Coping with interpersonal conflict among alcohol abusers in outpatient treatment

The purpose of the study was to measure the effect of a behaviorally-oriented intervention concerning social skills training among persons with a history of alcohol abuse and to measure concomitant enhancement of their self-perceived efficacy for sobriety. The intervention was based on Prochaska and DiClementi's Transtheoretical Model for Change and Miller and Rollnick's Motivational Interviewing techniques.Bandura's Social Cognitive Learning Theory was applied to the context of alcohol abuse, the central tenet of which holds that cognitively mediated experience engenders learned efficacy expectations. These are reinforced for good or ill by success or failure to respond adequately to high-risk situations involving interpersonal conflict. Thus, the model is non-linear and reflexive in nature. The conceptual framework was derived from a biopsychosocial model of alcohol abuse and relapse.Subjects were recruited from two outpatient program groups from the same facility (convenience sample of 46 subjects, male = 32, female = 14, ages 19-60). Over a five-week period, subjects in the treatment group (n = 22) participated in a behaviorally-structured program of social skills instruction. Comparison group subjects (n = 24) attended a single cognitively-oriented lecture on the significance of interpersonal conflict as a relapse trigger.Subjects involved in intensive outpatient treatment at a large Midwestern hospital underwent pre- and posttesting of the two dependent variables, coping with interpersonal conflict and self-efficacy for sobriety. Data was collected in the form of the Coping with Interpersonal Conflict Scale (CICS) (developed by the investigator) and the Situational Confidence Questionnaire (SCQ).Multivariate analysis of variance with repeated measures (MANOVA-RP) was used to test the hypotheses that: (1) behaviorally-oriented social skills instruction (treatment group) would result in a greater degree of enhancement of self-efficacy for sobriety compared with the cognitively-oriented instruction on interpersonal conflict (comparison group) and (2) the treatment group would show significantly greater improvement in coping with interpersonal conflict. Pearson correlations were used to test a third hypothesis that improvement in self-efficacy for sobriety would parallel (correlate with) improvement in ability to cope with interpersonal conflict.The results supported the hypothesis that behaviorally-oriented social skills instruction would selectively enhance self-efficacy for sobriety when compared with instruction that was solely cognitive in nature, a group by time pre-posttest) interaction (F (1,44) = 4.03, p =.051). Simple effects analyses revealed that self-efficacy for sobriety significantly improved as a result of social skills instruction (F(1,44) = 7.9, p < 0.01) but not in the comparison group (F = 0.54). Contrary to the hypotheses #2, the ability to cope with interpersonal conflict was not selectively enhanced in the treatment group subjects, group by time interaction (F(1,44) = 0.15). In fact, the results revealed a paradoxical effect of an apparent decrement in the ability to cope with interpersonal conflict. (Abstract shortened by UMI.)