Changing Perceptions About Self-Change and Moderate-Drinking Recoveries From Alcohol Problems: What Can and Should Be Done?1

Despite abundant indications that resolutions from alcohol problems without treatment are common, there appears to be little awareness that such recoveries occur and a general skepticism regarding their possibility. This paper presents results from a study investigating the impact of hypothetical newspaper articles about self-change and moderate-drinking recoveries on subjects' beliefs. It is concluded that newspaper articles do not appear to have much impact on the public's perceptions. The importance of modifying the general public's knowledge about recoveries from alcohol problems without treatment are discussed.     

Extension of the taste-test analogue as an unobtrusive measure of preference for alcohol

The utility of the taste-test analogue for obtaining an unobtrusive measure of preference for alcohol was examined. Thirty-two male undergraduates participated in each of two taste-rating tasks. In each task. subjects were presented with two beakers containing beverages they were to rate. Although one container was labeled “Alcohol”, and the other was labeled “Orange Juice”, both actually contained only orange juice. Subjects rated the beverages differently on 52% of the dimensions for which ratings were completed. Furthermore, subjects estimated that they had consumed an average of over three ounces of alcohol in the combined taste tests. Wider use of the analogue preference test may have significant value in the study of the determinants of human alcohol drinking behavior.     

Food priming: A therapeutic tool to increase the percentage of meals bought by chronic mental patient

In a motivating ward environment for schizophrenics, three methods of maximizing food as an effective reinforcer were tested. On the basis of pre-treatment measures, patients were classified as (1) “non-chronic meal missers” who served as control patients (Group A), (2) “chronic meal missers” because they had no tokens (Group B), or (3) “chronic meal missers” because they chose not to eat but had tokens (Group C). One of the following three experimental treatments was then administered when a patient missed a meal : (1) visual food priming (observing others eat), (2) oral food priming (sampling one teaspoon of each type of food for that meal), and (3) free meal (being offered a free meal when it was missed). Oral and visual food priming were found to be equally effective in increasing the percentage of meals bought by patients. A post-treatment follow-up for Group B found that this increase was even greater during the follow-up phase. The percentage of meals bought by patients in the free meal condition of Group B decreased during the treatment phase but was significantly above pre-treatment measures during the follow-up phase, suggesting that complete reinforcer sampling may also be an effective technique for increasing the percentage of meals bought.     

Evaluating the performance of departments of psychotherapy

Conceptual and practical issues which surround attempts at assessing the efficiency of psychotherapy departments are surveyed and the advantages and disadvantages associated with performance indicators reviewed. The issues of assessing efficiency in general and the selection of appropriate indicators at both national and local levels are discussed. It is concluded that it is possible to find indicators which reflect the value of a psychotherapeutic service to the community within which it is based, and that the identification of a generally agreed set of such parameters is a matter of priority.     

A Dual-Focus Motivational Intervention to Reduce the Risk of Alcohol-Exposed Pregnancy

Project CHOICES developed an integrated behavioral intervention for prevention of prenatal alcohol exposure in women at high risk for alcohol-exposed pregnancies. Settings included primary care, university-hospital based obstetrical/gynecology practices, an urban jail, substance abuse treatment settings, and a media-recruited sample in three large cities. The intervention was based on motivational interviewing and targeted both adoption of effective contraception and reduction of alcohol use. Treatment included 4 manual-guided sessions delivered by mental health clinicians and 1 contraceptive counseling session delivered by a family planning clinician. This paper describes the rationale for treatment; the use of motivational interviewing and the transtheoretical model for a dual-focused approach to behavior change; the development of the Project CHOICES intervention; development of the study protocol and treatment manual; and selection, training, supervision, and monitoring of study counselors. Implications for future applications of the intervention are discussed.     

Alcoholics treated by individualized behavior therapy: One year treatment outcome

One-year treatment outcome results are reported for 70 male alcoholics who, while hospitalized at Patton State Hospital, served as subjects in an experiment evaluating ‘Individualized Behavior Therapy (IBT)’ techniques. Initially, subjects had been assigned to a controlled drinking or non-drinking (abstinence) treatment goal, and then were randomly assigned to either an experimental group receiving IBT or a control group receiving conventional state hospital treatment. One year follow-up results demonstrated that IBT treated subjects had functioned significantly better than control subjects. Dependent variable measures included daily drinking disposition, general emotional adjustment, vocational satisfaction, occupational status, driving status and an index of residential status and stability. The results support the view that some ‘alcoholics’ can acquire and maintain controlled drinking behavior over at least a 1-yr follow-up interval. The difficulties of designing and applying sophisticated follow-up procedures and measures are discussed.