1>= !& |Q ' @ c1 %c 5m <5
<! !+ . c4 > <\ d Ob! 9 ,!?, ' -9! -,
E6E< d`= >@ `! ).(Wallace, 1986
o! 9:i8
Ob! 9 5! 9`! 5! -1 = dQ< .i b
! !Q d9t '9! 9 Q& i8! %-1, +d
> x
6 5! 0Q .@c1& Q,c = E < 5
>@ t @c . `! ! Ob- HN!E< 9 b! <E
E %HP ' dQE@c !+ < D 5`= b@,
).(Lawson, Peterson & Lawson, 1983
:
!Q 2! @c !?, ->, !?i ! .2 E!9 -6
! @c 52 QE 1 i
>> ' 9H
Q 5 -6 ! 52 d- %-6 @2` ;, !?i PQH
5i@c ! ` c ;, i@> ' ! 2%- d
2 d y>@ .5b9 E Jellinek
b -6 w9!Q ;,
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"!" -6< . ! ;1 >= 52 !?i P 5i QH@c
8r E9 ' g4 9y d .%-
:
Total Abstinence
iH= g !+ !?i ! 2E ' 2!< 9-
5!6 5i@c %E %- xi! y1! D11 d9
)! dQ= 9t ! 9b,t t1 ! 9@! !9
.(i8b k4iX !?i !!2 ' 2 = g !+ !y1
{E c`!2 = t ' @c E1 4H 9,=g
! !Q d9t 9 '< .]< Ohlms !Q @c < E!4H
' @c = 5m )! 9@!( %= g 5m@c <] ;,Q
w9=) g! 9@!( ).(Ohlms, 1983
!
:
9iQ dy !?i -,c E!E 5N .5mQiQ
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8P E< 5mQi ' %N= ;,c E,Qi <!2 <!2 rQiH
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< 5= D "! E, 5!?i f- !41 = -Q E! &!
Q! !41 E -1 f= 5!?i!4< . E! 5 !?, Kellinek -1; %c
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6 59 .- ;,!
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<' dQ" 1 , t
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= < 0E" ! EE9 2 E1`, < - kQ4i-6 !<2t1 .52
' <!"c iP xHi @c4 < 5 OP 0E< 9 '
b -, jt ! 5< i1 Irreversible D= % i D!4 b-
2 ' mt E< . %! !H6 d9t D i -= 5- 5
)= g !+( ' -,! y1 i 5i2 ! 4 !1
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!H6-
< .6
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!?i dQ= QH 5i @, DP@c .' !& % @c !?i -
= dQ
>> ' ! -, \ D4H @.;1 %c
! - !?i 5 ! Ei 24E, < b !+
' !& % ;,!1 5< NH 6+H @c Q& ;, ' %E;,
" z 5 d-H ; . b k4i! b - Ei 5
;,c D %N" <E 1!j 5 ' DP+ 5m@cb . <] Q+ != E
QE = g !+ P, = %-ib 5i %-,y1@.
E6+H Todd & Selekman E, >@ @c 5'iQ
!?i ! 2y !?, 5< -P - {
+`9 b m @c
' i %-, H
b z6, -!4 5i D
H@c
Q Ob-< .H6+H >@ H 1! {
+'
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.i %-,y1< 9 5<~ `9 ! b1 % !?i %- ' %- d%-,
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y ' b 6+H 5< i- t =m %--
iP t 0E< ;H6, %-PP rQ?! @4
i1 Q& 5c 5< xQH X ' t ! ! ) Shapiro,
.(19808 P d i- !?, - ;H6,` 5!
@ (Todd & Silikman, 1991) -EEQ X i-b
b-1 ?i 52!6 9 ;,= g d 5m@c <] +;
`! !
!m .56 E !c6 Ob8, DP+ + d) d( m
= - 5b .(Thorely, 1985) ;< f9
' !& % 5X ib E %-
<6+H 5 >@ @c 5 'iQ= g !+ - - 5
X Qj?' %-iHci 5m@c 8 Ob6+H
>@
H z6,- Emrick & Hansen, 1983; Helzer et al, ) 5
.(1985; Porich, Armor & Braiker, 1981
: :
bi = Jellinek!?i ! 2 5@?' QE1
>> 5i
@c ' 9 .' !& % `Q 5 %-PQE !?i !2
g DP! -,`<\ 5i< .d@c ! !?i !fEE9 = 2
%- !"c dQ '< xc" % )< 5!j( !?i' ' @c-,
" d!@,< E @c H, !P 0@i %E` E< .!j
Ob!?i ' !?, g41 1@> i 9 ' %-<! < dQH
6+ %- <2t1 .@c' <] !?i ! fic 2 i c
%- 2 y>@ 5 b1 f9 %-`Q !' Q
9, ' %-P; ' >@ xm 9,!
) Pattison, Sobell & Sobell, 1977; Heather & Robertson, 1983; Lawson,
.(Peterson & Lawson, 1983
;,
H
<2t1' <] !?i !b %- f= 2 QE
' <!m < 5!+b . <] !?i @c! f,@ !"c1 d- P
!H6
,` 6 H t.5,
]< >>
QHi1 !?i ! 2" 4E, d@ dE9 5< HN
@c!?i< . ! 2 5 xQH! 5HN g ?i 5iQ>@ -6
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! @c 52 ! @c1! b <] -, !QE ,= - 5i1 5
5< 1970 @ `! c+,]1 52E >@ c9 i
H >@ 4E
b@ = QHi1 .@c
b P, s
>> d' 5iQ !?, -!?i ! 5< 2'< .@c
dQ" ) (Bailey, 1970 %85 QH,`> N )>5N
!6( b s D4 %-NX E "y1 ! @c".
X dQE
>> !?i ! 2 Qj?' !Q
6+H
]1 @c 'iQ= g !+ - .- 5
< bi = f!?i ! 2 '9 = g !+ dE9 ' !4H
@c d\<y xH, 5 9i` = 9i . 'iQb -
9 5E %90!Q
>> @c
).(Todd & Selekman
: :
< 5 !-S 1962 @ + % 5 D4H!?i ! 2E %!H6
= E< .- %!]1 L.D. Davies 86 Q 93E < 59
6+H <!1 5 ,4, = % ' %->
+ i %-,@c ,
= .4 L.D Davies > %-i QH1 %m @c !41E
.Qm 5i = %-, @ c1 %-c 5 .-,mb !?i ~=i DQ41
! 2 5!6 y1 ! @c !1 %= g 5m
@c E ; . 1 = 5i>6 E61 %-,!4H ' c5
!?i QHi1 !.2
b -,m <] !4H %- ' c !Q! @
w9 <E !4H ' @c m 5 5 = 5i!Q
w@1 i8 9 D4H @ ' ;c @c m @b .
< E!Q 9 L.D. Davies QHi1 d61 OP 5) NH!?i
! (Heather & Robertson, 1983) (2 9 i !"c < dE9 5
@c >, !?i ! 2 dEy 9, -< 4
9,! E< . x!"c ' <! ib %-1% L.D. Davies %-
,c , i = d1, @c m < .0E s x! '
%P9 i !j ; z = ' mt ) Esser, 1963; Selzer,
.(1963; Smith, 1963; Tiebout, 1963
: :
1 L.D. Davies %!"c Ni1;= E< ) Linda and
1 (Mark Sobell 1973; 1976 !Q= 9iQt P-i
= E< .+ 1 Sobell & Sobell i
d; !41 86 E P
400@ , = xH9 !H6b =; !?i ! H= % .2 Obi
' Pc P 200 -i d
H -= g !+
- 5 P
H -@!+1 %c - 5 1 = Hd
P' 412 P!P Q`:5
o P`' : 5 P!P Q@ 100- 5
= g !+
1
4 !+ 5itH "5i
! 5-P ."%
o P" :, 5 P\ P 41!P 5< Q P`'
@ 100- 5 = g !+ 1 E %
H .5i- d
10
11
!+ !+ !41 QE Qm E ( 1 H Heather & ) i-
.(Robertson, 1983
' !& % i 5i@c @ @> ' H i-
d; 5@c 5< d+6@ kE]< !?, @!+1 %c !H6 z ;,y1
i ' mt " fQ 9 ,c .d61!?, @!+1 %c
! ;, < 1 d 5m@c = dQb 5i %- k4@ 1
5m@c i.
0
.-'
+ ,- * ) '& % :
.1 ;, d 5i dP@c QPH @c !41 E
g
i b 1!+ @c .< 5= !& ;,]< D= D+ " dOb
d ' 5i@c < 5 !P Q 5
\DQ41 D
@ %c
dQ= 5 "9Q?! !P Q
!Q % ? %- !-!
<E !4H ' !+ t @c !QX! '
d .
' .2!& % H t 5,! ' 9 @1 !Q' 5m@c
{ `! 1@H,t' !& % `! 1@H,t c
!X xPH X ' 8 8 5m@c ;,]< 1P
&! = D !j H N! Pi < 5 5m@c c
rH ' !+ !< 1 = g !+ i Qj?'
5i@c ) .(c,
.3 E y1 5i@c b =6 !+ r!1 5< m!
i
4H @ %-1!+1 %c ' !+
5
\! = N, ;\=, .
:'
+ ,- Controlled Drinking
k4ib - 5 !?, @!+1 %c 56 ' iH%
<!2 !?, %E @!+1 %c - ' 5<! @c
%= d1 .dE !Q 5 DQb -
1 5 icd
H % b < E!4H ' c 5m @c gH
Ob!4H ! ! c!+ !41 E ) Anderson, 1987; Pattison,
(Sobell & Sobell, 1977; Sobell & Sobell, 1987
b1 c !+ \ 01 5@ Kuhn -2 " = 5< f
dE9 @c !6 >!?, |Q @!+1 %c OP 5P .
= D g % ;,@ @ OP 5 NH' OP
5P . !?, @!+1 %c %@ QE1
>> < dE9 5 @c
P1 -mQ d x,P1 E!?i 5EQ4 Ob d 5
:5
o : !?, @!+1 %c < 5< f+@ @c 5 c i-
?!?i< .;1!+1 c@ d N= -H6, ' <!c @.;1 %c
< 5> 5< gi!N !?, @!+1 %c
f!
6
! g@ !+ @9 -\Q< .;1 %c !+ 11 !Q < 5
12
~Q! 9 < 5 ~Q! 9 @!+1 %c yc1
5< 5cH bc .b < 5 @!+1 %c d!?i !2
E, + c< . x; ) !& ;,]< (Fingarette, 1988 c>
c f 'mX !Q < 9 > ' gi;,
@.;1!+1 %c
:, o+ d N\E>
Q9 kQ4!?i < - .5 =!f,
!?, @!+1 %c -S bi !?i < dE9 5 @c +1d
5< N\EP @1 1!j w9 |H?i 5< 5N\E P
5i@c <! 9 5@> 9` %- t 5 'iQ@%c
!+1 - - 5 %-Qb - !6 5 .8 %<5
9 9
6 = dQ= ,, ;H6,]@1 ;1 ' dQ
" E c+1 ' >@ ' -, 5< xQH@
Q1 !+1 %c@1 ;@>, -, % D4HE b ;1 < = %-y4 <5
;9 {
+ %-< %rH @ .b-1 |Q x,P 5,,E
D\ ~E
>> < dE9 5 .@c d %-i !"c Q
!?, kQ4 @!+1 %c @> 5< i-
@c '9 .-1 iE
d>, i' 2 01" c 5< kQ4i
c Pi
g 5 5< kuhn -6 < .Q4
g
-Qm w9 Q4= ' - !j< . Q4
c @ < -@ ! D 5 OP' s! ' P, fQ " 5,<;
=; ' ! !H6?! !41 -i 8P E` . < 5 <]
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b <] " @ < 5 '9 2 fEQ4, -41
H
.kuhn -2 8 @ - @?' OP 5P QE1
>> w@1
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.1 Paradigm N 5 OP
?9 .2 OP 5QE1 NH
>>.
-S .3 9 Anomalies D4H OP 5 NH !H6.
.4"! -S @ + X-!6 ?- 5 OP.
-S .5 OP 5P New ParadigmX ' 9 @ OP
5 NH' OP 5P .Paradigm Shift
?9 .6 OP 5P QE1
>>.
:k
E 5< %b E ! ! \ 01 5@ kuhn -2 "
. g " -6 ~1 f1b < 5 9
%-1' -6S 6S!4 rm ~1`<c %<c ! = N`! b
< %-' P ~1 d! \ 01 5.kuhn -2
13
<2t1' <]
6 kuhn %" < 5
xP ! D % ~Q Q 5 ]< f gS 6 %c
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6S@@ QE
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%@E <E 5, 26 &! r<c Q4X
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9 ' N= -, E 1 , Q4
1 ! 6 .-i11 <] Q4 %-6 ! 0QmQ
1 E %P9= . !& ;, Q4 5E4i
% ' - %8@ .;EE; <] " =9 D 5< -
ct1 , =9 D !j ,4 Qm %N Ob .b Q41@
5i @ OP 5 NH' OP 5P Paradigm shift@
< 5 d1 5i 9; ]1 %E Qm D %PHi !j .5
< D 5`9 <] @ OP 5 NH' OP 5P
@ <! OP 5P QE DP
>> .b 1 Ox4
N OP 5P " <ENH < 5 DPb !m <; 9,=kQ4 ;1
1 ' !NH DP
>> 9,!.
14
x!1%
" 1991 -i w@Q 5 - <4, 5 -H
E w@1 ",H,t ' , y d
5 t .E! :-
!c6 5.5 t
x!1%
" 1991 dy d 5 t ) D -1H
E w@1 ",H,t ' , y d
5 t .E! :-
!c6 5.5 t
15
Alcoholics Anonymous
1939 Alcoholics Anonymous. New York: World Service Inc.
.Alden, L.E
1988 Behavioral Self Management Controlled- Drinking Strategies in a
Context of Secondary Prevention Journal of Consulting and
Clinical Psychology, 56, 280 -286.
.Anderson, S
1987 Alcohol Use and Addiction Encyclopedia of Social Work.
Eighteenth edition.
.Bailey, M.B
1970 Attitudes Towards Alcoholism Before and After a Training
Program for Social Caseworkers Quarterly Journal of Studies on
Alcohol, 31, 669-683.
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