Development of a skill training program for parents of substance-abusing adolescents.

This report discusses the development of a coping skill training program for parents of substance-abusing adolescents and presents preliminary data on the effects of the program on parent functioning and adolescent substance use. The behavioral-analytic model of program development was used to sample representative problematic situations experienced by parents of substance-abusing adolescents, obtain an effectiveness-scaling of responses to these situations, and derive alternate forms of a situational role-play measure of parental coping. These situations and scoring guidelines were then used to create the skill training program. Parents of substance-abusing adolescents not in treatment subsequently were randomly assigned in a pilot investigation to either a skill training or delayed treatment condition. Skill training resulted in significant improvement in parental coping skills relative to delayed treatment. Moderate to large improvement in the parent's report of their own functioning, family communication, and the teen's marijuana use also favored the skill training group.

Treatment settings for persons with alcoholism: evidence for matching clients to inpatient versus outpatient care.

This study compared inpatient, intensive outpatient, and standard outpatient treatment settings for persons with alcoholism and tested a priori hypotheses about the interaction of setting with client alcohol involvement and social network support for drinking. Participants (N = 192) were assigned randomly in cohorts to 1 of the 3 settings. The settings did not differ in posttreatment primary drinking outcomes, although inpatients had significantly fewer jail and residential treatment days combined than outpatients. Clients high in alcohol involvement benefited more from inpatient than outpatient care; the opposite was true at low alcohol involvement levels. Network drinking support did not moderate setting effects. Clients low in cognitive functioning also appeared to benefit more from inpatient than outpatient care. Improved outcomes might be achieved by matching degree of alcohol involvement and cognitive functioning to level of care.

Substance use in individuals with mental retardation.

Alcohol and drug use among individuals with mental retardation (MR) has received little empirical attention. Two studies are reported: In Study 1, individuals (n = 122) with MR were surveyed regarding their personality characteristics, alcohol and drug use, and skills to avoid substance abuse. Results indicate that although the majority of participants did not drink alcohol, among those who did, the ratio of misusers to users was nearly 1:1. In addition, misusers were deficient in specific skill areas. In Study 2, participants (n = 84) were randomly assigned to receive a prevention program in either (a) assertiveness building, (b) modeling and social inference, or (c) a delayed treatment, control condition. Results suggest that each program, at least in the short-term, improved substance knowledge and enhanced skills. Overall, these results suggest that substance use interventions focused toward individuals with MR may be beneficial.

Participant selection biases in a randomized clinical trial of alcoholism treatment settings and intensities.

Eligible participants and decliners in a randomized study of inpatient, intense outpatient, and standard outpatient treatments for alcoholics were compared and contrasted on a series of demographic, social stability, psychological, legal, drug use, problem severity, and treatment history variables. Among 302 individuals meeting eligibility requirements, those agreeing to participate, compared with decliners, were more likely to be unemployed, be residentially less stable, have legal problems, use other drugs, have a more severe alcohol problem, have a recent treatment history, and were less likely to have problems with violence. Participants also were more likely to be male and non-white, although gender and racial effects were not significant when other variables were controlled for. The implications of these findings for generalizing the results of inpatient-outpatient studies are discussed, and the need for routine reporting of decliner characteristics in research reports is stressed.

The spouse situation inventory: a role-play measure of coping skills in women with alcoholic partners.

This article reports on the psychometric evaluation of the Spouse Situation Inventory (SSI), a role-play measure of coping skills in women with alcoholic partners. The study examined the generalizability, alternate form reliability, test-retest reliability, and construct validity of the measure in 472 women from both treatment and nontreatment populations. The SSI had acceptable generalizability and reliability. SSI performance also had predicted relationships with measures of general escape coping, alcohol-related coping behaviors, the woman's drinking, the partner's drinking in the treatment group, and the partner's problem recognition in the nontreatment group. The SSI shows promise as a reliable and valid measure of coping skills in this population and has direct implications for development and evaluation of skill training programs.