Martin Lakin

Stages and processes of change among polydrug users in methadone maintenance treatment

We applied the stages-of-change model of Prochaska and DiClemente to the problem of drug use among methadone maintenance patients to examine correlates of different stages of treatment readiness. The 276 subjects were divided into stage categories based on self-reported drug use and questionnaire responses regarding plans to discontinue unauthorized drug use in the future. Confirmatory factor analytic procedures validated four process scales derived from a 60-item questionnaire. Each stage was characterized by a profile of change-process scores largely consistent with predictions, though these scores did not distinguish stages as clearly as has been reported in previous research. Analysis of subject characteristics revealed that those in the Precontemplation stage reported significantly longer treatment tenures than subjects in any other stage besides Maintenance.

Coping strategies and continued drug use among methadone maintenance patients

Drug addiction has been conceived as a maladaptive means of coping utilized by individuals unable or unwilling to deal with stresses in more adaptive ways. Although a growing body of evidence supports the link between alcohol abuse and maladaptive coping styles, there is relatively little empirical support for the connection between maladaptive coping and other kinds of drug use. The present study employed a cross-sectional design to assess coping and drug use in a sample of 276 methadone maintenance patients. Structural equation modeling was used to assess the factor structure of the coping measure and the relationship between coping and unauthorized drug use. The results suggest that coping and drug use are related in this population and that this relationship is different for Black patients than for White patients.

Morality in group and family therapies: multiperson therapies and the 1992 ethics code.

Although virtually every psychotherapeutic approach or orientation has adapted group and family therapy to its conceptions of psychological dysfunctions and how to treat them, levels of training of practitioners in all of these approaches are often insufficient to meet the requirements of ethically as well as technically responsible conduct of treatment for persons in groups and families. The new ethics code (American Psychological Association [APA], 1992) does include a few issues specific to multiperson therapies, but other issues critical to the competent practice of group and family therapy remain unaddressed. The result can be confusing to those applying standards for individual therapy to multiperson therapies. It is argued that the classical ethical concerns of psychotherapists, informed consent, confidentiality, countertransference reactions, aand intrusions of therapist values, require special sensitivity to how they are expressed in mulitperson therapies. Practitioners of group and family therapies must be better sensitized to the technical distinctions and the associated ethical vulnerabilities of the modalities they use. Future planning for revision of the APA ethics code should take these factors into account.

A Therapeutic Vehicle in Search of a Theory of Therapy

The authors examine processes involved in group sensitivity training and cite various studies and points of view that attempt to explain the emotional impact such training has in encouraging behavioral and attitude modification. They suggest that the changes that may be induced through sensitivity training appear to be similar to those that may be induced through psychotherapy. If it is possible through further investigation to specify what it is that seems to induce change in the public situation of the sensitivity training group, then it may be possible to learn more about what is effective in the therapeutic situation.

Content analysis of helping group interactions: Toward a developmental perspective

Age comparative content analyses were carried out for eleven support-discussion groups. Comparisons of six groups of elderly persons and five groups of college youth revealed that the older more frequently discuss bodily changes, family relations, significant others and external sources of self respect. The young were more concerned with physical vulnerabilities. The elderly were more likely to discuss matters in terms of the past. The results are considered in the light of a life stage developmental conception of group behavior which could have implications for helping interventions.

Group Processes in Helping Groups: Toward a Developmental Perspective:

Ten interaction dimensions of group behavior and three emotional atmosphere categories were coded and analyzed on the basis of interactions among old and young participants in experimental “support-discussion” groups. The seven groups of elderly and five groups of young differed significantly with respect to frequencies of Boundary, Self-disclosure, and Support behaviors. In addition, the young were rated as showing signs of boredom more frequently. The implications of these results for development and age-linked assumptions about helping group interactions and interventions were explored. The results suggest that this approach is promising in generating knowledge that could facilitate age-appropriate group intervention strategies.