En eksperimentell studie av sosial ferdighetstrening for alkoholikere: Ett års resultater

Abstract

Lasse Eriksen er psykolog og har vrert ansatt som universitetsstipendiat og amanuensis i psykiatri ved Universitetet i Trondheim siden 1979. Han har hele tiden arbeidet med et forskningsprosjekt vedrørende evaluering av alkoholismebehandling.Sverre Bjørnstad er psykolog og har vært ansatt sorn universitetsstipendiat i psykiatri ved Universitetet i Trondheim og sorn psykolog på Solhaugen Helseheim.K. Gunnar Götestam er professor i psykiatri ved Universitetet i Trondheirn og overlege på Trøndelag Psykiatriske Sykehus, avd. østmarka siden 1977.This is a first report about an experimental study of the effect of social skills training in group versus a discussion group for alcoholics in an in-patient treatment program. Alcoholics often have deficits in social skills and assertiveness, which serve to maintain their alcohol abuse. Training in social skills, therefore, should enhance treatment effectiveness. This study compared the results of the members in the two groups during a one-year follow-up after discharge.Twenty-four alcoholic in-patients, who volunteered to participate, were randomly assigned to either a social skills training group (SSTG) or a control group (CG). Social skills training was carried out in small groups of six patients each for a 90-minute session for eight weeks. The CG was dispersed to four traditional discussion groups of eight patients with a 90-minute session every week. The SSTG patients returned to the discussion groups after finishing the skills training. All patients participated in the rest of the regular treatment program at the institution.The members of both groups completed a self-assertiveness test before the start of the groups, and 3, 6, 9 and 12 months after discharge. In addition, the alcoholics completed a short self-report, which they returned by mail every other week after discharge. Everybody, except one lost subject, completed self-reports. Twenty of the alcoholics gave their permission to let significant others report on their behavior. All these significant others sent their reports regularly. The alcoholics' self-reports were checked against significant others' reports and found to be consistently reliable (r=0.96). Each completed self-report sent from a patient or a significant other would also serve as a lottery ticket to increase the adherence. The alcoholics returned 96 % and the primary significant others returned 95 % of the possible reports.The one-year follow-up results show that the SSTG patients drank about 2/3 as much alcohol as the CG patients and that the SSTG patients had more than twice as many working and sober days as the CG patients. The mean sober period after discharge was short, but six times longer for the SSTG. The CG had three times as many admissions at institutions during the one-year follow-up and spent four times as many days in these institutions. The SSTG spent more nights at home than the CG. The differences between the groups were all significant (p<.005 except for one variable which was p<.05).The conclusion is that social skills training in group for in-patient alcoholics seems to produce a very good outcome compared to the traditional discussion group. The implementation of social skills training for this population of alcoholics seems to be a re-commendable alternative or addition to conventional treatment, irrespective of the fact, that none stayed abstinent during the one-year follow-up.