This article describes a cognitive-behavioral program for substance abusers which was first implemented in the Baltimore City Jail in 1987. Similar but separate programs are provided for male and female inmates, consisting of twelve to sixteen contact hours over three to four weeks. In addition to conventional drug and alcohol information (physiologic and psychological effects, treatment options), the program emphasizes cognitive and behavioral skills which can prevent substance abuse, including training in consequential thinking, and stress and anger management. Over a two-year period, 607 males and 131 females were served, of whom 429 (59%) completed the entire program. Both males and females showed statistically significant improvement from pretest to posttest in all knowledge areas. Inmates gave high ratings to the program and group leaders reported substantial change in client attitudes toward drug and alcohol use. Knowledge scores at the end of the program were highest for those who scored higher at pretest, rated their group leader higher, and were rated by their group leader as more active participants. Client participation was the strongest predictor of program outcome.
To determine the availability of effective reinforcers of activity which could be delivered in an outpatient drug abuse clinic, a survey was administered to 25 Methadone maintenance patients. The privilege of taking Methadone home on occasion was the most powerful single reinforcer, while psychotherapy (not yet part of the program) had a low reinforcing property. Further exploration and cross-validation are needed.
A procedure based upon simple response cost approach to weaken constant headache complaint was described. S was a 14-yr.-old girl who presented the complaints over a period of 9 mo. Since other consequential means to control this behavior were difficult to employ, the present procedure requested S to write down conditions related to the headache complaints. The effectiveness of the procedure was evaluated by dual assessment method. Data showed that her complaints were eliminated within 8 wk.
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