Alcoholism: Its Treatments And Mistreatments Its Treatments and Mistreatments

This important book provides a review of the Minnesota Model of alcoholism treatment, which combines current clinical treatments and the 12-step principles of Alcoholics Anonymous with the goal of abstinence. It critically examines the research base supporting cognitive behavior therapy approaches to alcoholism. Using evidence from biosociobehavioral science and critical analyses of alcoholism treatment outcome literature, the book rebuts the view of cognitive behavior therapists that "alcoholism is nothing but a bad habit". This book fills a vital need, describing which alcoholism treatments work and which do not. It is an invaluable guide to the helping professions caring for alcoholics, alcoholism counselors, social workers, nurses, clinical psychologists and psychiatrists as well as the intelligent layperson interested in alcoholism and its treatment. It also serves as a textbook for alcoholism courses and as an ancillary text for abnormal psychology courses. Doody Review Services Reviewer: Michael Easton, MD(Rush University Medical Center) Description: This is a critical review of certain cognitive behavioral theory models, conceptualizations, research, and treatment recommendations for the disease of alcoholism. Its primary focus is on refuting the premise that alcoholism is a "bad habit. Purpose: The book focuses primarily on critically addressing and challenging a number of cognitive behavioral researchers and authors on their alcoholism studies, methodologies, results, and conclusions. Audience: It appears to be written for experts in this area, perhaps geared toward the researchers and authors whose theories the author is refuting. It also is directed at those involved in the development of research studies, the analysis of their results, and publications in the area of alcoholism research. Features: The book starts with defining the biobehavioral disease concept of alcoholism and how some cognitive behavioral theories miss the mark in terms of their theoretical conceptualizations and treatment recommendations. The author discusses his perspective of how Alcoholics Anonymous works and how various cognitive behavioral approaches are not necessarily effective. Assessment: The author offers some valuable and pointed assessments of various cognitive behavioral theories, research, and publications in the area of alcoholism. Although many of the author's assertions may be correct, he appears to use this book as a platform for his views and opinions. Contents 6 1. A Biosociobehavioral Disease Conception of Alcoholism 8 Alcohol and the Brain 14 The Saga of Phineas Gage 17 Predicting Relapse 24 Denial 25 MEOS: A System Affected by Excessive Alcohol Consumption 28 Alcoholism, Stress, and the Immune System 28 Conclusion 30 2. Alcoholism Treatments and Mistreatments 32 Ignorance Is Strength 32 Treatment Programs That Work 35 Importance of Aftercare 35 Comprehensive Assessment and Treatment Outcome Research (CATOR) Registry 37 Intensity of Treatment Services and Treatment Outcome 40 Two Neglected Australian Studies 43 A Study of Women 43 A Study of Men 45 Oxford House 46 Schick Shadel Aversion Conditioning 46 Results 47 The Community Reinforcement Approach 48 Project MATCH: The US$27 Million Dollar ‘Slice of Baloney’ 52 1. Project MATCH was unnecessary. 52 2. Project MATCH lacks generality (i.e. external validity). 52 3. Project MATCH claims to have internal validity. 54 Randomized Control Trials (RCTs) 60 Naturalistic Longitudinal Studies 65 Rehabilitation of the Rand Report 70 Controversial Results of a Large Epidemiological Survey 79 3. What Makes Alcoholics Anonymous Work 84 Attachments and Social Affiliations 84 Early Studies of Separation Stress and Attachment 85 Harlow on Love 86 Beta-endorphins 89 Separation Stress and Alcohol Consumption 91 Serotonin 93 Oxytocin and Vasopressin 93 Prolactin and Touch 95 Effects of Support Groups and Self-disclosure 96 Alcoholics Anonymous and Social Affiliation 104 Cue Exposure and Response Prevention 107 A Humanist Alternat ive to A.A.’s Twelve Steps 109 Religiosity/Spirituality 110 Conclusion 113 4. Expectancy Theory and Research: Balderdash! 114 The Balanced Placebo Experiment: Dogma Rules 114 A Critical Examination of Marlatt et al. (1973) 118 Demand Characteristics: An Alternative Interpretation 120 Additional Contradictions of the Expectancy Hypothesis 122 British and Scandinavian Research Contradicting the Social Learning Theory of Alcohol Dependence 124 Expectancy and Behavioral Skills Training as Secondary Prevention for At-Risk College Students 128 Goldman’s Interpretation of Expectancy 130 Priming Alcohol Consumption by Positive Expectancies 133 Expectancy and Secondary Prevention: A Double Whammy 138 Disclaimer 139 5. Self-selection of Alcoholism Treatment Goals: Harm Reduction or Induction 142 Self-selection of Alcoholism Treatments 143 Ethical Principles Guiding Treatment Research and Practice 144 Respect for Persons 145 Beneficence 146 Justice 146 Informed Consent 146 Information 147 Comprehension 147 Voluntariness 148 Assessments of Risks and Benefits 148 Justice 148 Evidence Purporting to Support Self-selection 149 Evaluation of Treatment Self-selection 150 Harm Reduction versus Harm Induction: Brain Damage, Quality of Life, and Alcohol Consumption 152 Harm Reduction as Secondary Prevention 156 Generality of Problem of Adherence to Ethical Principles 161 Evaluating Diminished Intellectual Capacity 162 Understanding Information 162 Denial 165 Demonization 168 Reality 168 A Conflict of Interest 169 Conclusions 170 6. Little Albert Redux II: Bias and Lack of Scholarship in Textbooks 172 Background to My Entering the Field of Alcoholism Studies 175 Phaseology 179 Controlled Drinking 183 Causes of Alcoholism 187 Treatment 188 Project MATCH 190 Butcher, Mineka, and Hooley (2004) 191 Comer (2004) 194 Davison, Neale, and Kring (2004) 198 Therapy for Alcohol Abuse and Dependence 198 Cognitive and Behavioral Treatments 199 Moderation in Drinking 200 Kendall and Hammen (1998) 201 Kendall and Hammen (1998) continue: 205 Nolen-Hoeksema (2004) 207 Alcoholism Treatment 208 Schuckit (2000) continues: 209 Cognitive-Oriented Treatments 210 Oltmanns and Emery (2004) 214 Raulin (2003) 215 Discussion 218 Textbooks for Alcoholism Counselors and Other Helping Professionals 219 Hester and Miller (2003) 219 Edwards et al. (2003) 221 Conclusion 222 7. Sociology of Science and Alcoholism Studies 224 The Eighth Deadly Sin 225 Who Is Watching over the Watchdogs? 226 Letters to Griffith Edwards 229 Discussion 232 Letters to Kenkel 232 Discussion 232 Conclusion 233 What Is to be Done? 236 References 238 Appendix 1: Letter to Griffith Edwards 272 References 279 Appendix 2: Letter to Mary Beth Kenkel 282 Index 320 This important book provides a review of the Minnesota Model of alcoholism treatment, which combines current clinical treatments and the 12-step principles of Alcoholics Anonymous with the goal of abstinence. It critically examines the research base supporting cognitive behavior therapy approaches to alcoholism. Using evidence from biosociobehavioral science and critical analyses of alcoholism treatment outcome literature, the book rebuts the view of cognitive behavior therapists that "alcoholism is nothing but a bad habit". This book fills a vital need, describing which alcoholism treatments work and which do not. It is an invaluable guide to the helping professions caring for alcoholics, alcoholism counselors, social workers, nurses, clinical psychologists and psychiatrists as well as the intelligent layperson interested in alcoholism and its treatment. It also serves as a textbook for alcoholism courses and as an ancillary text for abnormal psychology courses "This important book provides a review of the Minnesota Model of alcoholism treatment, which combines current clinical treatments and the 12-step principles of Alcoholics Anonymous with the goal of abstinence. Using evidence from biosociobehavioural science and critical analyses of alcoholism treatment outcome literature, the book rebuts the view of cognitive behaviour therapists that alcoholism is nothing but a bad habit. This book fills a vital need, describing which alcoholism treatments work and which do not. It is an invaluable guide to the helping professions caring for alcoholics, alcoholism counsellors, social workers, nurses, clinical psychologists and psychiatrists as well as the intelligent layperson interested in alcoholism and its treatment." - - Back Cover Key Features:Provides a scholarly review of evaluations of the 12-step-oriented Minnesota Model alcoholism treatment programs, which show positive long-term outcomes unmatched by cognitive therapy treatmentsFormulates a biosociobehavioral theory explaining why Alcoholics Anonymous (AA) is effective