Steven M. Ross

Self-efficacy in alcoholics: Clinical validation of the situational confidence questionnaire☆

Recent theory and empirical data suggest that self efficacy plays an important role in resistance to relapse for substance abusers. This study investigated the validity of the Situational Confidence Questionnaire (SCQ), a new instrument designed to measure self-efficacy expectations in purported high-risk drinking situations. The SCQ was administered to 46 short-term sober (STS) and 25 long-term sober (LTS) alcoholics. STS subjects were newly admitted alcohol treatment patients and LTS subjects had been abstinent for at least one year. Results indicated significantly higher self efficacy for LTS subjects than for STS subjects on total score and on 7 of the 8 subscales (p less than .001). Stepwise discriminant analysis yielded a linear combination of three subscales to account for 49% of the total variance; 92% of the LTS and 65% of the STS subjects were correctly identified by the classification function. These results extended earlier work with the SCQ using newly sober subjects and, in addition, provide encouraging validity data for the SCQ.

The reliability and validy of three measures of assertion in a drug addict population

An assertion scale constructed for use with drug addicts was subsequently validated using behavioral performance and self-report measures in a multitrait-multimethod matrix ( Campbell & Fiske, 1959 ). The general notion of “assertion” was broken down into five subareas involving: authority, drugs, positive feedback, negative feedback, and heterosexual interaction. An age-matched group of addicts and nonaddicts differed significantly in assertiveness in the areas of drugs, authority, and positive feedback.

The Assessment and Training of Assertive Skills with Drug Addicts: A Preliminary Study

The effects of a short-term behaviorally-oriented assertion training program were evaluated with a sample of drug-abuse patients concurrently involved in an ongoing inpatient program. Assertion questionnaire and verbal performance data were obtained from both a treatment and a no-treatment group prior to and following 3 weeks of assertion training. The results indicated consistent and significant group differences on the verbal behavior variables, but not on the questionnaire data. The results also suggested that the assessment of assertion by situationally defined problem areas may be more accurate and sensitive to change than a more general definition and assessment of assertive behavior.

The use of a videotape pretherapy training program to encourage treatment-seeking among alcohol detoxification patients

Two alternative programs were utilized to encourage 31 male alcohol detoxification patients to become involved with treatment for alcoholism. The experimental (pretherapy training) procedure used videotaped modeling with subsequent discussion in an effort to encourage problem disclosure, to counteract denial, and to communicate information about treatment and the benefits that might be expected. A comparison procedure consisted of commercially available films and discussion which were considered to provide very general exhortations to viewers to remain abstinent from alcohol. Results indicated greater treatment-seeking on the part of experimental subjects. Experimental subjects left detoxification with a treatment referral and made initial treatment contacts significantly more than comparison subjects. Follow-up data suggested that experimental subjects who entered treatment programs may have been more successful in treatment than comparison subjects who entered programs.

Self-efficacy, standards, and abstinence violation: a comparison between newly sober and long-term sober alcoholics.

Recent theory and empirical data suggest that self-efficacy plays an important role in resistance to relapse for substance abusers. Another key in the relapse process, according to Marlatt and Gordon (1985), is the abstinence violation effect, which comprises self-attribution for failure and affective reaction to violation of self-imposed standards. The combination of unrealistically high standards and low self-efficacy for following those standards may potentiate the risk for relapse. A 25-item questionnaire designed to assess self-efficacy and standards was administered to alcoholics newly admitted to an inpatient treatment program and alcoholics who had been sober for at least 1 year. The groups did not differ with regard to having high standards, but the successfully abstinent alcoholics had significantly higher self-efficacy expectations than the newly sober alcoholics. These results suggest that treatment programs may need to include interventions which decrease unrealistic standards as well as those designed to increase self-efficacy expectations.

State-dependent learning and its implications for treatment of drug abusers

The potential relevance of laboratory demonstrations of state-dependent learning are discussed in relation to (1) the process-of-becoming-addicted, (2) treatment of the addict, and (3) taking prescribed medications. A functional analysis of drug-taking behavior as an approach to understanding both state-dependent effects and drug-taking in general is presented. Some addicts or potential addicts may take drugs to gain access to responses learned while in a drug state. To insure that addicts do not escape from newly-learned, albeit fear-laden social skills, it may be necessary to progressively punish actual drug-taking behaviors, while strengthening the new social behaviors.

Behavioral Group Treatment for Addictive-Appetitive Disorders

Early critics of behavior therapy charged that support for the approach rested largely on studies of the innocuous, transient ailments of college students (e.g., Cooper, Furst, & Bridger, 1969). Naturally, behavior therapists did not take such a slur lying down. Attempts were made by some to logically refute the charge (Levis, 1970; Mahoney, Kazdin, & Lesswing, 1974; McGlynn, 1975) and by others to empirically prove the criticism false. This latter reaction has taken the form of expanding the range of problems and client groups that are amenable to behavioral techniques, among the most aggressively tackled of which have been the addictive and appetitive disorders of alcoholism, smoking, obesity, and drug abuse. As a result, we now have an enormous amount of information on behavior therapy’s ability to alter these historically prevalent and intractable patterns. And because the bulk of those treatment outcome studies employed a group format, we also have a wealth of data that is pertinent to the practice of behavioral group therapy per se.