Abstract
Groups of middle-income outpatient problem drinkers were randomly assigned to one of two treatments: a multicomponent positive reinforcement procedure emphasizing moderation, or “traditional” denial-confrontation therapy emphasizing abstinence. There were no significant differences between participants assigned to the two procedures with respect to pretreatment characteristics. Participants reduced their alcohol consumption significantly in both treatments. Behavioral participants reduced alcohol consumption significantly during therapy, whereas traditional participants reduced significantly prior to therapy. Significantly more traditional participants dropped out of therapy than did behavioral. The data suggested that the effects of traditional therapy were mixed, helping those participants who were receptive, driving out those who were not; moreover, reduced consumption seemed to be more the result of compliance with initial therapist demands (made during the screening period) than the effect of denialconfrontation in subsequent therapy. Behavioral treatment was more successful in several indicators of outcome; the improvement observed seemed to be attributable to the active therapeutic techniques employed.
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References
Armor, D. J., Polich, J. M., and Stambul, H. B. (1976).Alcoholism and Treatment, Rand Corporation, Santa Monica, Calif.
Bandura, A. (1969).Principles of Behavior Modification, Holt, Rinehart and Winston, New York.
Cautela, J. R. (1970). Covert reinforcement.Behav. Ther. 1: 33–50.
Chapman, R. F., Smith, J. W., and Layden, T. A. (1971). Elimination of cigarette smoking by punishment and self-management training.Behav. Res. Ther. 9: 255–264.
Cheek, F. E., Franks, C. M., Laucius, J., and Burtle, V. (1971). Behavior modification training for wives of alcoholics.Quart. J. Stud. Alcohol 32: 456–461.
Cohen, M., Liebson, I. A., Faillace, L. A., and Allen, R. P. (1971). Moderate drinking by chronic alcoholics.J. Nerv. Ment. Dis. 153: 434–444.
Davies, D. (1962). Normal drinking in recovered alcohol addicts.Quart. J. Stud. Alcohol 23: 94–104.
Fehr, D. N. (1976). Psychotherapy: Integration of individual and group methods. In Tarter, R. E., and Sugarman, A. A. (eds.),Alcoholism: Interdisciplinary Approaches to an Enduring Problem, Addison-Wesley, Reading, Mass.
Feldman, D. J., (1956). The treatment of chronic alcoholism: A survey of current methods.Ann. Int. Med. 44: 78–82.
Ferster, C., and Skinner, B. F. (1957).Schedules of Reinforcement, Appleton-Century-Crofts, New York.
Gerard, O., Saenger, G., and Wile, D. (1962). The abstinent alcoholic.Arch. Gen. Psychiat. 6: 83–95.
Hill, M., and Blane, N. (1967). Evaluation of psychotherapy with alcoholics: A critical review.Quart. J. Stud. Alcohol 28: 76–104.
Hunt, G. M., and Azrin, N. H. (1973). A community-reinforcement approach to alcoholism.Behav. Res. Ther. 11: 91–104.
Keller, F., and Schoenfeld, W. N. (1950).Principles of Psychology, Appleton-Century-Crofts, New York.
Lazarus, A. (1971).Behavior Therapy and Beyond, McGraw-Hill, New York.
Lloyd, R. W., and Salzberg, H. C. (1975). Controlled social drinking: An alternative to abstinence as a treatment goal for some alcoholics.Psychol. Bull. 82: 815–842.
Lovibond, S. H., and Caddy, G. (1970). Discriminated aversion control in the moderation of alcoholics' drinking behavior.Behav. Ther. 1: 437–444.
Mahoney, M., and Thoresen, C. (1974)Self-Control: Power to the Person, Brooks/Cole, Monterey, Calif.
Miller, P. M. (1972). The use of behavioral contracting in the treatment of alcoholics: A case report.Behav. Ther. 3: 593–596.
Miller, P. M., and Barlow, D. H. (1973). Behavioral approaches to the treatment of alcoholism,J. Nerv. Ment. Dis. 157: 10–20.
Miller, W. R. (1978). Behavioral self-control training in the treatment of problem drinkers. In Stuart, R. B. (ed.),Self-Management: Strategies and Outcomes, Brunner/Mazel, New York.
Nathan, P., and Briddell, D. W. (1977). Behavioral assessment and treatment of alcoholism. In Kissin, B., and Begleiter, H. (eds.),The Biology of Alcoholism, Vol. 5, Plenum, New York.
Nathan, P., and O'Brien, J. S. (1971). An experimental analysis of the behavior of alcoholics and non-alcoholics during prolonged experimental drinking: A necessary precursor of behavior therapy?Behav. Ther. 2: 455–476.
Pickens, R., Bigelow, G., and Griffiths, R. (1973). An experimental approach to treating chronic alcoholism: A case study and one-year follow-up.Behav. Res. Ther. 11: 321–325.
Pomerleau, O. F. (in press). Research priorities in alcohol studies: The role of psychology.J. Stud. Alcohol, Special Suppl.
Pomerleau, O. F., and Pertschuk, M. (1975). Behavioral treatment of alcohol abuse using multiple techniques. Paper presented at the meeting of the Association for the Advancement of Behavior Therapy, San Francisco.
Pomerleau, O. F., Bass, F., and Crown, V. (1975). The role of behavior modification in preventive medicine.New Engl. J. Med. 292: 1277–1282.
Pomerleau, O. F., Pertschuk, M., and Stinnett, J. (1976). A critical examination of some current assumptions in the treatment of alcoholism.J. Stud. Alcohol 37: 849–867.
Popham, R., and Schmidt, W. (1976). Some factors affecting likelihood of moderate drinking by treated alcoholics.J. Stud. Alcohol 37: 868–882.
Robins, L. N. (1966).Deviant Children Grown Up, Williams and Wilkins, Baltimore.
Rosalki, S. B., and Rau, D. (1972). Serum gamma-glutamyl transpeptidase activity in alcoholism.Clin. Chim. Acta 39: 41–47.
Sobell, L. (1977). Personal communication.
Sobell, L., and Sobell, M. (1975). Out-patient alcoholics give valid self-reports.J. Nerv. Ment. Dis. 161: 32–42.
Sobell, M. B., and Sobell, L. C. (1976). Second year treatment outcome of alcoholics treated by individualized behavior therapy: results.Behav. Res. Ther. 14: 195–215.
Summers, T. (1970). Validity of alcoholic's self-reported drinking history.Quart. J. Stud. Alcohol 31: 972–974.
Tiebout, H. M. (1951). The role of psychiatry in the field of alcoholism, with comment on the concept of alcoholism as symptom and as disease.Quart. J. Stud. Alcohol 12: 52–57.
Wolpe, J. (1969).The Practice of Behavior Therapy, Pergamon Press, New York.
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The present investigation was supported in part by the Governor's Council on Drug and Alcohol Abuse, Commonwealth of Pennsylvania. The opinions and conclusion stated herein are those of the authors and are not to be construed as official or as necessarily reflecting policy of the Governor's Council.
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Pomerleau, O., Pertschuk, M., Adkins, D. et al. A comparison of behavioral and traditional treatment for middle-income problem drinkers. J Behav Med 1, 187–200 (1978). https://doi.org/10.1007/BF00846639
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DOI: https://doi.org/10.1007/BF00846639