Thesis (PhD (Psychology))--University of Stellenbosch, 2010. / ENGLISH ABSTRACT: There is a paucity of research documenting women’s undisclosed drinking. This study explored the discursive accounts of women’s alcohol dependence, treatment history and barriers in accessing alcohol dependence treatment. The goals of this dissertation were to explore women’s alcohol dependence history; explore women’s treatment history (or lack thereof); identify barriers and nature of barriers that limit women’s access to alcohol dependence treatment; identify the reasons for women not accessing treatment, and to interpret women’s experiences of treatment per se. A Human Scientific Approach was adopted to examine and interpret how women’s drinking is socially constructed. A social constructionist approach was utilised to access and construct meaning from the discourses emanating from the women’s narratives of their experience with alcohol and their attempts at rehabilitation. Ten women were interviewed using the life story (narrative) interview method. The findings illustrate two major discourses namely, secret drinking and inaccessibility of appropriate treatment facilities for women alcohol dependents. This means that participants feel forced to conceal their drinking and to drink secretively because of the stigma associated with women drinking heavily. The stigma they experience translates into barriers (mostly internal barriers) to seeking institutionalised treatment. This makes it easier for them to seek alternative treatment such as an anonymous fellowship, like Alcoholics Anonymous. Other discourses signify the importance of problem identification and treatment readiness. This means that if the alcohol dependent woman realises what the real problem is causing her to use alcohol as an escape or as a coping strategy, she will be more willing to address the underlying problem. Recommendations are made focusing on micro and macro-level intervention strategies such as access to treatment, public health campaigns and policies to improve the quality of life of women recovering from alcohol dependence. / AFRIKAANSE OPSOMMING: Daar is min inligting beskikbaar oor die dokumentering van vroue wat in-die-geheim alkohol gebruik. Hierdie studie het die diskursiewe weergawe van vroue se alkoholgebruik, behandelingsgeskiedenis en hindernisse tot die behandeling van alkohol-misbruik verken. Die doelstellings van hierdie verhandeling is om die volgende te verken: Vroue se afhanklikheidsgeskiedenis; vroue se rehabiliteringsgeskiedenis (of die gebrek daaraan); die identifisering van hindernisse en die aard van die probleme wat vroue se toegang tot die behandeling van alkohol-misbruik beperk; die identifisering van redes waarom vroue rehabilitering weier; en die interpretasie van vroue se belewings van behandeling per se. ‘n Humanisties-wetenskaplike benadering is gebruik om die sosiale konstruksie van vroue se drinkgewoontes te ondersoek en te interpreteer. Die verstaan van en die skep van betekenis van die diskoerse van die vroue, en die temas wat na vore gekom het vanuit hul vertellings/narratiewe van hul alkohol-ervarings en hul pogings tot rehabilitering, is binne die raamwerk van die sosiaal-konstruksionistiese uitgangspunt aangepak. Onderhoude is met tien vroue gevoer en die narratiewe metode is gebruik. Die bevindings toon twee hoofdiskoerse naamlik, drinkery in-die-geheim en die ontoeganklikheid van gepaste behandelingsfasiliteite vir vroue met afhanklikheidsprobleme. Dit beteken dat vroue ondervind dat hulle gedwing word om in-die-geheim te drink, as gevolg van die stigmatisering van vroue en oormatige alkohol-gebruik. Hierdie stigmatisering kan herlei word tot hindernisse (meestal interne hindernisse) te make met ge-institutionaliseerde behandeling. Om die rede is dit makliker vir vroue om alternatiewe behandeling soos anonieme gemeenskappe, byvoorbeeld Alkoholiste Anoniem te oorweeg. Ander diskoerse beklemtoon die identifisering van probleme en die instemming tot rehabilitering. Dit beteken dat wanneer die alkoholis die werklike probleem vir alkohol-gebruik verstaan as ‘n ontsnapping of as ‘n hanteringsstrategie, sy meer gewillig sal wees om die onderliggende probleem aan te spreek. Aanbevelings is gemaak met die fokus op mikro- en makrointervensiestrategieë, soos die toegang tot rehabilitering, openbare gesondheidsveldtogte en beleide ten einde die leef-kwaliteit van vroue in die herstelproses van alkoholafhanklikheid te verbeter.

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.

Thesis (M Social Work)--Stellenbosch University, 2015. / ENGLISH ABSTRACT: Alcohol is the substance that people throughout the world abuse most often. South Africa has one of the highest alcohol use level with more than 30% of the population struggling with alcohol-related problems (Telesure, 2010; Nevid et al., 2008: 297; Pisa et al., 2010:4). Statistics showed that approximately 17,5 million South Africans are affected by alcohol, but many more South Africans’ lives are completely disrupted through constant, direct daily contact with the individual abusing alcohol like a parent or life partner (Telesure, 2010). Due to this, alcohol dependency is classified as a family illness in the medical circles and by society. Alcohol dependency can tear families apart and disrupt family dynamics and –processes including rules, rituals, routines, communication, social life, finances, homeostasis and family roles (Stepping Stones, 2013). Alcohol dependency has a great impact on the functioning and existence of a family and to restore the damage alcohol dependency creates in a family, the family should play an important role in the rehabilitation process of the alcohol dependent. This study, therefore, had the goal to determine the role of a social worker in a rehabilitation centre for alcohol dependents from an ecological perspective. A combination of quantitative and qualitative research was used in this study. Furthermore, an exploratory and descriptive research design was used during the research because the available literature showed a lack of information concerning the role of the social worker in a rehabilitation centre for alcohol dependents. A purposeful sample, namely probability sampling, was used to identify participants. The researcher could, therefore, choose participants who qualified for inclusion. The data was collected using a semi-structured questionnaire during 23 individual interviews. An overview of the participants’ beliefs and opinions concerning the subject of the study was gained. The questionnaire consisted of open- and closed questions and was based on information obtained from the literature study. Data from the semi-structured questionnaire was processed and analysed and the results of this empirical study were used as basis for the conclusion and recommendations made in this study. The main findings showed that there is a need for family counselling during a rehabilitation programme for alcohol dependents since there is a definite lack of involvement of the family during the rehabilitation process for alcohol dependents. Further findings showed that rehabilitation programmes mainly provide individual counselling to alcohol dependents and minimal focus and attention is given to the family and after care services. The most important recommendation of this study is that social workers should use the ecological perspective when providing services to alcohol dependents. This perspective can ensure that the necessary services are delivered to effectively address alcohol dependents during a rehabilitation process. Recommendations also showed that social workers should involve the family more during a rehabilitation programme since the support of a family plays an important role during the rehabilitation process. / AFRIKAANSE OPSOMMING: Wêreldwyd is alkohol die middel wat deur die meeste misbruik word en Suid-Afrika het een van die hoogste alkohol inname syfers, met meer as 30% van die bevolking wat sukkel met alkohol-verwante probleme (Telesure, 2010; Nevid et al., 2008: 297; Pisa et al., 2010:4). Statistiek dui daarop dat sowat 17,5 miljoen Suid-Afrikaners deur die inname van alkohol geaffekteer word, maar baie meer Suid-Afrikaners se lewens word egter totaal ontwrig weens konstante, direkte daaglikse kontak met die individu wat alkohol misbruik soos byvoorbeeld ’n ouer of lewensmaat (Telesure, 2010). Weens hierdie spesifieke rede word alkohol-afhanklikheid in mediese kringe en in die samelewing as ’n gesinsiekte geklassifiseer. Alkohol-afhanklikheid kan gesinne uitmekaar skeur en veroorsaak dat die gesinsdinamika en –prosesse, soos byvoorbeeld die reëls, rituele, roetines, kommunikasie, sosiale lewe, finansies, homeostase en gesinsrolle, totaal ontwrig word (Stepping Stones, 2013). Alkohol-afhanklikheid het sodoende ’n geweldige impak op die funksionering en voortbestaan van ’n gesin, en om die skade wat alkohol-afhanklikheid in ’n gesin veroorsaak te herstel, behoort die gesin ’n belangrike rol te speel in die rehabilitasieproses van die alkohol-afhanklike. Hierdie studie het daarom ten doel gehad om die rol van ’n maatskaplike werker in ’n rehabilitaisiesentrum vir alkohol-afhanklikes vanuit ’n ekologiese perspektief te bepaal. ’n Kombinasie van kwantitatiewe en kwalitatiewe navorsingsbenaderings is in hierdie studie benut. Verder is daar tydens hierdie ondersoek ’n verkennende en beskrywende navorsingsonderwerp gebruik, aangesien die beskikbare literatuur ’n gebrek aan inligting rakende die rol van ’n maatskaplike werker in ’n rehabilitasiesentrum vir alkohol-afhanklikes toon. Daar is gebruik gemaak van ’n doelbewuste steekproefmetode, naamlik die nie-waarskynlikheidsteekproef, om deelnemers te identifiseer. Die navorser kon dus die deelnemers kies wat aan die kriteria vir insluiting voldoen. Die data is ingevorder deur die gebruik van ’n semi-gestruktureerde vraelys, tydens 23 individuele onderhoude. ’n Geheelbeeld van die deelnemers se oortuigings en menings aangaande die onderwerp van die studie is verkry. Die samestelling van die vraelys bestaan uit oop- en geslote vrae en berus op inligting wat uit die literatuurstudie verkry is. Data van die semi-gestruktureerde vraelyste is verwerk en geanaliseer en die resultate van die empiriese ondersoek is as basis gebruik vir die gevolgtrekkings en aanbevelings wat in hierdie studie gemaak is. Die hoofbevindinge dui op ’n behoefte aan gesinsberading tydens ’n rehabilitasieprogram vir alkohol-afhanklikes aangesien daar ’n definitiewe gebrek aan die betrokkenheid van die gesin tydens ’n rehabilitasieprogram vir alkohol-afhanklikes is. Verdere bevindinge dui daarop dat rehabilitasieprogramme grootliks op individuele berading aan die alkohol-afhanklike fokus en minimale aandag word aan die gesin en nasorgdienste gegee. Die belangrikste aanbeveling van hierdie studie is dat maatskaplike werkers die ekologiese perspektief moet gebruik tydens dienste wat aan alkohol-afhanklikes gelewer word. Hierdie perspektief kan verseker dat die nodige dienste gelewer word om alkohol-afhanklikheid tydens ’n rehabilitasieprogram effektief aan te spreek. Aanbevelings dui ook daarop dat maatskaplike werkers die gesin tydens ’n rehabiltiasieprogram meer moet betrek aangesien die ondersteuning van die gesin ’n belangrike rol speel tydens die rehabilitasieproses.

Department of Psychology. Bibliography : leaves 72-76.

Alcohol use disorders are common and make a significant contribution to the burden of disease throughout the world. This is especially true among the younger age groups. Although these disorders are common, evidence suggests that those affected do not seek help for their disorders. In order to understand this, reviews of the treatment literature and the epidemiological data on prevalence and correlates of alcohol use disorders and treatment seeking are presented. These reviews confirm that effective treatments exist and that screening in primary care can be efficacious. The reviews also highlight deficits such as the need for more epidemiological evidence on the validity of DSM definitions of alcohol use disorders and for more Australian data on the prevalence and correlates of the disorders and related treatment seeking. This thesis sets out to address these deficits applying sophisticated statistical techniques to data from a large nationally representative Australian sample. A confirmatory factor analysis of the eleven criteria that specify alcohol dependence and abuse examined the validity of DSM-IV definitions of alcohol use disorders and the best solution was found to be a single factor, not two as currently defined. These findings question the bi-axial nature of alcohol use disorders that has underpinned their definition since the publication of DSM-III-R in 1987. Data from this national sample also confirm that, in line with research from other western countries, Australians have high levels of alcohol use disorders, especially amongst males and younger people. Also no association was found between alcohol dependence and treatment seeking, and young people were least likely to seek treatment. However, a relatively large proportion of young people who drink had been in contact with their GPs in the past year; demonstrating that there is ample opportunity for screening and referral for treatment for alcohol use disorders in this vulnerable group. This research has found that although alcohol disorders are not necessarily associated with disability, there are those who can benefit from treatment. It suggests that outcomes for such individuals may be improved by better specification of disorders as well as improved access to best treatments.

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.

M.A. (Social Work) / The treatment of alcoholism is/provided for by many institutions. Social work is one of the disciplines directly involved and responsible for the treatment of alcoholics. One of a number of problems inherent to service delivering to alcoholics is the problem of premature termination of treatment. In this study the occurrence of premature termination at the West Rand Clinic of the South African National Council on Alcoholism and Drug Dependence is determined and the effect of premature termination of the treatment programme on the alcoholic is explored. To this end, patient files for the period January 1984 to December 1984 are examined. Four groups were identified on the basis of time spend in the treatment programme and stratified samples were drawn from these groups. A telephone schedule, based on relevant literature and the researcher's professional experience, was compiled and interviews were conducted to explore the effect of premature termination on the alcoholic. The findings of the study are summarized in the following conclusions : - The premature termination rate at the West Rand Clinic is congruent with findings of similar research. - Patients who terminated treatment prematurely reported lower levels of well~being than patients-who completed treatment.

No description available.

The purpose of this study was to compare the effectiveness of trad~tional group therapy treatment for alcoholic out-patient clients with group therapy plus approaches that incorporated behavioral self-control techniques. Reducing anxiety in social situations was the focus of the behavior therapy treatments. Only alcoholics who were highly anxious (eightieth percentile), according to their scores on the Institute for Personality and Ability Testing (!PAT) Anxiety Scale, were used as subjects. The subjects were 24 clients from the San Joaquin County Alcoholism Rehabilitation Center who were all undergoing group therapy at the beginning of the study. Trios of subjects were matched on their !PAT scores and then randomly assigned to one of three treatment groups: control (group therapy only), desensitization (group therapy plus systematic desensitization), and combined behavioral (group therapy plus systematic desensitization plus covert sensitization and covert self-reward). Treatment effectiveness was measured by administering the Michigan Alcoholism Screening Test {MAST) and the San Joaquin County Alcoholism Screening Test (SJCAST) to the subjects at the beginning of the study (pre-testing) and at the completion of the behavioral treatment three months later (post-testing). Each subject's spouse or significant other also responded to the MAST and SJCAST at pre- and post-testing. Eighteen of the original 24 subjects, 17 males .and one female, completed the study. Each of the four measures of treatment effectiveness was analyzed using a split-plot factorial 3.2 analysis of variance, with type of treatment as the between subjects variable and pre- and post-testing as the within subjects variable. There was no significant difference between groups at pre-testing (except for the MAST taken by alcoholics where the desensitization group scored worse than the other two groups). At post-testing, all four measures showed significant differences between the three types of treatment (F's = 6.5, 6.3, 4.7, 11.6; 2/15 df; p < .05), with the two behavioral treatment groups showing significantly more improvement than the control group in seven of .the eight comparisons. The two behavioral treatment groups did not differ from each other. The main effect -for pre- and post-testing showed significant improvement for all groups, again on all four measures (F's - 354.9, 120.5, 87.8, 72.0; 1/15 df; p < .01). Correlation coefficients between alcoholic and significant other's responses ranged from +.61 to +.81 (p < .01 in call cases) on both the MAST and SJCAST at pre- and post-testing. The results demonstrate that all three types of therapy were effective in achieving improvement from pre- to post-testing. Adding behavioral self~control treatment to group therapy, however, resulted in even greater improvement than group therapy alone.

This is a report of an investigation assessing outcome in a consecutive series of alcohol dependent patients admitted to the Avalon Treatment Centre from 21 October 1985 to 14 April 1986. Although extensive work has been done on the epidemiology of alcoholism among "coloured" people * [classified in terms of the population registration Act]. A direct result of the original field survey by Gillis, Keet and Slabbert was the establishment of this centre. A follow up study of people identified as having drinking problems in the original field survey showed that few people stopped drinking on their own account. Little is known about treatment outcome of patients hospitalized at this centre. Treatment at The Avalon Treatment Centre is based on therapeutic community principles, group therapy, family and social case work as well as the use of antabuse. Contact with Alcoholics Anonymous is encouraged during and after hospitalisation. In addition patients are also followed up by a community sister.