Journal of Substance Abuse Treatment, Vol. 6, pp. 69-70, 1989 Printed in the USA. All rights reserved.

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ABSTRACTS FROM (VIDA r

ALCOHOLICS’ ATTRIBUTIONS OF FACTORS AFFECTING THEIR RELAPSE TO DRINKING AND REASONS FOR TERMINATING RELAPSE EPISODES

This study was designed to examine alcoholics’ attri- butions about their relapses. The subjects were 36 male alcoholic participants in a study of the effective- ness of group behavioral marital therapy (BMT) for alcoholism. Subjects’ treatment condition had been determined by random assignment to either the BMT, interactional marital therapy, or control group. At a two year posttreatment follow-up interview, subjects were asked what they thought the main reasons were for starting and stopping drinking in their two most recent relapses. Subjects’ responses showed that both interpersonal and psychological factors were perceived to affect relapses, with some treatment group differ- ences in how relapses were viewed. Subjects reported a variety of factors in their stopping drinking, with anticipation of negative consequences the most fre- quently reported reason. The treatment groups did not differ on their attributions for relapse termina- tion. The results were interpreted as replicating and extending previous studies of relapse among alco- holics by showing the importance of spouse and other family members in subjects’ attributions of relapse and their termination. 3 Ref.

Maisto, S.A,, O’Farrell, T. J., Connors, G. J., McKay, J.R., Pelcovits, M. (1988). Addictive Behav- iors 13, 79-82.

For reprint: Stephen A. Maisto, Butler Hospital, 345 Blackstone Boulevard, Providence, RI 02906.

THE EFFECT OF TYPE OF AFTERCARE FOLLOW-UP ON TREATMENT OUTCOME AMONG ALCOHOLICS

Past research on methods for actively engaging alco- holics in aftercare has been mixed with respect to the effects of such efforts on treatment outcome. The present study examined whether active follow-up meth- ods do aid in engaging the alcoholic in treatment, whether such procedures improve treatment outcome, and how much responsibility the therapist must be willing to assume in order to maintain the patient in treatment. Appointment keeping was significantly im-

*National Institute on Drug Abuse, Rockville, Maryland.

proved by a home-visit follow-up method in the first 6 months postdischarge (p .Ol). However, there was no one-to-one correspondence between improved ther- apy attendance and improved treatment outcome. When subjects were classified into treatment dropout and treatment completion groups, however, a treat- ment effect was achieved. The most intensive follow- up condition increased the probability of treatment completion, supporting to some degree the utility of aggressive follow-up. However, it was concluded that the cost of such procedures probably will limit their use since a significant economic variable (number of days hospitalized during the follow-up year) was not affected by type of aftercare. 38 Ref.

Gilbert, F.S. (1988). Journal of Studies on Alcohol 49(2), 149-159.

For reprint: Francis S. Gilbert, Sepulveda Veterans Administration Medical Center, 16111 Plummer Street, Sepulveda, CA 91343.

PREVENTING RELAPSE TO COCAINE

An effective treatment program for cocaine addiction must incorporate education and counseling. Educa- tion is a key element in preventing relapse; patients must be taught to understand the subtle cues by which they are affected, the multiple factors that drive their cocaine use, and the need for complete abstinence from all mood-altering substances, including alcohol and marijuana. Although abstinence is essential to relapse prevention, it is not the only issue. Recovery can be achieved only when patients change their atti- tudes and behaviors that led to and/or were associated with drug use. Patients must learn: (1) that relapse begins long before drug use occurs, (2) to anticipate high-risk situations, and (3) to develop alternative coping skills to manage the stress and frustration of daily life. Moreover, if relapse does occur, it must be viewed as a learning event rather than as a negative, guilt-provoking disaster in order to avoid recurrences. Analytically oriented psychotherapy is contraindicated early in therapy; counseling and self-help groups must provide support that is reality-based. 4 Ref.

Washton, A.M. (1988). Journal of Clinical Psychiatry (supplement) 49(2), 34-38.

For reprint: Arnold M. Washton, Ph.D., The Washton Institute, 4 Park Avenue, New York, NY 10016.

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