Social role negotiation skills for substance-abusing adolescents: a group model.

A group model for therapeutic early intervention (secondary prevention) with nonaddicted adolescent substance abusers is proposed, based on a Social Role Negotiation model of substance abuse integrating concepts form role theory and cognitive developmental theory. The description of the group model, a structured short-term approach, includes a variety of exercises which promote developmental improvement in the essential skills of role-taking, role-making, and definition of the situation. An individualized intervention strategy is proposed for each group member, based on a theory-based taxonomy of substance-related problems. Strategies for using family involvement to support an adolescent group are described.

Families of adolescent drug abusers: systemic interventions to attain drug-free behavior.

Adolescent drug use in the community is a widespread social problem. The abuse of alcohol and/or other illegal drugs ranges from random experimentation to a complex pattern of regular use of a combination of drugs. This paper addresses systemic therapeutic interventions which have been constructed to achieve drug-free behavior. The family is considered the unit of treatment. Contextual goals (necessary to attain a therapeutic climate) and family goals are delineated. These include unity and action within a parental coalition, therapeutic utilization of urinalyses, the bogeyman cometh, probation, home detoxification, and countering adolescent sabotage. Family structural and interactional features outside the explicit arena of drug-taking, such as marital conflict or adolescent autonomy/dependence issues, are not addressed but are discussed elsewhere. Clinical illustrations to document interventions discussed are provided.

Enhancing marital sexuality: an evaluation of a program for the sexual enrichment of normal couples.

The popular but little researched sexual enrichment program developed by LoPiccolo and Miller was modified and the revised Enhancing Marital Sexuality (EMS) program was evaluated using the Sexual Interaction Inventory (SII) and the Dyadic Adjustment Scale (DAS). A pretest-posttest-follow-up control group design was used to assess the effectiveness of EMS in improving couples' sexual and marital satisfaction. Thirty-four couples were randomly assigned (with replacements) to either the no-treatment control condition or the 11-hour EMS program. Results indicated extensive short-term improvements in sexual satisfaction for both sexes and some short-term gains in marital satisfaction for couples. At 3-month follow-up, improvement was sustained on SII scales of perceptual accuracy for both sexes, and on self-acceptance and pleasure scales for females. No marital satisfaction gains were evident at follow-up. It was concluded that long-term sexual satisfaction gains, especially for females, justify the continued use and refinement of the EMS program. Findings also indicated that marital satisfaction may be too broad a category to be affected by educational training with as specific a focus as sexual enhancement. Suggestions are made for further research.