Integrated behavior change techniques for problem drinkers in the community.

Abstract

Problem drinkers in the community were subjects in a study that evaluated the therapeutic potential of learning techniques in changing abusive drinking patterns and achieving moderation. The following procedures were studied: videotaped self-confrontation of drunken behavior, aversion training for overconsumption, discrimination training for blood alcohol concentration, alternatives training, behavior counseling, and alcohol education. All the techniques were applied to Group 1 (» = 23), the last four to Group 2 (« = 19), alcohol education only to Group 3 (n = 21), and the last three to Group 4 (n = 17). During the first year of follow-up, significant decreases in alcohol intake were found for all groups, and the percentage of moderate drinkers changed from .0% to 62.5%. Significant differences between groups were not found. The effects on outcome of a large variance in pretreatment subject characteristics such as alcohol intake, as well as the amount of possible change in alcohol intake, the program's learning orientation, and blind follow-up are discussed as factors that may partially account for the lack of differential treatment effects. These issues are considered when comparing the results of this study with the results obtained in a similar study at Patton Hospital with chronic alcoholics. We conclude that moderation is a more attainable and feasible goal for problem drinkers than for chronic alcoholics.Evidence is mounting that drinking usually begins during adolescence and that social

Focused versus broad-spectrum behavior therapy for problem drinkers.

“…With regard to problem drinkers, findings have been mixed. Several investigators have found a modest advantage of broad-spectrum or multimodal procedures over a focused approach (Alden, 1978;Caddy & Lovibond, 1976;, whereas others have found no significant difference between minimal and more extensive approaches (Edwards et al, 1977;Miller, 1978;Miller & Taylor, 1980;Vogler et al, 1977). In two studies using random assignment, we have found no significant differences between BSCT administered by a paraprofessional therapist and BSCT offered in a self-help (bibliotherapy) format (Miller, Gribskov, & Mortell, in press;Miller & Taylor, 1980).…”

Self-estimation of blood alcohol concentration: A review

“…A combination of viewing individualized recordings of one's own intoxicated behavior, discrimination training, forms of aversive conditioning, instruction of healthy alternative activities to drinking, and behavioral counseling resulted in consummatory reduction in approximately 63% of alcoholic subjects (Vogler, Compton, & Weissbach, 1975; Vogler, Weissbach, Compton, & Martin, 1977). However, in addition to continued uncontrolled drinking episodes, the average intake at follow-up was more than 20 drinks per week, much higher than intake of moderate drinkers.…”

Abstinence Versus Controlled Use: A Fresh Perspective on a Stale Debate

“…Although no definitive answer emerges, it seems safe to say that some persons have done so and apparently quite successfully. Research indicates that those who succeed in maintaining problem-free drinking tend to be individuals whose degree of alcohol problems were less severe before treatment, whereas those with more severe alcohol problems and dependence fare best with total abstinence (Armour, Polich, & Stambul, 1978;Edwards, Duckitt, Oppenheimer, Sheehan, & Taylor, 1983;Finney & Moos, 1979;Miller & Baca, 1983;Miller & Joyce, 1979;Miller, Leckman, Tinkcom, & Rubenstein, 1986;Orford, Oppenheimer, & Edwards, 1976;Polich, Armor, & Braiker, 1981;Smart, 1978;Vogler, Compton, & Weissbach, 1975;Vogler, Weissbach, Compton, & Martin, 1977).…”