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Essay Subject: Research design to determine difference in recovery rate for clients treated by recovering addict/counselors and non-addict counselors.... More...

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Paper Abstract: Research design to determine difference in recovery rate for clients treated by recovering addict/counselors and non-addict counselors. Paper Introduction: Introduction Purpose The purpose of this investigation is to determine whether there is a difference in the recovery rate between those clients receiving treatment from drug treatment center counselors who have manifested previous substance use/abuse and those who have not. Background The determination of such difference proves integral in the effort to provide more effective and efficient treatment to substance abusers, particularly given the tremendous costs to individuals who abuse substances, their families, their employers, and society in general. Trice (1986) notes that substance abuse in one form or another reportedly occurs in 35 Text of the Paper: The entire text of the paper is shown below. However, the text is somewhat scrambled. We want to give you as much information as we possibly can about our papers and essays, but we cannot give them away for free. In the text below you will find that while disordered, many of the phrases are essentially intact. From this text you will be able to get a solid sense of the writing style, the concepts addressed, and the sources used in the research paper. 22). The first study used alteration of the reward sequence, whilethe second used assignment to a restricted environment. Changing Times, 113-118.----------------------- 11 New York: New YorkState School of Industrial and Labor Relations, Cornell University. (199 ). Journal of Clinical Psychology, 455-456. The subjects will self-administer theDAST both before and after treatment to determine their levels of drugdependence. . Therehave been relatively few valid and reliable studies entailing the treatmentof alcoholism or other substances and the manipulation of the variableprior counselor substance use/abuse (Leavitt, 1982). . For those clients treated for alcohol/cocaineuse/abuse, 7 percent attained total abstinence while 75 percent hadcurrent abstinence and 45 percent had maintained total abstinence at the 18-month follow-up session. For thisinstrument, those scores attaining a rating of 5 or above are indicative of". Hunt, Barnett and Branch (1971, pp. Hunt, W.A., Barnett, L.W., & Branch, L.G. The subjects must havebeen referred for treatment by professionals (e.g., physicians, socialworkers, supervisors, clergy, etc.). Theseflaws do not, however, destroy the possibility that reward manipulation orrearrangement can play a significant role in the successful treatment ofalcoholism. Relapserates in addiction programs. Journal of Substance Abuse Treatment, 7(l),21-29. ."("Unhooking," 1987, p. Colorado: Aspen. All four of the groupswill be provided the same therapy modality for a 6-month period within thesame drug treatment center program. Given that this program maintainsanonymity and, thus, no member records, there is unreliable data as to thenumber of members who successfully complete rehabilitation. IntroductionPurpose The purpose of this investigation is to determine whether there is adifference in the recovery rate between those clients receiving treatmentfrom drug treatment center counselors who have manifested previoussubstance use/abuse and those who have not.Background The determination of such difference proves integral in the effort toprovide more effective and efficient treatment to substance abusers,particularly given the tremendous costs to individuals who abusesubstances, their families, their employers, and society in general. Frawley and Smith (199 , p. The follow-up Sobell and Sobell study discovered that 28 percent ofthe subjects remained totally abstinent, while 18 percent were nonproblemdrinkers (Leavitt, 1982, p. 217-218) addressed reward manipulation as a means to treatalcoholism. The second experimental group will consist of 5 femalealcoholics who receive therapy from female counselors who have previouslymanifested substance abuse problems and are now in recovery. (1986, April21). The independent variable consists of counselors who have previouslymanifested substance abuse problems, while the dependent variable consistsof the positive outcome of therapy. Chemical aversion therapy inthe treatment of cocaine dependence as part of a multimodal treatmentprogram: Treatment outcome. (1971, October). The second control group will consist of 5 female alcoholicswho receive therapy from female counselors who have not previouslymanifested substance abuse problems. 455-456) reviewed the treatmentsuccess for a variety of studies conducted by numerous researchersregarding heroin abuse and recidivism. There were,however, methodological flaws in each study, including the lack of controlgroups, the use of experimenters who represented authority figures, and theuse of laboratory settings, as opposed to naturalistic settings. This, then, gives support for chemicalaversion treatment programs regardless as to whether the therapist has ahistory of substance abuse. Hunt, Barnett and Branch (1971, pp. As well, this organization tends to be moreattractive to those alcoholics who are recovering and/or who wish tomaintain abstinence (Leavitt, 1982, p. . 456).Methodology The methodology of this investigation will entail the use of twoexperimental and two control groups. Although this treatment program used some counselors whohad had experience with prior substance abuse of varying kinds, thisvariable was not manipulated. The term positive outcome of therapyrefers to an abstention rate at the 1-year follow-up that is 3 percent.This time-frame and percentage are theoretically based upon the findings ofthe Rohan study as reviewed by Hunt et al. Given acceptance of either goal, the relapse rate for alcoholicswas quite high. 23). Business Insurance, 11. 215-216), produced impressiveresults. The early Voegtlin study (Leavitt, 1982, p.217) treated in excess of 4, alcoholic patients with the emetic drugapomorphine, and reported that 51 percent abstained from drinking foralmost a two-year period, while only 23 percent remained abstinent fornearly ten years. Thetherapists will then compare and contrast the pre- and post-treatmentscores of their clients to determine whether the experimental hypothesiswas affirmed. Moreover, therelapse rate for substance abusers is typically high for most forms oftreatment, ranging from drug therapy to electroshock treatment, which putsforth an imperative that drug treatment centers discover those treatmentapproaches and strategies by which substance abuse can be effectivelytreated. Alcoholics Anonymous, a well-known self-help oriented organization,reports tremendous "success" with its rehabilitation program. 118). (1971, p. Although there exists no consensus as to the exactpercentage of alcoholics who will become non-alcoholics, what is ofimportance is that those alcoholics not self-recovering require some typeof formal treatment. a significant drug problem and correspond to patients seekingtreatment for drug dependency" (p. Far more significant is the reduction in thefrequency of having Blood Alcohol Content (BAC) exceed . It will never happen to me. Further, there were methodological flawsrelative to the lack of control groups, controlling for those clients whowere receiving "talking" therapy along with drug therapy, controlling forthe varying motivations of clients to remain abstinent (e.g., job security,possible family loss), and questions as to whether statistical manipulationwas appropriate. 26) report rather impressive results fortheir treatment of alcohol/cocaine users/abusers and cocaine users/abusersusing chemical aversion. Thus, 21 of the 28 conditioned subjects had learned to controltheir drinking, and experienced improvement in their overall functioning.There were, however, several methodological flaws in this study whichdetract from the impact of its findings. In fact, one clientin the alcohol/cocaine group relapsed into alcohol use between the 6-monthand 18-month follow-up sessions. New York: JohnWiley & Sons. Although AlcoholicsAnonymous and Cocaine Anonymous use "counselors" who are recoveringalcoholics or cocaine addicts, for the purposes of experimentation thereare no control groups used that receive counseling from nonrecoveringcounselors. The subjectswill be randomly selected using a random numbers chart with the client listof the drug treatment center. Rosati, M. 2 1). McClellan (1985, p. The changing Nature of EAP practice.Personnel Administrator, 29-3 , 32, 34-35 & 37. The methodology proved flawed in this study, however, inthat there was no control group consisting of clients who received therapyfrom therapists having histories of substance abuse. Trice, H.J. The pretreatment figure for the frequency of excess BACwas 3.5 times per week, and the posttreatment figure only about .5 timesper week. The first experimental group willconsist of 5 male alcoholics who receive therapy from male counselors whohave previously manifested substance abuse problems and are now inrecovery. McClellan, along with other researchers at the Philadelphia VeteransAdministration Medical Center stated, ". Hunt, Barnett and Branch (1971, pp. This study had several limitations, however,including the loss of clients between treatment program commencement and 18-month follow-up, a very small sample size, and some clients who had totalabstinence from cocaine but not alcohol or vice versa. In sum, the above cursory review has shown that not all programs areequally successful in the percentage of clients who are "unhooked" fromsubstances. Trice(1986) notes that substance abuse in one form or another reportedly occursin 35 percent of all families, with dysfunctionalism producing such resultsas wife battering, child abuse, and other forms of domestic violence.Rosati (1986, p. Frawley, P.J., & Smith, J.W. The Pickens study, Cohen study, and the Hartford study (Leavitt,1982, pp. This is possibly due to several reasons, including therelatively high percentage of individuals who are alcoholics, the length oftime this disease has plagued humankind, and the large number of treatmentapproaches and strategies that have been applied to its treatment. 34) reports that the average in-patient stay for any addiction exceeds $6, , while the average out-patient treatment program can average $4, , depending upon the length ofstay and the number of therapists and other professionals orparaprofessionals involved in the provision of treatment. 222) claims that approximately 25-4 percent of all alcoholics will become non-alcoholics without any form offormal treatment. The firstcontrol group will consist of 5 male alcoholics who receive therapy frommale counselors who have not previously manifested substance abuseproblems. There are, however,methodological flaws in the manner in which its statistics are gathered bythis alcohol treatment program. Thisreported success is allegedly attributable to the use of "counselors" whohave previously used/abused substances, the group setting, the support ofgroup members, and the confidentiality of the program. For three months following treatment, the relapserate had markedly increased to 4 percent; by the sixth month, the rate hadfurther increased to 3 percent; and, by one year, the relapse rate hadreached 2 percent. "Unhooking from Drugs." (1986, October). All of these studiesfound that when rewards are either manipulated, or their sequencesrearranged, the frequency and amount of drinking decreases. The subjects will then be paired with theappropriate therapists into their indicated groups. References Black, S. The Brill and Lieberman study (p.456), which used two groups of clients, revealed that the relapse rate forheroin addicts was lowest (1 percent abstainers) for less than a weekfollowing treatment. 455-456) report that the Rohanstudy on the effectiveness of alcoholism treatment revealed that therelapse rate for alcoholics was lowest (1 percent abstainers) for lessthan a week following treatment. Bacon (Leavitt, 1982, p. (1982). The therapists will score the DAST for their clients. . 223). The last studymanipulated the contexts in which drinking occurs. For three months following treatment, therelapse rate had increased to approximately 35 percent abstainers; by thesixth month, the rate had further increased to approximately 25 percentabstainers; by one year, the relapse rate had reached 2 percentabstainers.Hypotheses The following hypotheses are submitted based upon the literaturereview as presented above: H : The use of counselors who have previously manifested substanceabuse problems will have no effect on the outcome of therapy for substanceabusers. Drugs and Behavior (2nd ed.). Alcoholism in America. The subjects must range in age from 18-55 years. Thesubjects will not be currently abstinent and must have been indulging forat least 3 days prior to the commencement of therapy, and consumingalcohol at least a+ the level of problem drinking. 7 percent outsidethe laboratory. The modality will consist of "talking"therapy, with the use of chemical aversion only when absolutely indicated.The experimental groups will receive therapy on alternate days to avoid orminimize inter-client contamination. Leavitt, F. Shouldtotal abstinence have not been the goal, then 54 percent of the subjectsrelapsed. The use of this type of experimental design is indicated in order tomanipulate the independent variable as noted above to either affirm ordisaffirm the experimental hypothesis. These include faulty monitoringof the BAC of controls, the use of increased alcoholic content beverages bythe experimental subjects, and questionable statistical manipulation.These findings do, however, infer electric shock therapy can be used totreat some clients for the disease alcoholism. 455-456) report that the Hunt andMatarazzo study on the effectiveness of smoking treatment revealed that therelapse rate for smokers was lowest (1 percent abstainers) for less thana week following treatment. Further, giventhe lack of specificity as to the rate of success, there is nodifferentiation as to the percentage of members who have achievedabstinence, for what period, or what percentage of members have relapsedand during what time-frame. Further, it is indicated to measurethe dependent variable. (1985, August). For two weeks following treatment, therelapse rate had increased to approximately 65 percent abstainers; by thethird month, the rate had further increased to 4 percent abstainers; byone year, the relapse rate had reached 3 percent abstainers. (1986). The therapists must be the sameethnicity as are the subjects.Data Collection The data collection will be accomplished with the use of the DrugAbuse Screening Test (DAST), which has a test range of (i.e., "noproblem") to 1 (i.e., "severe") (Frawley & Smith, 199 , p. (1982). 11) notes that approximately $4 billion are lost byemployers on an annual basis due to problems surrounding substance-abusingemployees, including declined productivity, tardiness, absenteeism,increased use of medical benefits, accidents, and skyrocketing workercompensation claims. The subjects must all be of the sameethnicity, but can have divergent marital status, levels of education, andemployment status. H1: The use of counselors who have previously manifested substanceabuse problems will positively affect the outcome of therapy for substanceabusers. Moreover, several ofthe patients were currently undergoing "talking" therapy through a varietyof programs and/or individual practitioners, which may have influenced theabstention rate. the worse the psychiatricimpairment, the less likely drug-free treatment will help . For those clients treated for cocaine use/ abuse,56 percent attained total abstinence, while 78 percent had currentabstinence and 89 percent had maintained total abstinence at the 18-monthfollow-up session. This instrument has been used aninnumerable amount of times to successfully indicate the level of drugdependence, although no indicators of reliability or validity wereavailable.Procedures The necessary human subject protocol and other requirements will bemet as indicated by the American Psychological Association. The use of electric shock therapy as treatment for alcoholism in theLovibond and Caddy study (Leavitt, 1982, pp. For this study, the experimental subjects maintained reducedintake after 5 weeks. . That is, over a four-year period, 72percent of the subjects relapsed, if total abstinence was the goal. EAPs save money by saving people. McClellan, K. Beyond these, given the increased vigilance of insurance firms andother third-party payors as to the monitoring of treatment eligibility,treatment length, and the amount of payment/reimbursement allowed persession, there is even more reason for drug treatment centers to discovertreatment approaches and strategies that prove efficient.Literature Review The disease alcoholism has been most studied relative to the outcomeof treatment approaches and strategies when compared to other abusedsubstances (e.g., cocaine, heroin, quaaludes, uppers, downers, etc.)(Trice, 1986). 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