TERUGVALLE BY ALKOHOLISTE: DIE VERBAND TUSSEN HOeRISIKOSITUASIES EN SELFDOELTREFFENDHEID

Abstract

The most vexing question facing the alcoholic is not how to stop drinking, but how to maintain sobriety. A relapse model has been developed primarily under the impact of social-learning theory, providing a new and promising direction for the maintenance of initial behaviour change. The major tenet of this approach is that if a client enters a high-risk situation the judgment of self-efficacy determines whether or not drinking takes place. While there is a growing body of empirical evidence of the power of self-efficacy, less research has been conducted among inpatient alcoholics. One of the questions is whether there is a relationship between high-risk situations and self-efficacy, and this study examined this relationship. At the same time the frequency of high-risk situations was determined, and attention paid to the difference in self-efficacy between relapsed and sober alcoholics. The study consisted of 100 alcoholics who relapsed after inpatient treatment, and 50 alcoholics who were sober for at least six months after in-patient treatment. The mean age of the V relapsed group was 41.7 years, and 44.4 for the sober group. The relapsed group had a mean of 2.7 treatments, and the sober group 2.2. The mean period of sobriety for the sober group was 29 months. A test battery was administered to relapsed alcoholics at five in-patient clinics. The same five clinics (as well as Alcoholics Anonymous), were used for the sober group. The relapsed group completed the psychometric tests within the first week of treatment. The test battery consisted of the Michigan Alcoholism Screening Test (Selzer, 1971), the depression scale of the General Wellbeing Schedule (U.S. Public Health Service, 1977), Drinking Profile (Joubert, 1987), Inventory of Drinking Situations (Annis, et al., 1987) and the Situational Confidence Questionnaire (Annis & Graham, 1988). All than 33.53 relapsed and sober alcoholics obtained a score seven on the Michigan Alcoholism Screening Test for the relapsed group and 34.76 for the sober greater (mean group). The mean daily alcohol consumption for the relapsed group was 255.61 ml. (18.04 standard drinks), and 231.64 ml . (16.48) for the sober group. Almost a quarter of the relapsers drank 23 or more standard drinks per day, whereas only a seventh of the sober group had consumed 23 or more standard drinks prior to abstaining. Unfortunately it was not possible to determine whether consumption correlated with relapses or sobriety. Relapsers (67 %) were found to be subject to more depression vi than sober alcoholics (32 %). Unpleasant emotions were also found to be the highest risk situation (mean 54.96). This was followed by testing personal control (mean 48.40), positive social situations (mean 47.42), pleasant emotions (mean 47.40), social pressure to drink (mean 44.86), temptations and urges (mean 43.93), physical discomfort (mean 41.01) and lastly interpersonal conflict (mean 39.28). A slight to moderate correlation (0.19 to 0.39) was found between high-risk situations and self-efficacy. Although sober alcoholics had higher self-efficacy scores (mean 85.23) than relapsers (mean 73.08), the effect size between self-efficacy and sobriety was slight to medium (0.33 to 0.67). Based on these findings it is proposed that in-patient treatment facilities take cognition of the high-risk situations and ensure that these situations are addressed during treatment. Moreover, it is proposed that further research be undertaken to determine the relationship between consumption and sobriety, high-risk situation and self-efficacy. Although there is a suggestion of a relationship between high-risk situations and self-efficacy, as well as self-efficacy and sobriety, further research is needed. Not withstanding the need for further research, the present findings suggest that treatment aimed at increasing selfefficacy is viable and should continue.