Prevention and Treatment of Alcohol Problems Research Opportunities (1990) / Chapter Skim
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12 Advances in the Treatment of Other Psychoactive Substance-Use Disorders: Implications for Research on Treatment of Alcohol Problems
12 Advances in the Treatment of Other Psychoactive Substance-Use Disorders: Implications for Research on Treatment of Alcohol Problems
Pages 247-266
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From page 247... ...
Most persons with drinking problems are not self-identified and are not trying to stop drinking. Thus, research on smoking cessation occurs in a substantially different social climate from alcohol treatment research, which may limit the applicability of some of the smoking research to the alcohol field.
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From page 248... ...
Moreover, alcoholism treatment research has not systematically evaluated the change strategies alcoholics actually use in order to determine which interventions might be effective at different stages in the change process. The following questions represent opportunities for research on processes of change: · Do persons with drinking problems go through identifiable stages of change and use unique processes at different stages?
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From page 249... ...
O ~ The following questions represent opportunities for research on cognitive variables: · Do self-efficacy and outcome expectancies predict success in changing and in maintaining changes in drinking behavior? · If self-efficacy and outcome expectancies predict positive treatment outcome, what treatment techniques or settings can most successfully affect these variables?
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From page 250... ...
studies of the relative effectiveness of different types of coping responses. The following questions represent opportunities for research on relapse and coping studies: · Are different types of relapse situations and coping responses associated with different outcomes or drinking episodes?
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From page 251... ...
studies of other aspects of the alcoholic's social environment. The following questions offer opportunities for research on social support studies: · Are certain partner behaviors associated with more and less positive alcoholism treatment outcomes?
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Relatively little attention has been given to methods of altering the internal components of an individual's motivation. The following questions represent opportunities for research on motivation studies: · Do specific health beliefs or positive expectancies about the benefits of decreasing or stopping drinking positively affect an alcoholic's decision to decrease or stop drinking and to maintain change?
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From page 253... ...
In summary, the highest one-year success rates come from multiple-component, behaviorally based treatment programs that specifically combine rapid smoking with other behavioral treatments And nicotine gum with behavior therapy (Schwartz, 1987~. Several factors differentiate smoking cessation treatment from alcoholism treatment.
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From page 254... ...
Simple physician advice, taking as little as one minute, will yield median quit rates of 6 percent; physician advice coupled with other interventions (e.g., additional information, questionnaires, feedback about health effects, careful guiding of quit attempts) results in one-year quit rates of 22 percent (Schwartz, 1987~.
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The following questions represent opportunities for special population studies: · What types of alcoholism programs attract and retain the highest proportions of potential subjects who are minority group members? · What is the relative effectiveness of alcohol treatment materials that are specially tailored to the target population, compared with generic materials?
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From page 256... ...
patients presenting for treatment and the growing reliance among drug dependence treatment providers on methods and procedures similar to those that were traditionally used for alcohol dependence (e.g., AA, relapse prevention, breathalyser screening, disulfiram) bring these two fields even closer and suggest several avenues for future collaborative treatment and research efforts.
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From page 257... ...
By contrast, group therapy, as generally practiced in alcohol dependence treatments, is not manual guided or supervised, may or may not be professionally guided, and often uses a confrontational approach. The following are opportunities for alcoholism treatment research suggested by psychotherapy research in drug dependence: · Research is needed to evaluate the role of manual-guided or supervised procedures in the performance and efficacy of group psychotherapy for alcohol-dependent patients.
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From page 258... ...
These extinction procedures have been shown to reduce opiate- or cocaine-related arousal and drug craving but only after a long series of exposures, usually 30 sessions (Childress, McLellan, and O'Brien, 1986~. These studies of conditioned factors in drug dependence parallel findings of conditioned physiological responses in alcoholics after the presentation of alcohol-related cues (Ludwig and Stark, 1974; Meyer et al., 1981)
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From page 259... ...
These drugs have been evaluated, and the implications for their use in alcohol detoxification are reviewed in Chapter 13. There are separate types of pharmacological agents that have been developed and tested by drug abuse treatment researchers, each of which has a different therapeutic goal.
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From page 260... ...
1. There is a significant comorbidity of nicotine dependence and alcohol dependence and a significant comorbidity of other psychoactive drug dependence and alcohol dependence.
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From page 261... ...
Behavioral methods are among the most commonly applied approaches to smoking cessation and the treatment of other drug dependencies. The use of behavioral approaches has been more limited in the alcohol field.
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From page 262... ...
Measurement and extinction of conditioned withdrawal-like responses in opiate dependent patients. In Problems of Drug Dependence, 1983.
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From page 263... ...
Rossi, K Perun et al. Social support, demoralization, and quitting smoking: A structural model.
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From page 264... ...
Predicting response to alcohol and drug abuse treatment: Role of psychiatric severity.
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From page 265... ...
live and four mg nicotine chewing gum and group counselling in smoking cessation: An open, randomized, controlled trial with a 22 month follow-up. Addict.
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From page 266... ...
Woody, G
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