Thesis (M.S.)--Boston University / This study will present one of the methods of treatment for alcoholism, Conditioned Reflex (Response) Therapy, at the Washingtonian Hospital in Boston, Massachusetts, where it is felt that success can be achieved in the treatment of some cases. It may be that this new treatment method is at last on the way to removing the aura of hopelessness, that is, if patients can be selected from the larger alcoholic group who can be considered to have a fairly high probability of success. This Conditioned Reflex treatment group has a high percentage of successes. There are also a certain number of failures. The purpose of this study is to look more closely at the characteristics of both groups of patients, the successes and the failures, to see if the number of successes can be increased by an even more careful selection of candidates for treatment. Before discussing the Conditioned Reflex treatment group, it would seem useful to discuss the larger group from which these patients are chosen and some of the theories of alcoholism.

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Master of Science

The purpose of this study was to build upon a conceptual model of the alcoholic family system. The variables investigated were: differentiation of self, as represented by quantity and quality of involvement with family of origin; and nuclear family structure, as represented by hierarchy and primary coalition types. These variables were chosen in order to provide some theoretical understanding of how alcoholism is both maintained and transmitted by family systems. Forty-two families in which the father was an alcoholic took part in this study. Both the alcoholics and their spouses completed an abbreviated form of the Personal Authority in the Family System Questionnaire (PAFS-Q), the Family of Origin Involvement Questionnaire, and the Madanes Family Hierarchy Test. At least one child from each family also completed the Madanes Family Hierarchy Test. Chi-square test results indicated that these families reported significant amounts of hierarchy reversal, nonmarital primacy, and nonaverage contact with family of origin. When compared to norm group scores on the PAFS-Q, alcoholic subjects and their spouses indicated more nuclear family triangulation, intergenerational fusion, and intergenerational triangulation. Pearson Product-Moment Correlation results indicated that nuclear family triangulation was related to intergenerational fusion, presence of hierarchy reversal, and nonmarital primacy. For alcoholics only, more time spent recovering, more contact with parents, nonmarital primacy, and more intergenerational triangulation were related. These study results were interpreted as supporting a developmental model for the maintenance and transmission of alcoholism in the family. Clinical implications include the necessity of doing family of origin work with alcoholic families as well as the importance of including as many members as are willing in family therapy. / Ph. D.

Abstinence used to be the only recommended goal for persons affected with alcohol misuse. In recent years there has been a trend to suggest controlled drinking for some alcohol abusers. The comparison of abstinence versus controlled drinking indicates that controlled drinking goals have proved to be successful in a limited attempt with problem drinkers having middle income, average intelligence, stable job and adequate social support system. Severely dependent alcoholics (gamma type) have been trained in some instances to control their drinking in a laboratory environment, but their control erodes over time. The controlled drinking controversy has partly to do with different theoretical perspectives on alcoholism, but part of it has to do with the issue of territoriality. What is needed at this point is an effective and thorough evaluation of a variety of alcohol-treatment programs with a variety of problem drinkers and alcoholics. In this endeavor a research design is proposed as an extension and improvement over the existing research methods on the comparative suitability of abstinence versus controlled drinking.