This study investigates the differential treatment efficacy of Experiential Systemic Therapy (ExST) with a comparison treatment called Supported Feedback Therapy (SFT) as it is applied to the problem of alcohol dependency. The inquiry also compares the treatment effectiveness of ExST when offered to the individual alcoholic (ExST-I) and when provided in couples therapy conjoint treatment (ExST-C). An ecological approach to assessment was developed for the investigation. Selfreport questionnaires tapping an array of areas including indices of alcohol use, intrapersonal functioning, couples adjustment, and family characteristics were employed to measure treatment effects from the perspectives of father, mother, and eldest child. Participating families met inclusion criteria including an alcoholic dependent father and a non-alcohol abusing mother in a state of marital distress residing in an intact family situation with at least one child living at home. One hundred and fourteen families were randomly assigned to participating therapists and one of three treatment conditions including ExST-I, ExST-C,or SFT. Therapy was conducted at two out-patient clinics, one located in an urban setting and the other operating in a rural context. Data were collected from all participating families before and after treatment. Data were also gathered at a three month follow-up from participants in the ExST-I and ExST-C treatment conditions. The results of the mixed model multivariate analyses indicated that there were no significant differences between ExST and SFT evident at post-treatment; however, both treatments were found to have promoted highly significant improvements on measures of drinking behavior, intrapersonal symptomology, marital adjustment and family satisfaction. When ExST-I and ExST-C were compared, the results revealed no significant differences between the treatment formats although both parents reported highly significant post treatment changes on all instruments. Additionally, the significant changes associated with ExST-I and ExST-C which were reported by both parents at post-treatment were found to be equally durable at the end of a three month follow-up. The results of the analyses based on the eldest child’s perspective showed that the assessments of family satisfaction were unaffected by the treatment conditions and remained consistent across all measurement occasions. Within system analyses which provided detailed examination of the magnitude of changes reported by both parents at post-treatment were performed. The within system results based on measures probing the assessment domains of alcohol, intrapersonal, couple and family from the father and mother perspectives, revealed that the improvements achieved by the treatments were far reaching and touched a wide array of areas in statistically significant and clinically relevant fashions.

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

Thesis (D. Min.)--Erskine Theological Seminary, 2001. / Abstract. Includes bibliographical references (leaves 109-111).

Thesis (D. Min.)--Erskine Theological Seminary, 2001. / Abstract. Includes bibliographical references (leaves 109-111).

Thesis (D. Min.)--Erskine Theological Seminary, 2001. / Abstract. Includes bibliographical references (leaves 109-111).

M.A. (Social Work) / Please refer to full text to view abstract

This study investigates the differential treatment efficacy of Experiential Systemic Therapy (ExST) with a comparison treatment called Supported Feedback Therapy (SFT) as it is applied to the problem of alcohol dependency. The inquiry also compares the treatment effectiveness of ExST when offered to the individual alcoholic (ExST-I) and when provided in couples therapy conjoint treatment (ExST-C). An ecological approach to assessment was developed for the investigation. Selfreport questionnaires tapping an array of areas including indices of alcohol use, intrapersonal functioning, couples adjustment, and family characteristics were employed to measure treatment effects from the perspectives of father, mother, and eldest child. Participating families met inclusion criteria including an alcoholic dependent father and a non-alcohol abusing mother in a state of marital distress residing in an intact family situation with at least one child living at home. One hundred and fourteen families were randomly assigned to participating therapists and one of three treatment conditions including ExST-I, ExST-C,or SFT. Therapy was conducted at two out-patient clinics, one located in an urban setting and the other operating in a rural context. Data were collected from all participating families before and after treatment. Data were also gathered at a three month follow-up from participants in the ExST-I and ExST-C treatment conditions. The results of the mixed model multivariate analyses indicated that there were no significant differences between ExST and SFT evident at post-treatment; however, both treatments were found to have promoted highly significant improvements on measures of drinking behavior, intrapersonal symptomology, marital adjustment and family satisfaction. When ExST-I and ExST-C were compared, the results revealed no significant differences between the treatment formats although both parents reported highly significant post treatment changes on all instruments. Additionally, the significant changes associated with ExST-I and ExST-C which were reported by both parents at post-treatment were found to be equally durable at the end of a three month follow-up. The results of the analyses based on the eldest child’s perspective showed that the assessments of family satisfaction were unaffected by the treatment conditions and remained consistent across all measurement occasions. Within system analyses which provided detailed examination of the magnitude of changes reported by both parents at post-treatment were performed. The within system results based on measures probing the assessment domains of alcohol, intrapersonal, couple and family from the father and mother perspectives, revealed that the improvements achieved by the treatments were far reaching and touched a wide array of areas in statistically significant and clinically relevant fashions. / Education, Faculty of / Educational and Counselling Psychology, and Special Education (ECPS), Department of / Graduate

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.

The purpose of the study was to compare behavior patterns of alcoholics before and after they stopped drinking. Specifically, changes in the interactions of thinking, feeling, and acting behavior components of two groups of recovering, non-relapsed, alcoholics with 6 months or less and a third group with 5 or more years of sobriety were analyzed. The study used TFA Systems™, an integrated and multidisciplinary theoretical model, to discern factors related to stopping drinking and maintaining sobriety. Research methodology included purposeful sampling from AA, residential, and outpatient substance abuse centers. The Hutchins' Behavior Inventory (HBI) was used to assess behavior in high risk drinking situations for: (a) before starting to drink behavior [Group 1]; (b) 6 months or less of short-term sobriety behavior [Group 2]; and (c) 5 years or more sobriety behavior [Group 3]. Results were analyzed using quantitative and qualitative methods. Responses from a structured interview were analyzed using methods from the TFA/HBI Analytic Guide and the askSam data management system. The short-term recovery groups differed in demographic factors from the group with 5 or more years of sobriety. Past drinking behavior was characterized with a Feeling-Acting-Thinking (F-A-T) sequential orientation. Those with six months or less sobriety had a Feeling-Thinking-Acting (F-T-A) orientation. People with five or more years of sobriety had a Thinking-Feeling-Acting (T-F-A) orientation with integrated and nearly balanced TFA triads. Qualitative measures indicated that with longer sobriety anticipatory thoughts about drinking changed to thoughts of positive alternatives and positive self-focus. Results suggested that the first change to begin in recovery is to shift negative action toward positive thinking behavior. The next change appeared to occur in learning to integrate feelings and actions. Maintenance tasks appeared to focus on integrating and balancing all behavior components. How the TFA model met the need for a client adaptable and integrated model with assessment methods across phases of recovery was discussed. / Ph. D.

This participatory research journey looked at the lives of adult children of alcoholics, with particular reference to how identity is affected by growing up in a home where one or both parents are struggling with alcohol abuse, and how this struggle with identity carries through into adulthood. A study was made of the particular discourses which impacted negatively upon the child from this home and the manner in which the discourses had a negative impact later on as an adult. Through narrative pastoral conversations the possibilities for healing, as well as the barriers for healing were explored. Through this exploration alternative stories were created. A vital part of the study was focused upon the witnessing of the stories of the participants` lives and the acknowledgement of some of the events from their childhood that formed their identity and contributed to who they are today. / Practical Theology / M.Th. (Practical Theology)