PubMed · 8040910
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N P Johnson. A commentary on the 12-step program.. https://doi.org/10.1016/0740-5472(94)90024-8
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Alcoholism treatment research has traditionally focused on direct questions of efficacy, such as is a particular intervention better than no treatment or is one treatment more effective than another. Recent projects, however, have also attempted to identify variables explaining why treatments vary in their effects. Many of these variables relate to the process of treatment itself or changes that may occur within the patients. Clinicians also need to continuously monitor progress of patients in engaging in behaviors supportive of long-term sobriety and how well the values and behaviors fostered by the particular treatment regimen are being incorporated into daily life. Measurement of process variables may assist in both regards. In the last decade several psychometric instruments have been developed to elucidate the processes involved in Alcoholic Anonymous (AA), a key adjunct of most formal alcoholism programs in the United States. These instruments measure dimensions such as involvement in AA, completion of steps, and adoption of values encouraged by AA. Six such measures are summarized here and several fruitful topics for future research on the measures are suggested.
The cognitive-behavioral model for the treatment of alcoholism is mainly based on social learning and conditioning theories. Clinical applications emphasize behavioral changes with acquisition of new skills and avoidance strategies. Individual or group therapy is in the form of cognitive-behavioral psychoeducational modules which are designed to take account of the degree of neuropsychological impairment and adopt specific objectives in accordance with patient motivation.
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