Robert G. Rychtarik

Spouse Contracting to Increase Antabuse Compliance in Alcoholic Veterans.

Developed and evaluated a home-based contracting program to determine its effect on the compliance rates of discharged alcohol patients to a disulfiram (antabuse) regimen. The three comparison groups included (a) no contract/no recording; (b) contract/recording; and (c) contract/recording plus instructions for positive reinforcement. Twenty-five patients who had been treated in a behaviorally oriented inpatient alcohol dependence treatment program and who lived with a significant other (i.e., spouse, sibling, parent) participated in the study. At the end of the 3-month period for which the disulfiram was prescribed, those Ss who were involved in contracting and recording reached criterion more frequently than those who were in the minimal treatment group. Furthermore, 84% of this S sample were abstinent at the 3-month follow-up according to collateral reports. The discussion centers on the use of home-based contracting as an inexpensive alternative to other, more costly disulfiram programs. Additional methods for obtaining measures of reliability on self-report of disulfiram usage also are discussed.

Treatment of an incest victim with implosive therapy: A case study *

A 22-year-old single female victim of incest trauma was treated via implosive therapy during five inpatient therapy sessions. Treatment consisted of repeated exposure through imagery to the incest scene and real or hypothesized thoughts and events related to the incest trauma. Results indicated that, by a follow-up session, behavioral, physiological, and self-report measures were all decreased from previous levels. Moreover, there was a generalization of extinction effect such that self-report and physiological responding to an imaginally presented current life stressor were markedly reduced. Self-monitoring of incest-related thoughts, dreams, and negative heterosexual relations also showed a significant decrease which was maintained at a 6-month follow-up. At a 12-month follow-up, the patient continued to report maintenance of treatment gains with respect to the incest trauma.

Consumer satisfaction in adult behavior therapy: Procedures, problems, and future perspectives

Until recently there has been very little interest in assessing client satisfaction regarding the delivery of adult behavior therapeutic services. Given this preeminent finding, relevant literature is reviewed with respect to: levels of satisfaction, comparisons with other approaches, comparisons within behavior therapy, satisfaction/outcome in behavior therapy, and acceptability of behavioral treatment procedures. Methodological and research-related questions are addressed. These include psychometric considerations, comparative analyses, reported levels of satisfaction, and global satisfaction versus component evaluation. Alternative strategies for the measurement of consumer satisfaction are discussed. Among these options are the utilization of solicited/unsolicited comments, unobtrusive measures, archival records, consumer dissatisfaction information, continuous measures of satisfaction, goal attainment scaling, and survey methods.

Alcohol use in television programming: effects on children's behavior.

The impact of televised use of alcoholic beverages on childrens behavior was evaluated in this study. Children were randomly assigned to one of three experimental conditions: (a) television with drinking depicted, (b) television without drinking, or (c) a no television control condition. Segments of the syndicated television show M.A.S.H. were used as the viewing stimulus. The impact of the various conditions was evaluated in a choice task requiring subjects to choose either martini or regular glasses of either whiskey or water to serve pictured adults and children. Results indicated that subjects who viewed television drinking were significantly more likely to choose alcoholic beverages for pictured adults but not children. No effect was found for glass preference. Results and implications of these findings and directions for future research are discussed.

Goal Choice of Alcoholics: Effects of Training Controlled Drinking Skills

Alcohol treatment outcome studies during the past twenty years have consistently reported that some alcoholics treated via abstinence orientated approaches obtain controlled responsible drinking (Selzer & Holloway, 1957; Bailey & Stewart, 1967; Davies, 1962). Moreover, recent outcome research suggests that controlled drink training may be an effective treatment at least for some abusive drinkers (e.g., Armour, Polich & Stambul, 1976; Caddy, Addington & Perkins, 1978; Sobell & Sobell, 1973; Vogler, Compton & Weissbach , 1975). Controlled drinking as a viable treatment goal for alcoholics, however, remains an area of continued controversy which appears to involve three major issues: (a) Do controlled drinking goals increase the probability of abusive drinking dispositions (Blume, 1977); (b) Are there unique characteristics of those alcoholics choosing controlled drinking goals (Bell, 1963; Lloyd & Salzberg, 1975; Miller & Caddy, 1977; Nathan, 1976); and, (c) Will controlled drink training encourage alcoholics to “try their luck” at other-than-abstinence goals (i.e., will it induce, “… despondent alcoholics to rationalize that the therapeutic goal of reducing excessive drinking to socially acceptable dimensions may be more easily attainable than complete abstinence” (Thimann, 1963, p.325)?

Assessing disulfiram compliance: Validational study of an abbreviated breath test procedure

An abbreviated breath test for detecting the disulfiram metabolite carbon disulfide (CS2) was evaluated in an analogue investigation of the sensitivity of the test in identifying disulfiram and non-disulfiram intake in a group of 14 alcoholic inpatients. Disulfiram (250 mg) was administered within an ABAB repeated measures design over a 12-day period with corresponding breath tests administered during morning and afternoon time periods. Dependent measures included spectrophotometric analysis of reacted test samples and visual ratings of sample color. Results indicated that the test was highly sensitive in discriminating disulfiram administration for the group as a whole, as well as for individual subjects. Moreover, visual ratings were more accurate than spectrophotometric cut-off scores in identifying disulfiram administration. The test shows considerable promise as a rapid means of assessing disulfiram compliance.