Maintenance Of Sobriety Research Articles

Counselor training as a treatment for alcoholism: the helper therapy principle in action.

Extensive harmful drinking of alcohol is a major problem for many groups of Australian Aborigines and western treatment approaches have had limited effect. In order to stress cultural factors in treatment, a program to train indigenous Aborigines as alcoholism counselors for their communities was developed. In its more than 10 years of existence 145 counselors have been graduated. Of those initially entering the two year program 60% have graduated. Most of those have found employment as alcohol counselors for their people, and the numbers of Aborigines treated has increased. About 90% of those who entered the training had severe repeated substance abuse disorders in their recent history. The training and the alcohol counseling employment appears to be highly associated with continuing sobriety. For those who graduated the program only 4.8% returned to drinking. Those who completed only the first phase, 8.4% returned to drinking. Of those who were terminated from the program, 74% returned to drinking. Training alcoholics as alcohol counselors appears to be associated with vocational success and maintenance of sobriety as predicted by Riessman's "helper-therapy principle."

Nicotine dependence and alcoholism epidemiology and treatment.

Nicotine dependence in alcohol-involved adults is a long-ignored treatment problem. The absence of its discussion in the literature is difficult to defend in light of medical and epidemiological data on the cost and prevalence of this dual addition. Most descriptive studies of alcohol abusers published in the past 20 years have reported tobacco use rates of at least 90%. There is a crucial need to educate treatment professionals and their clients about the additional health risks associated with joint nicotine dependence and alcoholism. Historically, certain barriers to active intervention have existed in drug abuse treatment facilities, including (1) concerns that urging clients to quit smoking might have an adverse effect on their maintenance of sobriety, (2) a tendency to minimize the strength and severity of nicotine addition, (3) a lack of informative data on how best to treat smoking in recovering alcoholics, and (4) financial issues related to marketing and insurance compensation. Recent data obtained from recovering alcoholics who have tried to quit smoking and anecdotal reports from alcoholism treatment centers that have begun addressing nicotine addiction are now challenging these barriers. Education, role modeling, environmental control, and development of staff expertise can be incorporated into standard alcoholism treatment programs to jointly treat these paired addictions.

Maintaining Sobriety: Stopping Is Starting

Treatment of alcohol problems typically focuses on the cessation of drinking. Although cessation is necessary and important to achieving sobriety, this article suggests that maintenance of sobriety is a crucial, but oft ignored, component of effective treatment. Alcohol relapse is discussed in the context of aftercare treatment employing a relapse prevention approach. Within this model, relapse is not automatically defined as a treatment failure but as an opportunity for intervention and the interruption of the relapse process. Determinants and predictors of relapse are discussed, and assessment and intervention strategies provided. A case study illustrates the components of the relapse process and the interventions employed to maintain continued sobriety.

Nicotine dependence and alcoholism epidemiology and treatment.

Nicotine dependence in alcohol-involved adults is a long-ignored treatment problem. The absence of its discussion in the literature is difficult to defend in light of medical and epidemiological data on the cost and prevalence of this dual addiction. Most descriptive studies of alcohol abusers published in the past 20 years have reported tobacco use rates of at least 90%. There is a crucial need to educate treatment professionals and their clients about the additional health risks associated with joint nicotine dependence and alcoholism. Historically, certain barriers to active intervention have existed in drug abuse treatment facilities, including (1) concerns that urging clients to quit smoking might have an adverse effect on their maintenance of sobriety, (2) a tendency to minimize the strength and severity of nicotine addiction, (3) a lack of informative data on how best to treat smoking in recovering alcoholics, and (4) financial issues related to marketing and insurance compensation. Recent data obtained from recovering alcoholics who have tried to quit smoking and anecdotal reports from alcoholism treatment centers that have begun addressing nicotine addiction are now challenging these barriers. Education, role modeling, environmental control, and development of staff expertise can be incorporated into standard alcoholism treatment programs to jointly treat these paired addictions.

Cigarette smoking cessation attempts by recovering alcoholics

Survey data on the smoking cessation experiences of 77 recovering alcoholics are reported. A comparison of successful and unsuccessful quitters addressed questions about optimal timing of cessation efforts, relative severity of alcohol and tobacco abuse histories, and the impact of cessation efforts on the maintenance of sobriety. Findings suggest that recovering alcoholics can successfully quit smoking without jeopardizing sobriety but that individuals with more severe substance abuse histories may be less successful. Although successful quitters tended to wait longer before attempting cessation, a comparison of the two groups was not statistically significant.

Comparison of the importance of Alcoholics Anonymous and outpatient counseling to maintenance of sobriety among alcohol abusers.

36 alcohol abusers who had attended outpatient counseling and Alcoholics Anonymous were asked to rate the importance of outpatient counseling and Alcoholics Anonymous to their maintenance of sobriety. They also reported the number of outpatient and Alcoholics Anonymous sessions they attended in the last 90 days. Alcoholics Anonymous was rated significantly higher in importance to maintenance of sobriety by participants with above median days (160 days) of sobriety than those with below median days of sobriety or than outpatient counseling by those with below or above median days of sobriety. A significant, positive correlation of .79 between attendance at Alcoholics Anonymous and days of sobriety was found.

Sobriety and American Indian Problem Drinkers

Problem drinking among American lndian people is a subject of much concern. This article addresses the factors which have contributed to the attainment of sobriety among a sample of American Indian people. The findings of this study indicate that recognition and acceptance of drinking problems constitute the first phase of the recovery process. Sobriety itself is the second phase, and personal and social adjustment is the third phase. Those factors which contribute to the discontinuance of drinking and the maintenance of sobriety are highlighted.

The Iceman Cometh and the Anatomy of Alcoholism

The Iceman Cometh and the Anatomy of Alcoholism Thomas B. Gilmore It would be difficult to imagine a work of literature more thoroughly steeped in alcohol than Eugene O’Neill’s The Iceman Cometh; with few exceptions every character in the large cast is or appears to be a confirmed drunkard. The central character of the play, however—Theodore Hickman, known simply and affectionately as Hickey to his drinking companions at Harry Hope’s skid-row saloon—confuses his friends when he shows up sober instead of drunk to celebrate Harry’s birthday. The fact that Hickey was a periodic drunk who never mixed alcohol with work and went on a spree only twice a year would not have raised doubts about the reality of his alcoholism for O’Neill, who was himself a periodic alcoholic until age thirty-seven when he began an almost totally successful abstinence for the rest of his life.l Although Hickey’s alcoholism may be surpassed in dramatic interest by his underlying psychological problems revealed late in the play, most viewers will be curious about the remarkable change in Hickey from inebriation to sobriety. For he claims to have achieved much more than abstinence; in claiming also the attainment of an unshakable peace or serenity, he seems to be implying that drastic reformation of character deemed essential by Alcoholics Anonymous for alcoholics seeking last­ ing sobriety. As even most laymen know today, Alcoholics Anonymous has been far more successful than any other regimen or method in achieving sobriety. If, therefore, Hickey tends to deviate widely from some of the most fundamental principles THOMAS B. GILMORE, Professor of English at Georgia State University, is working on a series of studies on alcohol in modem literature. Two of these, on Malcolm Lowry’s Under the Volcano and Saul Bellow’s The Victim, have recently been published in Contemporary Literature and Twentieth Century Literature. 335 336 Comparative Drama and practices of AA, the viewer aware of these will have good reasons to doubt his assertions of a happy, peaceful sobriety long before his terrible self-disclosures discredit them. Further­ more, if Hickey’s means of reaching this sobriety is unsound, he can scarcely fulfill his enthusiastic mission of conveying it to his old drinking friends at Hope’s tavern. In short, throughout the play the principles of AA provide an excellent means of analysis for examining Hickey’s salesmanship in order to de­ termine the quality of his new product or “line,” sobriety. Hickey’s practices, ideas, and achievements, closely as some of them may seem to resemble some of AA’s, are inauthentic. In fact, one enlightening way to characterize Hickey is to view his actions as a parody or travesty of genuine adherence to AA principles and procedures. For example, he doubtless succeeds, in a verbal sense, in avoiding “temperance bunk” (p. 79), an avoidance which AA certainly recommends; but his efforts to reform the denizens of Hope’s saloon by persuading them to surrender their pipe dreams are so zealously obsessive that late in the play Harry quite reasonably likens Hickey to “a bughouse preacher escaped from an asylum” (p. 244). But this is one of the least of Hickey’s failures. Not only is his sharing of “ex­ perience, strength, and hope,” a chief AA method for the establishment and maintenance of sobriety,2 extremely incom­ plete until late in the play; it is prompted by reasons which Hickey is apparently unconscious of and which are much less praiseworthy than the motive of helping others get sober. As his impatience with their intractability grows, his proselytizing is diluted by a cynicism that is an older and evidently a more fundamental part of him: he refers to his efforts as “selling my line of salvation” and compares them to the times when he would trick some “dame, who was sicking her dog on me,” into believing that “her house wouldn’t be properly furnished unless she bought another wash boiler” (p. 147). There is something more reprehensible at work here than Harry’s “bughouse preach­ er”; Hickey derives pleasure from his attempt to wield power over his former drinking companions. Instead of bidding them...

Alcoholism. Images, impairments, interventions.

Diagnosis of alcoholism requires a vigilant attitude and aggressive pursuit of supporting evidence by the primary care physician. Because the alcoholic is characteristically defensive and commonly denies the diagnosis, the physician must be persistent and honest when confronting the patient. Effective treatment is available through programs comprising patient and family education, psychotherapy, medical supervision, involvement in Alcoholics Anonymous, use of disulfiram (Antabuse), and follow-up care. Since the recovering alcoholic is vulnerable to relapse, long-term maintenance of sobriety requires not only abstinence from alcohol but also avoidance of psychoactive and narcotic drugs.

Self‐Efficacy Counseling and the Maintenance of Sobriety

Self‐efficacy in relation to one's addiction is shown to be a factor in sustained sobriety, and implications for counseling are explored.

Social Involvement and the Resolution of Alcoholism

This paper considers the relationship between involvement in leisure activities and the resolution of alcoholism by patients who attended a private inpatient alcoholism treatment hospital in the Southwest. Baseline data were derived from self-administered questionnaires and extensive, on-site interviews with 458 patients who were admitted to the facility between February, 1979, and May, 1980. Followup information was obtained through telephone interviews with patients 6 months after discharge from the facility. While previous research efforts have suggested that the alcoholic person is “passive” with respect to the expenditure of social energy, this paper explores the reverse hypothesis; i.e.; that the alcoholic is an “active” participant in leisure activities. Further questions addressed include the relationship between abstinence and the extent of leisure involvement, type of leisure pursued (particularly group-oriented versus solitary activities), and changes in the direction of energies from baseline to 6 months. Finally, this paper examines the applicability of a social control perspective (e.g., Hirschi, 1969) to the resolution of alcoholism by assessing the extent to which the degree of involvement is related to successful maintenance of sobriety—regardless of the type of activity pursued. For those patients who reported drinking at 6 months, consideration is given to the level of alcohol consumption. Statistical controls include measures of age, sex, marital status, and baseline severity. Working from within an input-process-output model of evaluation, discriminant function analyses are conducted in an attempt to assess the relationships among baseline severity, leisure involvement, and patients' drinking status 6 months post-admission. Discussion of the results of this study include an examination of the applicability of a theory-based model of social integration to research regarding the resolution of alcoholism. Possible directions for future research efforts are offered.

Mystical experience, drinking behavior and the reasons for drinking.

In his Gifford lectures of 1901, later published as Varieties o] Religious Experience, William James (1) suggested that consumption of alcohol satisfies need for transcendental experience: The sway of alcohol over mankind is unquestionably due to its to stimulate mystical faculties of human nature, usually crushed to earth by cold facts and dry criticisms of sober hour. Over 60 years later Clinebell (2) offered an intriguing modification of James's notion, stating that an important factor in etiology of alcoholism is the attempt to satisfy religious needs by a nonreligious means--alcohol. Clinebell sees three aspects of man's fundamental religious need: (1) need for an experience of numinous and transcendant; (2) need for a sense of meaning, purpose, and value in one's life; and (3) need for a feeling of deep trust and relatedness to life. As alcoholic's illness develops, he tends increasingly to handle all three aspects of his religious needs by means of This observation certainly is congruent with Twelve Steps of Alcoholics Anonymous (A.A.), which contain six references to importance of belief in and closer contact with a higher power or deity in attainment and maintenance of sobriety (3). Thus one could infer from orthodox A.A. ideology that--contrary to James--the mystical sensibilities, of alcoholics at least, are dulled by use of alcohol.

Alcoholics anonymous — An experiment of nature

Based on observations of Alcoholics Anonymous as its program has affected change in many members, and from clinical experience with alcoholic patients, a hypothesis is formulated concerning the effective psychological events which make possible the maintenance of sobriety. Four elements are recognized as playing an essential role: hitting bottom, surrender, ego reduction, and maintenance of humility. The application of this conceptualization in individual psychotherapy is discussed and illustrated with case material.

Alcoholics Anonymous–An Experiment of Nature

Based on observations of Alcoholics Anonymous as its program has affected change in many members, and from clinical experience with alcoholic patients, a hypothesis is formulated concerning the effective psychological events which make possible the maintenance of sobriety. Four elements are recognized as playing an essential role: hitting bottom, surrender, ego reduction, and maintenance of humility. The application of this conceptualization in individual psychotherapy is discussed and illustrated with case material.

The treatment of chronic alcoholics with citrated calcium carbimide (temposil).

The lack of side-effects and the absence of severe cardiovascular response during a Temposil-alcohol reaction, increase the desirability of treating the alcoholic by interfering with the metabolism of the alcohol. Although this drug is rapidly excreted, there would seem to be question as to whether the patient who decides to drink will be deterred by having to wait a few days longer to start, if he is taking disulfiram rather than Temposil. Some observers have not regarded the reactions, when the patient taking Temposil drinks, as being sufficiently severe. However, there would seem to be little correlation between the discomfort the patient experiences and the maintenance of sobriety. The methods of treatment which interfere with the metabolism of alcohol are applicable only to the alcoholic who wants help in abstaining, and Temposil seemingly offers this help with the least discomfort–to patient and physician.

Psychologic factors in chronic alcoholism.

Article1 January 1958PSYCHOLOGIC FACTORS IN CHRONIC ALCOHOLISMROBERT S. WALLERSTEIN, M.D., F.A.C.P.ROBERT S. WALLERSTEIN, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-48-1-114 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptSTATEMENT OF PROBLEMThe decision of The American College of Physicians to hold this symposium on the problem of alcoholism, and to bring the combined viewpoints of internist, sociologist and psychiatrist to bear on it, reflects our modern medical recognition of chronic alcoholism as a disease of major medical importance. This in itself marks a significant step in our understanding of this disorder, for it signifies the surmounting of the moral frame of reference within which chronic alcoholism has so long been regarded as a manifestation of ignorance, of vice, of sinfulness, or of all of these combined.In advancing... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Topeka, Kansas*From the Symposium on Alcoholism: A Complex Medical Problem, presented at the Thirty-eighth Annual Session of The American College of Physicians, Boston, Massachusetts, April 8, 1957.This paper is based on the condensation of the summary chapter of a book, Hospital Treatment of Alcoholism, by Robert S. Wallerstein, M.D., and associates, published June, 1957, by Basic Books, New York, N. Y.Requests for reprints should be addressed to Robert S. Wallerstein, M.D., Associate Director of Research, Menninger Foundation, Topeka, Kansas. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byThe Use of DisulfiramComparison of the Importance of Alcoholics Anonymous and Outpatient Counseling to Maintenance of Sobriety among Alcohol AbusersMatching Problem Drinkers With Optimal TreatmentsThe pharmacological treatment of the addictive disordersTHE PHARMACOLOGICAL TREATMENT OF THE ADDICTIVE DISORDERSTechniques for the Use of Hypnosis in Group TherapyGroup Hypnotherapy: A Brief SurveyResearch activities related to treatment of alcoholismGroup hypnotherapy techniques with drug addicts 1 January 1958Volume 48, Issue 1Page: 114-122KeywordsAlcoholicsAlcoholismAlcohols ePublished: 1 December 2008 Issue Published: 1 January 1958 PDF downloadLoading ...