Michael R. Liepman

Evaluation of a Program Designed to Help Family and Significant Others to Motivate Resistant Alcoholics into Recovery

Little empirical work has been done in the alcohol field on the issue of motivating reticent people into treatment. This study explored the impact of a program that involved counseling an alcoholics social network to eventually confront the alcoholic in urging him or her to seek treatment. Twenty-four social networks (relatives plus significant others) participated in this study and of these, seven formally confronted the alcoholic. Social networks were not randomized to confronting vs nonconfronting conditions, although the comparison groups were equivalent on several important dimensions. Results indicate that alcoholics who were confronted were significantly more likely to enter an alcohol detox or rehabilitation program and to remain continuously abstinent than were nonconfronted alcoholics. This study suggests that the alcoholics social network can be helped to become highly influential in motivating the alcoholic to seek treatment.

Patient-treatment matching for alcoholic men in communication skills versus cognitive-behavioral mood management training

It would be helpful to be able to predict which alcoholics will be more likely to benefit from specific forms of treatment in order to optimize treatment resources. Certain hypothesized patient-treatment matching predictions were investigated with 52 alcoholics who received either communication skills training or cognitive behavioral mood management training in addition to a standard Veterans Administration inpatient alcoholism treatment program. Significant interaction effects showed that alcoholics had worse treatment outcomes in mood management training if they had higher initial anxiety or urge to drink in high-risk role plays or lower had higher initial anxiety or urge to drink in high-risk role plays or lower education. No significant interaction of treatment with irrational beliefs or marital status was found. Communication skills training seemed to be equally effective for alcoholics at any educational level, irrespective of initial coping skill, anxiety, urge to drink, alcohol dependence, or marital status. Thus, although mood management training seems to be as effective as communication skills training for alcoholics with higher education, less anxiety, and less urge to drink, communication skills training benefits a broader spectrum of patients, regardless of initial level of education, alcohol dependence, skill, anxiety, or beliefs.

The Use of Family Behavior Loop Mapping for Substance Abuse.

Addiction is a chronic condition with the potential for episodes of remission and relapse. Substance abuse by family members affects family function. There are two distinct phases (i.e., wet and dry) in substance abuse affected families. Family Behavior Loop Mapping as a method of diagramming the repetitive behavior cycles specific to wet and dry phases is introduced, and its use in assessing family functioning and designing effective interventions is illustrated by case examples.

Volunteer bias in a study of male alcoholics' sexual behavior

Studies on sexual behavior frequently require that subject volunteers engage in intrusive/sensitive assessment procedures. While earlier investigators have found that these demands may result in volunteer bias (volunteers differing from nonvolunteers), these studies were limited to nonclinical samples. The present study involved 182 males admitted to an inpatient alcoholism rehabilitation program. Those patients who volunteered to participate in an intrusive study examining sexual functioning were dissimilar to nonvolunteers. Compared to nonvolunteers, volunteers reported a greater interest in sex, less satisfaction with sex, more concerns about sexual functioning, a greater incidence of premature ejaculation, and a greater incidence of negative sexual experience. Volunteers also had a higher MAST score, used outpatient substance-abuse counseling more often, and more frequently had a diagnosis of cocaine/amphetamine dependence and cannabis dependence. These differences between volunteers and nonvolunteers suggest a need to use caution when generalizing the results of similar studies to the overall population. Procedures that may help to minimize volunteer bias are offered.

Family History of Alcoholism in Males: Absence of Distinguishing Features for Treatment Matching

One variable for subtyping the alcoholic population that could influence treatment-matching efforts is family history of alcoholism. This study compared two groups of male patients undergoing rehabilitation for alcohol dependence (39 family history positive [FHP] versus 36 family history negative [FHN]) on a number of salient dimensions for which specific targeted intervention components might be implemented. The FHP were similar to FHN subjects on all variables except that FHP had significantly fewer years of education than did FHN. Several possible explanations to account for these findings are discussed.