Treatment goals of alcohol-dependent and drug-dependent patients.

At the time of admission to treatment, 450 alcohol-dependent patients and 198 drug-dependent patients were asked to complete a brief questionnaire regarding their interest in 26 treatment goals. An analysis of the goal questionnaire data revealed that from the total sample of patients more than 70 percent wanted assistance, in addition to help with substance dependency, with medical problems, psychological problems, school or job counseling, and recreational guidance. Between alcohol- and drug-dependent groups, statistically significant (p less than .05) but small differences were found for numerous goal items, with drug-dependent patients wanting assistance for more goal items than alcohol-dependent patients.

Formulating therapeutic objectives as a prelude to program evaluation.

The author emphasizes the need for more precise formulation of goals for mental health treatment programs. He describes the Veterans Administration's five-year effort at goal formulation using ideas borrowed from operations research and education. With goals from various VA programs as examples, he illustrates how goal statements can be written with more specificity. He also describes how matching rating-scale items can be developed to measure the degree to which each goal is being met.

Antipsychotic drugs: can education change prescribing practices?

Forty-two VA Hospitals participated in an evaluation of educational techniques for physicians on the use of psychotherapeutic drugs. The purpose of the study was to determine whether educational techniques, such as articles and videotapes can be instrumental in changing physician prescribing practices so that they are more in conformity with current recommendations. The 2 major findings of the study were that there was less polypharmacy--less use of antiparkinson drugs and less use of antiparkinson drugs for longer than 6 months--and that there were no statistically significant differences among educational groups.

An evaluation of the Veterans Administration day hospital program.

A study of the day hospital program of the Veterans Administration was aimed at determining how well patients functioned three months after admission in relation to nine treatment goals, and how much they improved between admission and follow-up. The study group consisted of 1410 patients admitted to 34 VA day hospital programs; follow-up interviews were conducted with 70 per cent of them. At follow-up less than 10 per cent of the patients showed significant problems related to delusions, hallucinations, irrelevant speech, suicidal preoccupation, antisocial behavior, drinking, poor hygiene and eating habits, and assaultiveness. However, almost a fourth were significantly withdrawn, about a third were anxious, and three-fifths were not self-supporting. From the perspective of improvement during the three months, the study showed that treatment was helpful in all areas except promoting economic independence; it was most effective in reducing perceptual-cognitive dysfunctioning, emotional distress, and interpersonal difficulties.

Evaluation of drug dependence treatment in VA hospitals.

A nationwide evaluation of 49 Veterans Administration drug dependence treatment programs was conducted using a sample of 1,655 patients. Their status with reference to seven treatment goals was assessed at admission and again 11 months later to determine change. The following changes were observed: a large decrease in heroin use; a small increase in the use of alcohol; moderate decline of involvement in the drug culture; moderate increase in psychological well-being; and small increase in economic independence. No statistically significant changes were observed in frequency of arrests, in establishment of stable living arrangements, in drug related medical problems, or in the ability to relate to other people. Implications of the findings for further research and program modification are discussed.

Antipsychotic drug use: physician prescribing practices in relation to current recommendations.

Forty-two Veterans Administration hospitals contributed data on all the psychotherapeutic drugs being prescribed for a sample of their patients. These prescriptions were compared with the recommendations in "Guidelines for Antipsychotic Drug Use" by Drs. Prien and Caffey (1975). Generally, the results showed moderate differences between the actual physician practices and those recommended in the guidelines. The most significant differences were in polypharmacy, use of antiparkinson drugs, dosage levels and "drug holidays". The use of once- or twice-a-day schedules and the administration of major portion of the dose at night were much closer to the recommendation.

Patterns of association voting behavior: I. Demographic correlates of voting/nonvoting and preference for candidates/issues.

A total of 58% of the eligible members voted in the 1974 APA balloting involving 6 officers, 13 amendments to the By-Laws, and a membership-initiated referendum. Analysis revealed that there was no significant relationship between member characteristics and voting/nonvoting behavior and that relatively few members followed specific voting patterns. The data support the view that most members voted carefully and relatively independently of organized influence.