Alcoholism Treatment with Environmental Support Contracting

Abstract

Environmental support contracting was evaluated as an ancillary treatment to more traditional alcoholism rehabilitation. Eighty-eight male alcoholics, who scored 10 or higher on the Environmental Deprivation Scale (EDS), were randomly dichotomized between experimental and control groups. The control group participated only in the routine, eclectic, 28-d inpatient alcoholism treatment program at this medical center. The experimental group additionally completed training to improve environmental support. Dependent variables included the EDS, the Maladaptive Behavior Rating (MBR), days of hospitalization, medical visits, and the number of medications. Each dependent variable was assessed prior to treatment, 3 months following initiation of treatment and/or 6 months following treatment. A high positive correlation was obtained between EDS and MBR scores on the 3 and 6 month followup. Both the experimental and control groups improved with regard to their level of environmental and control groups improved with regard to their level of environmental support and relative coping ability, showing less maladaptive behavior and hospitalization following treatment. The experimental group demonstrated statistically significant treatment benefit over the traditionally treated control group on both the EDS and MBR subcategories of employment at 6 months following initiation of alcohol treatment. Environmental support contracting appears to be a worthwhile addition to alcohol treatment regimen.