The Office of Programs for Alcohol and Drug Problems is the designated "Single State Authority" for the planning and development of alcohol and drug programs. It is within the State Mental Health Division, and is the interface between the Division, the counties, and the federal government with regard to alcohol and drug programs. The Division's Office of Management Support Services (MSS) is charged with the responsibility of developing an evaluation system for programs. This is being done in regard to the needs of programs and decision-makers concerned with programs. The Program Office is now providing input to MSS largely through this practicum paper, and through the involvement of the author with staff of MSS and the Division's Task Force on Evaluation Systems. The goal of the practicum, and the involvement with MSS, which will continue, is to assist in the development of an evaluation system that will enable the Program Office to better perform the tasks of assessing programs, and planning for this further development. While the subject is beyond the scope of this paper, such an evaluation system would be useful to individuals, organizations, and high level decision-makers outside the Program Office. For an evaluation system to be of use to the Program Office (or the other decision makers involved with alcohol and drug programs), it must provide systematic information regarding the extent to which the alcohol and drug service system and elements within it are able to: Identify the problems of potential clientele; Assign or establish goals which clients may realistically be helped to attain; and Provide treatment or services which enable them to reach their goals. Beyond answering process oriented questions such as these, the system must develop information concerning the impact, on the lives of clients, and on the community, of the services. It must provide this feedback in a way that is usable to programs so they may alter approaches to client problems, to the Program Office, and to the hierarchy of government officials responsible for programs.

The purpose of this project was to clarify the methodological considerations involved in the posttreatment follow-up evaluation of alcohol-abuse patients. A two-part project was undertaken in an attempt to answer the follow-up questions of how and when to measure treatment effects with discharged alcoholics. In Part I, a large-scale survey was utilized to examine return rates across various program evaluation methods and time frames. In Part II, the predictive validity of scores received at short-term follow-up in relation to scores received at 1-year follow-up was assessed for measures of psychosocial functioning and alcohol consumption.

The purpose of this study is to assess the effect of explanatory style on the coping strategies of women in recovery from addiction to alcohol and other substances.

Call number: LD2668 .T4 1985 A37 / Master of Science

Thesis (MA)--University of Stellenbosch, 2004. / ENGLISH ABSTRACT: The aim of this study was to explore the dynamics between spiritual fitness and women in recovery from substance-problems. The phenomenological method of enquiry, and within this context, the qualitative approach, was followed. Interviews with five women, four of whom received treatment at Stepping Stones Addiction Centre, constituted the empirical data on which this research was based. These interviews revealed remarkable experiences in the lives of these women. The findings of the research indicate that women in recovery with substanceproblems benefit tremendously from interaction with the dimension of spirituality. Spirituality was understood in terms of the experience of intervention or support by a power greater than themselves – an experience which gave meaning to the lives of these women, which is manifested in their way of being and way of acting. This includes a new sense of responsibility and self-respect which empower them to become co-creators of their lives, and to contribute compassionately to the well-being of others. The continuous and disciplined application of “spiritual tools”, practices and guidelines constitute a growing dynamics of spiritual fitness which forms part of a holistic approach to treatment and recovery. / AFRIKAANSE OPSOMMING: Die doel van hierdie studie was om die dinamiek tussen spirituele fiksheid en vroue met substansie-probleme in die herstelproses, te verken. Die fenomenologiese metode van ondersoek, en binne hierdie konteks die kwalitatiewe benadering, is gebruik. Onderhoude met vyf vroue, van wie vier behandeling ontvang het by Stepping Stones Addiction Centre, het die empiriese data waarop hierdie navorsing gebaseer is, gekonstitueer. Hierdie onderhoude het merkwaardige ondervindings in die lewens van die vroue blootgelê. Die bevindings van die navorsing toon dat vroue met substansie- probleme in die herstelproses geweldig by die interaksie met die spirituele dimensie gebaat het. Spiritualiteit is verstaan in terme van die belewenis van intervensie of ondersteuning deur ‘n mag groter as hulself – ‘n ervaring wat betekenis gegee het aan die lewens van hierdie vroue, wat gemanifesteer het in hul wyse van bestaan en wyse van handel. Dit sluit ‘n nuwe begrip van verantwoordelikheid en selfrespek in, wat hul bemagtig om mede-skeppers van hul lewens te word, en op ‘n deernisvolle en empatiese wyse tot die welsyn van ander by te dra. Die voortgaande en gedissiplineerde toepassing van spirituele toerusting, gebruike en riglyne lei tot ‘n toenemende dinamiek van spirituele fiksheid wat deel vorm van ‘n holistiese benadering tot behandeling en die herstelproses.

Thesis (MA)--University of Stellenbosch, 2004. / ENGLISH ABSTRACT: Two recent local studies of relapse among individuals who had attended inpatient alcohol rehabilitation programmes in the Western Cape found relapse rates of up to 60%. A high incidence of comorbid anxiety, low self-efficacy and avoidant coping style were principal reasons cited for relapse. The following literary review was undertaken in an effort at better understanding current findings on the comorbid relationship between alcohol abuse/dependency and anxiety, and on dysfunctional coping styles and relapse. It also reviews current literature and theory concerning the treatment of alcoholics using the Relapse Prevention (RP) model of therapy. Based on these findings, recommendations are made for the application of RP to the clinical psychology groups run for alcohol abusing/dependent inpatients at Neuro Clinic D, Stikland Hospital, Western Cape. Relapse Prevention Therapy was selected because of its integrated approach to addressing both substance abuse and the inadequate coping styles that often render people vulnerable to anxiety, depression and relapse. It was also chosen because of the more constructive, less punitive approach it takes to substance dependence/abuse and the issue of lapses and relapse. The recommendations made in this review should not, in any way, be seen as criticism of the existing programme at Neuro Clinic D. They are, essentially, the individual reflections of the author based on the four months he spent conducting clinical psychology groups in the unit and the findings of two local studies that looked at some of the reasons for relapse following treatment in this and other local facilities. The specific focus on the groups run by clinical psychologists should also not be seen as ignoring the important and valuable work done by other professionals in the unit; notably those in psychiatry, nursing, social work, occupational therapy and pastoral care. On the contrary, information gathered by these professionals is vital to the team effort of rehabilitation, and the identification of psychosocial stressors and cognitive patterns that place people at risk of relapse. / AFRIKAANSE OPSOMMING: Twee onlangse plaaslike studies van terugvalonder pasiënte wat binnepasiëntalkoholrehabilitasieprogramme in die Weskaap bygewoon het, het terugvalkoerse van tot 60% gerapporteer. 'n Hoë voorkoms van komorbiede angs, lae sin van self-vermoë en 'n vermydende streshanteringstyl was die hoofredes aangevoer vir die terugval. Die volgende literatuur-oorsig is onderneem in 'n poging tot 'n beter begrip van huidige bevindinge oor die komorbiede verhouding tussen alkoholmisbruik/afhanklikheid en angs, en oor wanfunksionele streshanteringstyle en terugval. Die oorsig beskou ook huidige literatuur en teorie aangaande die behandeling van alkoholiste deur middel van die Relapse Prevention (RP) model (Terugvalvoorkomingsmodel) van terapie. Op grond van hierdie bevindinge word aanbevelings gemaak VIr die toepassing van RP op die kliniese-sielkundegroepe aangebied VIr alkoholmisbruikende/afhanklike binnepasiënte by Neurokliniek D, Stiklandhospitaal, Weskaap. RP is gekies op grond van sy geïntegreerde benadering tot beide substansmisbruik en die onvoldoende streshanteringstyle wat dikwels mense kwesbaar maak vir angs, depressie en terugval. Die model is ook gekies as gevolg van die meer konstruktiewe, minder strafgerigte benadering tot substansafhanklikheid/misbruik en tot val en terugval. Die aanbevelings in hierdie oorsig moet in geen opsig beskou word as kritiek op die bestaande programme in Neurokliniek D nie. Hulle is, in wese, die individuele gevolgtrekkings van die skrywer gebaseer op sy vier maande ondervinding met sielkundegroepe in die eenheid en op die bevindinge van twee plaaslike studies wat ondersoek ingestel het na sommige van die redes vir terugval na behandeling in hierdie en ander plaaslike fasiliteite. Die spesifieke fokus op die groepe wat deur kliniese sielkundiges bestuur word moet ook nie gesien word as 'n geringskatting van die belangrike werk van ander professionele mense in die eenheid nie, in die besonder dié in psigiatrie, verpleging, maatskaplike werk, arbeidsterapie and pastorale sorg. In teendeel, inligting ingesamel deur hierdie mense is lewensbelangrik vir die spanpoging van rehabilitasie, en vir die identifisering van psigo-sosiale stressors en kognitiewe patrone wat pasiënte vatbaar maak vir terugval.

Assignment (MA)--University of Stellenbosch, 2003. / ENGLISH ABSTRACT: In the South African context, research on the impact of alcohol rehabilitation is particularly limited. This study aimed at describing the impact of the alcohol rehabilitation programme offered at Neuro Clinic D, Stikland Hospital. Outcome was assessed at 12-15 months with the objective of exploring the perceptions and experiences of the ex-patients to ascertain whether there has been an improvement in psychological well-being and positive lifestyle changes. The study was motivated by a request made by the staff at Neuro Clinic D; as such an investigation has never been conducted. Both quantitative and qualitative methodologies were used to gather data from 44 out of the 166 ex-patients admitted to Neuro Clinic D between January and June 2002. The relationships between the rate of relapse and age, gender, marital status, employment status, previous rehabilitation, health problems, police contact, aftercare attendance, participation in the 3- or 4- week programme and other medication/substance abuse were explored. While no statistically significant relationships were found between any of the variables, some evidence of interaction emerged with regards to the relationships between relapse status and participation in the 3- or 4-week programme, aftercare attendance, employment and marital status. The qualitative analysis revealed four central themes, namely coping mechanisms; responses to specific components of the programme; confounding factors and the impact of the programme. An integration of the quantitative and qualitative data supports the conclusion that while there was a low rate of consistent abstinence, the respondents reported an overall post-treatment improvement in psychological well-being and positive lifestyle changes. / AFRIKAANSE OPSOMMING: Navorsing op die impak van alcohol rehabilitasie is besonder beperk in die Suid-Afrikaanse konteks. Hierdie studie het ten doelom die impak van die alcohol rehabilitasie program, gebied deur Neuro Kliniek D, Stikland Hospitaal, te beskryf. Die uitkoms is bepaal na 12-15 maande deur die persepsies en envaringe van eks-pasiente te ondersoek om sodoende vas te stelof daar verbetering was in sielkundige welstand en of positiewe leefstyle veranderinge aangegaan is. Die betrokke studie is gemotiveer deur 'n versoek gerig deur die personeel van Neuro Kliniek D, aangesien so 'n ondersoek nog nooit vantevore gedoen is nie. Beide kwantitatiewe en kwalitatiewe metodologieë is gebruik om data in te samel van 44 die 166 eks-pasiente toegelaat tot Neuro Kliniek D tussen Januarie en Junie 2002. Die korrelasie/verhouding tussen die terugvalkoers en ouderdom, geslag, huwelikstatus, werkstatus, vonge rehabilitasie, gesondheidsprobleme, polisie kontak, nasorg bywoning, deelname in die 3- of 4-week program en ander medikasie/substans misbruik is ondersoek. Terwyl geen statisties beduidende verhoudinge gevind is tussen enige van die veranderlikes nie, is daar wel aanduidings van interaksie met betrekking tot die verhouding tussen terugvalstatus en deelname aan die 3- of 4- week program, nasorg bywoning, werkstatus en huwelikstatus. Die kwalitatiewe analise het 4 sentrale temas onthul, naamlik, hanteringsmeganismes; response tot spesifieke komponente van die program; verydelende faktore en die impak van die program. 'n Integrasie van die kwalitatiewe en kwantitatiewe data steun die gevolgtrekking dat alhoewel daar 'n lae voorkoms was van volgehoue onthouding, die respondente wel 'n algemene verbetering in sielkundige welstand en postiewe leefstyle veranderinge na behandeling gerapporteer het.

Research reports that an estimated forty-three percent of adults, or seventy-six million people, in the United States have relatives who are alcoholic. In addition, one in eight individuals, or an estimated 30 million adults, has an alcoholic parent. The literature suggests that the impact of growing up in an alcoholic family system may affect psychological functioning well into adulthood. Adult children of alcoholics (ACOAs) are at increased risk for a myriad of psychological symptoms including substance abuse/dependency, problems in interpersonal relationships, depression, anxiety, and low self-esteem. However, research has also indicated that there may be more heterogeneity within this group than previously reported. It has been suggested that while patterns of maladjustment and increased risk for psychological distress may be evident, no clear “syndrome” related to this population was supported. This study explored whether an ACOA’s childhood family role (i.e. Hero, Scapegoat, Mascot and Lost Child) explained variance within this population, using adult attachment and family of origin health as outcome measures. Results did not support this hypothesis. This study also examined between group differences in adult attachment styles and family of origin health between a sample of ACOAs and Non-ACOAs. Analysis indicated that ACOAs reported significantly more Fearful attachment styles than Non-ACOAs. As well, post-hoc analyses indicated that ACOAs described their families of origin as promoting significantly less personal responsibility, as well as, having lower support for the expression of emotions and constructive conflict resolution than Non-ACOAs. This study provides information which may be utilized by clinicians working with this population. The impact of less secure attachment styles within the therapeutic relationship should be considered. As well, this study provides evidence that a specific pattern of maladjustment secondary to the dynamics created by the disease of addiction may be present within alcoholic family systems that may differentiate them from other “dysfunctional” families. / text

This study identifies the alcohol intaKe patterns of 274 white patients attending an Urban General Practice. The average consumption rate was 6.5 drinKs per person per weeK (d/p/w). 40X of the surveyed group did not consume any alcohol. The drinkers averaged 11 dIp/wo 72X of the males drank and 501: of the females dranK. 4.31: of the population surveyed were drinking more than 28 dIp/wo Marital status made no real difference to consumption rates but unemployment (16 d/p/w) and being a manual labourer (11.7 d/p/w) did. People who had lost either their occupation (11.7 d/p/w) or a close family member (9.3 d/p/w) in the preceeding year had higher than average (6,5 d/p/w) consumption levels and these were increased further if they had identified an alcohol abuser in their family. This study also identifies the useful supportive services available to this particular community and its health care worKers with a brief discussion of the type of service prOVided and method of access to the service. The appendix contains a list of the services with the relevant address. telephone number and where possible the name of a contact person. / Thesis (M.Prax.Med.)-University of Natal, Durban, 1986.

Phenomenological inquiry was used to investigate stressors encountered by older adults during recovery from alcoholism. Thirteen men and thirteen women, ranging in age from 55 to 82 and in length of sobriety from 2 months to 41 years, generated 37 sources of stress which threatened stable recovery. Stressors were categorized as psychological, physiological, or environmental in origin.Results indicated that the number and multicomplexity of stressors intensified stress levels. Although some stressors were antecedent to sobriety, a significant proportion were unique in recovery and/or related to the maintenance of sobriety itself.Women's rates of response nearly doubled those of men. Women evidenced greater deficiencies in basic survival needs and family support for recovery, greater duration of stressors into the recovery period, and greater focalization on internal negative emotional states, particularly anxiety, guilt and anger. Males evidenced proportionally higher percentages of external sources of stress.Both genders showed higher percentages of environmental stressors than expected. Although the percentage of physiological stressors was lower than expected, there was notable incidence of iatrogenic cross-addiction to psychoactive medication during recovery.Treatment methods were an early sobrietal source of stress for both genders. Inpatient treatment experiences were negatively influenced by confrontive therapy approaches, mixed-age therapy groups, lack of assistance with problems other than alcoholism, and inattention to medical complications.This dissertation includes an extensive review of literature concerning alcoholism in older adults, and recommendations for research and practice. / Department of Educational Leadership