Process Research Data on a Potent, Feeling-Evoking Residential Treatment Program for the Simultaneous Counseling of Alcohol Abusers and Drug Abusers

Abstract

There are four goals in this study: (1) to describe an innovative counseling program (called CARE, Chemical Abuse Rehabilitation Effort) tailored to treat both alcohol abusers and drug abusers simultaneously, (2) to report process data on 156 residents treated in a program that emphasized the use of three potent treatment modalities, (3) to describe the clinical use of and consequences of the scream-evoking group therapy modality within a military residential program, and (4) to determine the utility of the scream-evoking group therapy procedure (that is, specify differences between clients who screamed versus those who did not) in facilitating successful program completion according to three criteria. A rating scale was specifically designed to assess the nature, intensity, and consequences of the “scream experiences.” Interobserver reliability coefficients were computed for all data involving clinical judgments and/or decisions. A total of 103 alcohol abusers and 53 drug abusers were treated from August 25, 1975 to January 7, 1977. For each of the five stages (A through E), five types of process data were used to measure the immediate impact of the treatment program: (1) response to psychodrama groups, (2) response to scream-oriented group sessions (SGSs), (3) unauthorized chemical use, (4) premature exits, and (5) clinical evaluations as to whether a client was clinically progressing upon discharge. Overall, alcohol abusers and drug abusers responded similarly to the intensive, emotion-evoking residential treatment as measured by each of the five process variables. However, more alcohol abusers than drug abusers met three combined “success” criteria for program completion. The innovative aspect of this residential treatment program is the integration of three potent counseling modalities—scream-evoking group therapy, psychodrama groups, and structured and spontaneous confrontations—that have been combined for the first time in this program. This is the first of only two programs in the military which utilize the scream-oriented group therapy methods. Fifteen methods of treatment are used to facilitate changes in problematic behaviors, attitudes, and/or feelings. The theoretical rationale for the use of these modalities is described. The SGSs are hypothesized to facilitate cathartic experiences via the scream experiences. The theoretical rationale for the use of abreactive/cathartic techniques is discussed from psychoanalytic, behavioral, and rational-emotive points of view.