Index Action stage bulimia and, 232 change model and, 10 movement to, 23, 51-57 self-help manuals and, 332 Addictive behaviors change model and, 3-27 cognition and, 59 See also entries under specific addictions Affect, 77 Aftercare. See Alcoholism aftercare Age differences, 211 Agoraphobia, 307 Alcohol abuse and alcoholism avoidance of decision making, 72-77 change and, 92, 93-94 cognition and, 59 conflict and stress factors in, 77-80 contemplation stage and, 61-65 criteria in determination of, 384 dependence and, 361-373 determination stage, 65-72 judgment shortcomings, 69-72 relapse prevention model for, 407-433. See a(so Relapse prevention model self-help manuals and, 335-353 self-regulation and, 30, 38-39, 43, 322-327 social costs of, 52 World Health Organization (WHO) and,51-57 Alcohol dependence syndrome, 361-364 Alcoholics Anonymous, 93 aftercare and, 438 Alcoholics Anonymous (Cant.) change model and, 103 description of, 298-300 effectiveness of, 135-136 182 relapse and, 409 spiritual aspects of, 98, 99 Alcoholism aftercare, 435-456 conclusions in, 448-453 definitions in, 436-437 effectiveness of, 437-444 factors affecting participation in, 444-448 treatment and, 436 Alcoholism survival model, 391-405 conceptual framework in; 393-394 early hypothesis in, 391-392 original study in, 392-393 prospective study in, 394-402 Alcoholism treatment, 121-174 aftercare in, 435-456 Alcoholics Anonymous, 135-136 aversion therapies, 139-144 broad-spectrum approaches to, 149-154 client matching in, 158-161, 175-203. See also Individualized alcoholism treatment conclusions in, 161-163 confrontation in, 134-135 controlled drinking goal and, 145-148 early interventions in, 204-220. See also Early alcoholism treatment 457
458 Alcoholism treatment (Coni.) educational strategies, 136-138 evolution in, 375-376 family involvement and, 309-315 hallucinogens in, 130 length and setting for, 154-158 marital/family therapy in, 138-139 operant methods in, 148-149 pharmacotherapy, 123-130 psychotherapy/counseling in, 131-133 psychotropics in, 128-130 research in, 121, 126 self-efficacy theory and, 410-412 simple intervention, 375-387 varieties of, 121-122 Anorexia nervosa, 227-228 bulimia and, 230 cultural differences and, 229 Antabuse (disulfiram) aftercare and, 440 community reinforcement approach with, 153 effectiveness of, 124-126 181 operant conditioning techniques with, 148 Antianxiety drugs, 128 Anticipatory regret, 77-78, 79 Antidepressants effectiveness of, 128-129 individualized alcoholism treatment and, 181 Antidipsotropic drugs, 124-127 Antipsychotics, 128 Anxiety alcoholism treatment and, 152 anticipatory regret and, 77 184 Apnea aversion therapy, 140-141 Assertiveness training alcoholism treatment with, 151 self-regulation model, 41 Attention, 324-325 Attitudes, 381 Attributional failure, 59-61 Autonomy, 10 Aversion therapy alcoholism treatment, 139-144 effectiveness of, 97 Aversion therapy (Cont.) 183 See also Electrical aversion therapy Behavior therapy outpatient treatment, 264 residential treatment, 263 Behavioral self-control training (BSCT) early alcoholism intervention, 206 185 Behaviorists, 17 Bibliotherapy early alcoholism intervention, 206, 209, 210, 218-219 See also Self-help manuals Biofeedback techniques, 152 Brain. See Neuropsychological impairment Broad-spectrum treatment alcoholism treatment, 149-154 192-193 Bulimia, 228-236 action stage and, 232 contemplation stage and, 231-232 definitions of, 228-229 maintenance stage and, 232-233 management of, 233-236 precontemplation stage and, 231 syndrome development, 229-231 Cancer, 110-111 Catastrophizing, 409 Change critical conditions for, 91-108 morality and, 98-99 nonspecialist professionals in, 94-96 prediction of, 92 situation and, 93-94 specialist treatment for, 96 Change model, 3-27 action stage, 10 commonalities among, 4 contemplation stage, 9 decisional balance and, 11-12 demands on, 3-4 development of, 99-105 experimental models of, 361-374
459 Change model (COl1t.) maintenance stage and, 10-11 patterns in, 13-16 prediction in, 12-13 process in, 7-8 relapse and, 5-6 smoking programs, 4-5, 280-282 stage process interaction in, 8-9 stages in, 5 strategy in, 19 therapist/client relationship and, 6-7, 20-25 transtheoretical approach, 17-18, 20, 24-25 Change process cognition in, 319-329 family in, 305-318 Chemical aversion therapy alcoholism treatment, 139-144 183 Choice, 80, 193 Citra ted calcium carbimide, 126-127 Client choice. See Choice Client/therapist relationship. See Therapist/client relationship Cognition addictive behavior and, 59 affect and, 77 avoidance of decision making, 72-77 change and, 92, 319-329 contemplation stage and, 61-65 decision-making assistance, 81-85 early alcoholism intervention, 207 expectancy-value model and, 111-112 judgment shortcomings, 69-70 multiple drug use treatment, 244 self-regulation and, 327-328 Cognitive Appraisal Questionnaire, 417-418 Cognitive change control theory, 320-322 cybernetic system and, 319-320 memory and thinking in, 327-328 self-regulation and, 322-327 Cognitive psychology, 59-89 Cognitive style, 188-190 Community psychology movement, 106 Community reinforcement approach (CRA) alcoholism treatment, 152-153 Community reinforcement approach (CRA) (COl1t.) 185 Compulsion change model, 361-365 dependence and, 364-365 Conceptual level, 189-190 Confessional process, 232 Conflict. See Stress Confrontation, 134-135 Conjunction fallacy, 69-70 Consciousness-raising, 15, 23 Contemplation stage anticipatory regret in, 77 bulimia and, 231-232 change model and, 9, 19-20,23 judgment and, 69 movement to action and, 51-57 movement to determination and, 59-89 thinking/reasoning and, 61-65 Control theory, 320-322 Controlled drinking alcoholism survival model, 394 alcoholism treatment goals and, 145-148 behavioral self-control training, 185 relapse prevention model and, 411 severity of problem and, 187 Coping Behaviors Inventory, 399-402 Coping skills training, 206, 210 Cost containment, 378 Counseling alcoholism treatment, 131-133 confrontation strategies, 134-135 Courts. See Legal system Covert sensitization, 142-144 Cues controlled study of, 365-373 decision-making assistance, 82-83 dependence/compulsions and, 364 feedback and, 71-72 inattention and, 76 Culture, 229 Cybernetic system, 319-320 Decisional balance, 11-12 Decision making alcohol abuse and, 65-72 assistance in, 81-85
460 Decision making (Cont.) avoidance of, 72-77 change model and, 100-104 conflict and stress in, 77-80 elimination-by-aspects model, 68-69 judgment and, 69 optimizing model, 65-66 practice implications, 105-106 satisficing model, 66-68 smoking and, 109-118 Deductive reasoning. See Cognition; Reasoning Delay, 73-77 Deliberation, 74-75 Demography, 211 Dependence change models and, 361-374 compulsions and, 364-365 treatment strategies and, 365 Depression self-regulation and, 327 treatment for, 307 Desensitization change model and, 23-24 See also Systematic desensitization Determination stage alcohol abuse and, 65-72 judgment shortcomings, 69-72 movement from contemplation stage, 59-89 Detoxification importance of, 275-276 opiate-dependency treatment and, 266 Diagnostic and Statistical Manual (DSM Ill) anorexia nervosa, 227-228 bulimia, 229 Dieting bulimia and, 320-321 obesity and, 222-224, 226 Differential approach alcohol dependence and, 194 client choice and, 193 cognitive style and, 188-190 179 life problems and, 192-193 neuropsychological status and, 191 Differential approach (Cont.) problem severity and, 186-188 self-esteem and, 191 social stability and, 192 Disease model, 91, 105 alcoholism treatment, 123 controlled drinking goals and, 185 motivation and, 207 Disulfiram (Antabuse) aftercare and, 440 community reinforcement approach with, 153 effectiveness of, 124-126 181 operant conditioning techniques with, 148 Drug abuse. See Multiple drug abuse; Opiate-dependency treatment Drug Avoidance Inventory, 243-244 Early alcoholism treatment, 205-220 bibliotherapy, 209 coping skills training in, 210 discussion of, 218-219 method in, 206-208 programs in, 206 results in, 210-218 Eating disorders, 221-238 anorexia nervosa, 227-228 bulimia, 228-236 obesity, 222-227 self-regulation model, 38-39 Educational achievement, 270-271 Educational strategies, 136-138 Electrical aversion therapy alcoholism treatment with, 141-142 relaxation training with, 151 See also Aversion therapy Elimination-by-aspects model, 68-69 Employment history, 270-271 EV model. See Expectancy-value models (optimizing model) Expectancies, 77-78 Expectancy-value models (optimizing model) decision making, 65-66 smoking and, 109-112 study examples in, 112-117 Expectations, 65-66
461 Family, 305-318 addictive behaviors and, 308-309 aftercare and, 439 alcoholism treatment and, 160, 309-315 emotional/behavioral problems and, 306-308 See also Family therapy; Social support networks; Spouse involvement Family history, 194 Family therapy alcoholism treatment with, 138-139 184-185 Feedback confrontation, 135 control theory and, 320 cybernetic system and, 319-320 early alcoholism treatment, 207 failures in, 71-72 overconfidence and, 71 Freedom, 80 Gender differences. See Sex differences General practitioners. See Physicians Groups. See Mutual aid groups Hallucinogens, 130 Heredity alcoholism treatment and, 160 194 Hypersexuality, 92 Hypertension, 300-302 Hypnosis, 144 Inattention, 75-77 Individual differences cognitive change and, 324 self-regulation model and, 36-38 Individualized alcoholism treatment, 158-161, 175-203 client choice and, 193 cognitive style and, 188-190 conceptual level for, 158 differential studies, 186-195 family history and, 160 life problems and, 160, 192-193 locus of control and, 159 matching hypothesis in, 176-178 Individualized alcoholism treatment (Coni. ) neuropsychological impairment and, 158-159, 191 perceived choice and, 160-161 predictor approach variai;1;:s, 193-195 predictor studies, 180-186 problem severity and, 186-188 research strategies in, 178-180 self-esteem and, 191 severity level and, 159 social stability and, 192 undifferentiated treatment contrasted, 175-176 Inferential learning, 71-72 Inventory of Drinking Situations, 413-415, 423-431 Judgment, 69-72 Key-level strategy, 19 Legal system drug abuse treatment programs, 266 opiate-dependency program, 271, 273-274 Life experiences alcoholism treatment and, 160 individualized alcoholism treatment and, 192-193 Lithium, 129-130 Locus of control alcoholism treatment and, 159 cognitive style and, 189 Lung cancer, 110-111 Lysergic acid diethylamide, 130 Maintenance stage bulimia and, 232-233 change model and, 10-11 self-help manuals and, 332 See also Relapse Marital therapy, 138-139 Maximum-impact strategy, 19 Memory alcohol abuse and, 322-323 self-regulation and, 327-328 Metronidazole, 127 Michigan Alcoholism Screening Test (MAST), 215, 314, 345 Modeling approach, 179-180
462 Moderate drinking. See Controlled drinking Morality change and, 98-99 overconfidence and, 71 satisficing model and, 67-68 Motivation alcoholism treatment and, 160 early alcoholism treatment and, 206-207 multiple drug use treatment and, 241-242, 253-255, 358 self-regulation model, 41-42 smoking cessation strategies, 282-284 Multiple Cue Probability Learning, 71-72 Multiple drug use treatment, 239-261 brief interventions in, 239-240 discussion of, 256-260 method in, 242-245 motivation and, 241-242 pretreatment drug use, 240 problem multiplicity in, 240-241 results in, 245-255 self-reliance and, 241 treatment progress, 242 Mutual aid groups, 289-304 Alcoholics Anonymous, 298-300 dynamics of, 294-298 growth of groups in, 290-291 hypertensive clubs, 300-302 interest in, 291-292 limits of, 302-303 range and characteristics of, 292-294 smoking cessation strategies, 285-286 Nausea alcoholism treatment, 140 183 Neuropsychological impairment alcoholism treatment and, 158-159 individualized alcoholism treatment and, 191 Nicotine gum, 285-286 Obesity change strategies in, 222-226 classifications of, 226-227, 236 treatment for, 308 See also Eating disorders Obsessive-compulsive rituals, 306-307 Operant conditioning techniques, 148-149 Opiate-dependency treatment, 263-277 assessment in, 268 discussion of, 274-276 method in, 267-268 philosophy and goals in, 264-267 results of, 270-274 subjects in, 268-269 Optimizing model. See Expectancy-value models (optimizing model) Overconfidence, 71 Personality. See Cognitive style Pharmacotherapy alcoholism treatment, 123-130, 131-133, 140, 148 antidipsotropics, 124-127 bulimia, 233-235 drug dependency and, 276 hallucinogens, 130 181, 183 obesity and, 226 psychotropics, 128-130 See also entries under names of specific drugs Physical exercise and, 226-227 Physicians change process and, 94-95 smoking cessation strategies, 284-285 Pledge taking, 98-99 Postdecisional regret, 78-80 Precontemplation stage bulimia and, 231 change model and, 19-20 Prediction alcoholism treatment and, 159 change and, 92 176-178 Predictor strategy, 180-186 Alcoholics Anonymous, 182 behavioral self-control training, 185 chemical aversion therapy, 183 community reinforcement approach, 185 covert sensitization, 183-184 disulfiram, 181 family therapy, 184-185
463 Predictor strategy (Cont.) 178-179 psychotherapy, 182 psychotropic medications, 181 relaxation training, 184 social skills training, 184 variables in, 193-195 Problem solving, 61-62 Proximity, 379-381 Psychoactive Drug Use History, 242, 246-247 Psychoanalysis, 96 Psychotherapy alcoholism, 131-133 bulimia and, 235-236 change process in, 8 focus of, 17 182 integration of methods in, 3 Rationality change and, 92 expectancy-value model and, 111-112 Reasoning, 63-65 Refusal, 73 Regret. See Anticipatory regret; Postdecisional regret Rehabilitation goals of, 435 See also Relapse Relapse alcoholism treatment aftercare, 435-456 change model and, 5-6 freedom and, 80 opiate-dependency treatment, 267, 271, 273-274 rates of, 407, 435 survival model, 391-405 Relapse Precipitants Inventory, 395-399 Relapse prevention model, 407-433 Cognitive Appraisal Questionnaire, 417-418 described, 412-413 Inventory of Drinking Situations and, 413-415, 423-431 self-efficacy theory and, 408-412 Situational Confidence Questionnaire, 415-416, 433 theoretical framework for, 408 Relaxation training alcoholism treatment with, 151-152 184 Religion, 94, 98-99 Residential treatment evaluation of, 263-264 legal system and, 271 self-regulation model, 42-44 Resistance, 31-32 Satisficing model, 66-68 Schizophrenia, 307-308 Self-concept, 9-10 Self-control self-regulation model and, 29-32 situation and, 30-31 Self-efficacy theory change model and, 10, 11 relapse prevention model and, 408-412 self-regulation model and, 31 temptation and, 16 Self-esteem, 191 Self-help manuals, 331-359 evaluation of, 338-353 future research directions in, 353-356 interest in, 332-335 research on controlled drinking and, 335-338 See also Bibliotherapy Self-regulation model, 29-47 alcoholism and, 333-334 cognitive change and, 322-327 control theory and, 321-322 cybernetic system and, 319-320 implications summarized, 45-46 individual differences and, 36-38 memory and thinking in, 327-328 obstacles in, 31-32 process in, 32-36 research support for, 38-44 residential treatment and, 42-44 self-control in, 29-32 unresolved issues in, 44-45 Self-reliance, 241, 257-258 Severity levels, 255 Sex differences aftercare and, 438 early alcoholism treatment, 211 obesity and, 225
464 Sex differences (COllt.) relapse and, 398-399 simple intervention studies and, 377 Sexuality, 92 Shifting-levels stategy, 19 Significant others anticipatory regret and, 77-78 See also Family; Social support networks; Spouse involvement Simple intervention, 375-387 attitudes and, 381 economics of, 378 evaluation of, 381-386 proximity, 379-381 stigma and, 379 studies in, 375-378 Situation early alcoholism intervention, 217 self-control situations, 30-31 Situational Confidence Questionnaire, 415-416, 433 Smoking change model and, 4-5, 6, 13 decision-making perspective on, 109-118 Smoking cessation strategies, 279-287 change process in, 280-282 integrated, 286 motivation in, 282-284 mutual aid in, 285-286 overview of, 279-280 simple interventions in, 284-285 spouse involvement in, 308-309 Social learning theory, 408 Social skills training alcoholism treatment, 150-151 184 Social stability, 192 Social support networks addictive behaviors and, 308-309 aftercare and, 439 alcoholism treatment and, 309-315 defined, 305 emotional/behavioral problems and, 306-308 functions of, 305-306 See also Family Social systems perspective, 29-32 Social workers, 95-96 Socioeconomic class aftercare and, 438 early alcoholism treatment, 211 Spiritual elements, 98-99 Spouse involvement addictive behaviors, 308 alcoholism treatment, 308-315 treatment effectiveness, 306 See also Family; Family therapy Stigma mutual-aid groups, 295-296 simple intervention and, 379 Stress change models and, 100 decision making and, 77-80 management techniques for, 151-152 Subjective expected utility (SEU) theory smoking and, 109, 110-112 study examples in, 112-117 Surgery, 224-226 Systematic desensitization, 152 Temperance movement, 98-99 Temptation, 16 Therapist/client relationship action stage and, 10 change model and, 6-7, 20-25 early alcoholism treatment, 206-207 self-help manuals and, 336 self-regulation model, 37-38 TOTE loop, 319-320 Values optimizing model, 65-66 See also Expectancy-value models Videotape self-confrontation, 135 Weight reduction programs, 308. See also Eating disorders WHO. See World Health Organization (WHO) World Health Organization (WHO), 51-57, 290, 333, 363, 378, 379,381