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Behavioral treatment of alcohol problems : individualized therapy and controlled drinking

1978; Linguagem: Inglês

Mark B. Sobell, Linda C. Sobell,

Behavioral and Psychological Studies

1 The Nature of Alcohol Problems.- Traditional Concepts of Alcohol Problems.- Alcoholics Anonymous.- Jellinek's Disease Concept of Alcoholism.- A Conceptual Reformulation.- Differences between Traditional and Empirically Derived Concepts.- Conclusion.- 2 Alternatives to Abstinence: A Departure from Tradition.- Once an Alcoholic, Always an Alcoholic!: Tradition Contradicted.- A New Look at an Old Problem.- Individualized Behavior Therapy (IBT): A Nontraditional Approach.- Traditionalists Respond to the Mounting Evidence.- Nonproblem Drinking Outcomes: Unexpected Consequences.- Conclusions and Cautions against Misinterpretation.- 3 The Functional Analysis of Drinking Behavior.- A Functional Analysis Model of Drinking Decisions.- What Constitutes a Drinking Problem.- A Detailed Consideration of the Model.- Implications: Strategies for Intervention.- Further Considerations.- 4 The Early Patton Studies: An Empirical Foundation.- The Research Setting, Circa 1969.- Baseline Drinking Behavior.- Videotape Self-Confrontation: A Demonstration of the Value of Scientific Method in Clinical Research.- Modifying Drinking Behavior.- Reinterpreting the Adage: First Drink, Then Drunk.- Evidence for a Learning Deficiency.- Integrating the Early Research.- 5 Individualized Behavior Therapy (IBT): A Broad-Spectrum Behavioral Approach.- Experimental Design.- Subjects.- Assignment to Experimental Conditions.- Treatment Procedures.- Facilities.- Overview.- Modification of the Drinking Response-Avoidance Contingencies.- Videotaped Drinking: Sessions 1 and 2.- Education: Session 3.- Videotape Replay: Sessions 4 and 5.- Analogue Failure Experience: Session 6.- Problem Solving Skills Training: Sessions 7 through 16.- Videotape Contrast and Summary: Session 17.- 6 IBT: Emergence of New Treatment Evaluation Measures and Procedures.- IBT Follow-Up Procedures.- Tracking Procedures.- IBT Outcome Measures: Drinking Behavior.- IBT Adjunctive Outcome Measures of Life Health.- General Adjustment.- Vocational Status.- Occupational Status.- Residential Status and Stability Index (RSSI).- Valid Driver's License Status.- Marital Status.- Use of Therapeutic Supports.- Possession of Research Program Do's and Do Not's Card.- Physical Health Evaluation.- Summary Measures of IBT Outcome.- Length of Follow-Up: How Long is Long Enough?.- A Look Back at IBT Follow-Up And a Look Ahead.- On the Use of Self-Reported Data.- Concluding Comments.- 7 IBT: Results.- Within-Treatment Results.- Nondrinker Experimental (ND-E) Subjects.- Controlled Drinker Experimental (CD-E) Subjects.- Follow-Up Results.- Data Sources.- Drinking Outcome: Functioning Well.- Drinking Outcome: Controlled Drinking.- Adjunctive Outcomes: General Adjustment.- Adjunctive Outcomes: Occupational Status.- Adjunctive Outcomes: Vocational Status.- Adjunctive Outcomes: Residential Stability and Status.- Adjunctive Outcomes: Driving Status.- Adjunctive Outcomes: Physical Health Status.- Adjunctive Outcomes: Marital Status.- Adjunctive Outcomes: Use of Therapeutic Supports.- Adjunctive Outcomes: Ancillary Evidence.- Adjunctive Outcomes: Research Program Card.- General Measures of Treatment Outcome.- Predictors of Treatment Outcome.- Method.- Findings.- Summary of IBT Results.- Within-Session Findings.- Treatment Outcome Findings.- 8 IBT: Interpretation of Results.- Follow-Up Procedures and the Interpretation of Outcome Variables.- The Value of Multiple Measures of Outcome.- Case Example: CD-E Subject J. L.- Case Example: CD-C Subject E. M.- Case Example: ND-C Subject R. N.- Controlled Drinking as an Outcome.- Other Considerations.- A Final Analysis.- 9 IBT in Retrospect.- Specific Treatment Components.- Shock-Avoidance Schedules.- Videotape Replay of Drunken Behavior.- Consumption of Alcohol.- Individual Therapy Sessions.- Control Group Assignments.- Controlled Drinking from the Subjects' Viewpoint.- Follow-Up as Continued Care.- Care, Interest, Concern, Help.- Someone to Talk to.- Awareness, Reminder.- It Will Help Others and Research Element.- General Likes and/or Dislikes.- Reflections on a Large-Scale Clinical Research Project.- 10 IBT in Private Practice and Outpatient Programs.- Differences between Inpatient and Outpatient Treatment.- General Considerations.- Compliance and Planning Treatment.- Shaping.- Addressing Immediate Treatment Needs.- Outpatient Behavioral Treatment Methods.- Methods Which Primarily Involve Changing the Antecedents or Correlates of Drinking.- Methods Which Primarily Involve Changing Behavioral Repertoires.- Methods Which Primarily Involve Changing the Consequences of Behaviors.- Concluding Comments.- References and Selected Readings.