Therapeutic community treatment for alcohol abusers: a one-year multivariate outcome evaluation

Perceived self-efficacy as a predictor of aftercare treatment entry by the detoxification patient

63 urban, male, polysubstance abusers enrolled in an inpatient, hospital detoxification program with plans for aftercare were administered a set of 27 items describing behaviors that staff members nominated as necessary to make a transition from detoxification to aftercare. Patients were asked to rate each item twice, estimating (1) the importance of the described behavior to the achievement of aftercare and (2) their perceived ability to execute it. These ratings produced two highly saturated univariate tests, the Importance to Aftercare Scale (alpha = .89) of 17 items that did not predict aftercare entry and the Perceived Efficacy to Aftercare Entry Scale (alpha = .90) of 20 items which did correlate (.28) with entering aftercare.

Substance abuse prognosis with an additional psychiatric diagnosis: understanding the relationship

Patients with alcohol and other substance abuse problems have poorer prognoses if there is a concomitant psychiatric diagnosis. However, because severity of psychiatric problems contributes more than the specific psychiatric diagnosis to prognosis, the nature of the interaction between substance abuse treatment outcome and an accompanying psychiatric diagnosis can be questioned. In this article an attempt is made to understand the poor-prognosis-with-psychiatric-diagnosis interaction through a literature review and an analysis of various problem areas that clients bring to substance abuse treatment. Problem areas were measured with a variety of instruments. The results show that groups that vary in severity of psychiatric problems also differ in severity of problems in other areas. As there is no doubt that such dual diagnosis patients pose a considerable treatment challenge, the implications of these findings for theoretical consideration and treatment planning are discussed.

Alcohol treatment outcome evaluation methodology: state of the art 1980-1984

The methodology of alcohol treatment outcome studies published during two sequential intervals from 1976 through mid-1984 is critically reviewed. Although considerable methodological improvements have occurred over time, major methodological deficiencies continue to characterize much of the literature, with inadequate reporting of subjects' pretreatment characteristics (e.g., severity of dependence) being the most striking problem. Pervasive differences across studies regarding the types of data gathered and the ways in which findings are reported seriously impede attempts to compare studies and weaken the types of conclusions that can be drawn about treatment efficacy in general. It is suggested that journal editors establish standards of reporting for follow-up studies.

Clinical limitations of neuropsychological testing in predicting treatment outcome among alcoholics

The purpose of the present study was to investigate a number of factors that may influence the relationship between neuropsychological impairment and treatment outcome among alcoholics. Cognitive deficit upon admission to treatment was significantly related to the individual's age but independent of the years of problem drinking and the recency of the last drink prior to assessment. Significant improvement was noted on measures of neuropsychological function over the period from treatment admission to 6-month follow-up assessment. On the average, improvement in functioning occurred across time despite drinking relapses during the intervening period. The individual's age, but not years of problem drinking, was associated with recovery of function; neither of these variables interacted with subsequent drinking status to affect differentially the changes in cognitive functioning. Finally, selected measures of neuropsychological function assessed both at admission and 6-month follow-up were reliably related to follow-up employment status but unrelated to the average amount of alcohol consumed per day and to the number of heavy drinking days during the 3-month period between the 6- and 9-month follow-ups. The results are discussed in terms of the need for determining the utility of neuropsychological measures in predicting everyday functioning among alcoholics and for selecting domains of assessment other than cognitive status to predict treatment outcome.

Increasing attendance at alcohol aftercare using calendar prompts and home based contracting

The effect of an appointment-keeping intervention on attendance at aftercare was examined for 50 male participants in an inpatient alcohol treatment program. Subjects received either a calendar prompt and home-based attendance contract intervention (Experimental group, N = 25) or standard aftercare treatment arrangements (Control group, N = 25). Participants were followed for eight aftercare sessions over a 6-month period. Results showed significant attendance differences between groups for the first seven aftercare sessions, with nearly twice as many experimental subjects as control subjects attending aftercare sessions. Further, significantly fewer experimental than control subjects (24% fewer) were dropped from the alcohol program for three consecutive nonattendances. The present study provides an effective technology for increasing aftercare attendance and thus potentially increasing the probability of long term maintenance of alcohol treatment effects.