The aftermath of heresy: a response to Pendery et al.'s (1982) critique of "Individualized Behavior Therapy for Alcoholics"

A point-by-point response is presented to Pendery et al.'s (1982) critique of the study “Individualized Behavior Therapy for Alcoholics (IBTA)”. Two independent, external investigations have critically examined the original records from the IBTA study. The IBTA study compared two different techniques for treating poor-prognosis, chronic alcoholic state hospital patients. It was found that a broad-spectrum behavioral treatment oriented to controlled drinking was a more effective treatment than was the standard hospital treatment program based on conventional wisdom. The Pendery et al. critique gave the appearance of being a refutation by presenting findings for only one group of Ss in a comparative study. In this response, it is shown that the experimental and control Ss were justifiably classified as gamma alcoholics, that Ss were randomly assigned to groups, and that the two groups were comparable in terms of pretreatment characteristics. Moreover, as regards the originally reported 2-yr treatment outcome findings, it is shown that Pendery et al, reported no specific events which were not already documented in the original study records which formed the basis for publications about the IBTA study. Finally, even in terms of long-term outcomes, i.e. mortality rates 10–11 yr after treatment, the experimentally-treated group (20% mortality) continued to fare better than the traditionally-treated group (30% mortality). Ironically, rather than Pendery et al.'s report being a refutation of the original published accounts of the IBTA study, it is concluded that the data reported by Pendery el al. actually strengthen the validity of the original publications. The attack on the IBTA study can be meaningfully viewed as a reflection of the scientific revolution presently underway in the alcohol field. The central impetus for conceptual change in the alcohol field, however, derives less from controlled-drinking research than from the lack of empirical support for conventional wisdom. Ideas are changing because the traditional view no longer inspires progress.