Alcoholism Rehabilitation—From People Who Actually Know Something

     Governments need not reduce taxes, they must reduce expenditures. Each American now owes about $40,000 in federal debt, each Canadian about $14,000. A few years ago, the relative positions were reversed. This represents a fiscal “death spiral”, “critical mass” and other descriptions of an unpleasant nature.

    A slave is someone who has no economic choices. The more of our money we give up, the closer we move to slave status.

    We’re getting close to the Copenhagen conference on Climate Change. I would say, “Let the posturing begin.”, but it’s been going on for a couple of decades. In the same way that Cold War hysteria was fueled by huge overestimations of the ability of the Soviets to project power beyond their borders, the Climate Changers fuel hysteria by predictions of disaster. None of their predictions has come true, so why do we have faith in their version of a disastrous future?

    On another hysterical front, the H1N1 virus is just not performing as  predicted. The scenario, as many have pointed out, shifted from the “epidemic” and value of the vaccine, to its availability. A certain number of people will desperately need something as soon as it’s not available.

    Over on anti-positivist (see blogroll to the right), Jim Fedako relates Karl Popper’s point about non-refutation to the Climate Hysteriacs–if all evidence must point to something and no evidence can point away–there’s something seriously wrong with the theory.

    More from    Hester, R.K., & Miller, W.R. (Eds), (2002) Handbook of Alcoholism Treatment Approaches: Effective Alternatives.  Boston: Allyn and Bacon.

     Confrontational counseling styles have enjoyed particular popularity in U.S. alcoholism treatment. Yet confrontational approaches have failed to yield a single positive outcome study.  (p. 27). 

    GC–Good drama– poor technique.

      Although Alcoholics Anonymous (AA) is widely recommended by U.S. treatment programs, its efficacy has rarely been studied [….]  Only two controlled trials were found in which AA was studied as a distinct alternative, both with offender populations required to attend AA or other conditions, and both finding no beneficial effect. (p. 31).

     GC–Good myth–poor therapy.

      One’s own professional hunches about what works and what doesn’t are well known to be fallible. One outcome evaluation, for example, showed that a ‘prevention’ program, about which both teachers and students were highly enthusiastic, actually increased students’ use of drugs.  Though we would like to believe that it isn’t so, ‘therapeutic’ interventions similarly can be ineffective or even detrimental.  (p. 81).

    GC–Good arrogance–poor effectiveness.

     Fifty years of both psychological […] and longitudinal studies […] have failed to reveal a consistent ‘alcoholic personality.’  Attempts to derive a set of alcoholic psychometric personality subtypes have yielded profiles similar to those found when subtyping a general population […].  That is, alcoholics appear to be as variable in personality as are nonalcoholics.  Studies of character defense mechanisms among alcoholics have yielded a similar picture.  Denial and other defense mechanisms have been found to be no more nor less frequent among alcoholics than among people in general. […]  There was simply no support for the view that alcoholics in general come into treatment with a consistent set of personality traits and defenses.  (p. 90).

     GC–Good layman theory–zero support.

     A strong and consistent finding in research on motivation is that people are most likely to undertake and persist in an action when they perceive that they have personally chosen to do so.  One study, for example, found that a particular alcohol treatment approach was more effective when a client chose it from among alternatives than when it was assigned to the client as his or her only option .  […]  Perceived freedom of choice also appears to reduce client resistance and dropout [….]  When clients are told they have no choice, they tend to resist change.  When their freedom of choice is acknowledged, they are freed to choose change.  (p. 93). 

      GC–Good elitism–poor technique. You can’t push a string.

Cheerio and ttfn,

Grant Coulson

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