Faculty Bibliography

Discusses, relative to Part I of the symposium 'Alcoholism Treatment Through Systems Intervention,' the nature of the social system, a definition of levels within a system at which intervention may take place, and problems associated with research on (and thus the outcome of) social intervention in alcoholism. It is contended that a general systems approach is helpful in considering social intervention in alcoholism since social issues may interact to produce drinking patterns that are not easily understood on the basis of a single social determinant.

A national movement of parent self-help groups has recently emerged to combat drug abuse in children and adolescents. This innovative modality addresses a major mental health problem in an area where manpower shortages are anticipated. On the basis of self-report data from 135 parent group members, the drug and behavior problems of their children were evaluated. Improvement was reported in the community at large but more frequently in the children of members. The parent groups differed notably in structure and activities; nonetheless, the underlying psychology of membership, i.e., the shared attitudes and social cohesiveness of the members, facilitated the achieving of common goals

An innovative approach to ambulatory alcoholism treatment is proposed, based on adapting a self-help modality to the institutional clinic setting, for more cost-effective care. It draws on the principles of social influence in large groups, and diffuses the therapist's perogatives among more advanced patients. The program thereby operates with half the usual counseling staff. In this study (n = 235), a controlled comparison of this approach was made with more conventional clinic treatment, based on small-group therapy. Retention and visit rates of the experimental patients over 1 year of care were no different from the control patients, and engagement of inpatients into ambulatory care was more effective

Presents an approach based on learning theory that is designed to enhance the effectiveness of psychotherapy for patients who abuse alcohol and other drugs. Until recently, psychotherapy has been thought to have only limited effectiveness in the treatment of alcohol and drug abuse. The proposed model of conditioned abstinence is used to clarify 2 characteristic clinical phenomena in addictive illness: the considerable vulnerability to relapse and the loss of control over quantity consumed. Techniques for extinguishing the conditioned cues that underline these phenomena are discussed. It is contended that certain conditioned drinking or drug abuse behaviors can be extinguished if the appropriate extinguishing stimulus is presented in a systematic way. By means of guided recall in a psychotherapeutic context, clients can become aware of the sequence of action of the CS and can label the CS themselves. Clinical examples are provided to illustrate various applications of this approach.

Members of the American Medical Society on Alcoholism were studied to shed light on medical manpower needs in the alcoholism field. Findings were compared to AMA and federal survey data for all American physicians. AMSA respondents were broadly distributed among specialties: primarily psychiatrists, internists, and family practitioners. They were evenly divided between office-based and institutional practice, and most were on medical school faculties. Regarding alcoholism treatment, they generally agreed that Alcoholics Anonymous is necessary and that nonmedical counsellors are effective, although their attitudes on the etiology of alcoholism were divided. This sample of physicians in alcoholism, although not inclusive of all in the field, represents a diverse group, with differing clinical and educational needs

Of 66 persons who left the Unification Church (the 'Moonies'), twenty-three (36%) reported that they had had serious emotional problems after leaving. After an average of 3.8 years, however, the former members studied here had apparently achieved a stable adjustment. Most of them retained a notable fidelity toward the sect and its beliefs, but those who had been 'deprogrammed' had more negative views and themselves had coerced other members to leave. The author examines the impact of group membership on individual development and looks at departure in relation to the psychopathology, such as depression and paranoid ideation, that may emerge