Changes in well-being, self-efficacy, and coping strategies during residential treatment of alcohol-addicted patients

  • Jan Chodkiewicz University of Lodz, Institute of Psychology
  • Ewa Gruszczyńska The Warsaw School of Social Sciences and Humanities (SWPS)
Keywords: therapy; alcohol addiction; changes; well-being; self-efficacy; coping with stress

Abstract

The aim of the study was to answer the question about changes in self-efficacy, coping strategies, and well-being during residential alcohol addiction psychotherapy. Correlations between these changes were also explored. The participants were 60 patients of a specialized alcohol addiction treatment center attending structural-strategic residential group therapy. Self-efficacy, well-being (two indicators: satisfaction with life and depression), and coping strategies (four indicators: problem-focused, emotion-focused, and meaning-focused strategies plus seeking social support) were assessed twice: at admission and then at the end of the treatment, i.e., six weeks later. The tools used for this purpose were, respectively: Schwarzer et al.’s Generalized Self-Efficacy Scale (GSES), Diener et al.’s Satisfaction With Life Scale (SWLS), Beck Depression Inventory (BDI), and Gruszczyńska’s Coping Questionnaire (KRS). The results of bivariate latent growth curve analysis with bootstrapping show a decrease in depression as well as an increase in strategies focused on problem, on meaning, and on seeking social support. All these changes were positively correlated, which indicates that the intensification of coping is connected with a decrease in depression. Additionally, pretest coping intensity was shown to moderate changes in satisfaction with life, which increased only in the “low copers” group. For the remaining variables, significant interindividual variances were found regarding both the starting points and the rates of change. Thus, results indicate the need for analyzing changes during treatment from two perspectives: in terms of group means and in terms of variance around these means, which capture interindividual variability in the change process.

References

Adamson, S. J., Sellman, J. D., & Frampton, C. M. A. (2009). Patient predictors of alcohol treatment outcome: A systematic review. Journal of Substance Abuse Treatment, 36, 75-86.
Anderson, D. (1993). Doświadczenie stanu Minnesota. In A. Dodziuk (Ed.), Wybrane spojrzenia na alkoholizm i jego leczenie (pp. 2-20). Warsaw: Polskie Towarzystwo Psychologiczne.
Annis, H. M., & Graham, J. M. (1988). Situational Confidence Questionnaire (SCQ 39): User’s guide. Toronto: Addiction Research Foundation.
Beck, A., Wright, F., Newman, C., & Liese, B. (2007). Terapia poznawcza uzależnień. Cracow: Wydawnictwo Uniwersytetu Jagiellońskiego.
Carver, C. S., Scheier, M. F., & Weintraub, J. K. (1989). Assessing coping strategies: A theoretically-based approach. Journal of Personal and Social Psychology, 56(2), 267-283.
Chodkiewicz, J. (2001). Rola zasobów osobistych w utrzymaniu abstynencji przez mężczyzn uzależnionych od alkoholu. Alkoholizm i Narkomania, 2(14), 277-289.
Chodkiewicz, J. (2005). Predyktory ukończenia terapii mężczyzn i kobiet uzależnionych od alkoholu. Postępy Psychiatrii i Neurologii, 14(1), 39-45.
Chodkiewicz, J. (2006). Zasoby osobiste a występowanie nawrotów u mężczyzn uzależnionych od alkoholu. In Cierpiałkowska L. (Ed.) Oblicza współczesnych uzależnień (pp. 175-185). Poznań: Wydawnictwo Naukowe UAM.
Chodkiewicz, J. (2012). Odbić się od dna? Rola jakości życia w przebiegu i efektach terapii osób uzależnionych od alkoholu. Łódź: Wydawnictwo Uniwersytetu Łódzkiego.
Chung, T., Langenbucher, J., Labouvie, E., Pandina, R. J., & Moos, R. H. (2001). Changes in alcoholic patients’ coping responses predict 12-month treatment outcomes. Journal of Consulting and Clinical Psychology, 69(1), 92-100.
Cierpiałkowska, L., & Kubiak, J. (2010). Niespecyficzne czynniki leczące a efektywność terapii alkoholików. Nauka, 2, 89-111.
Cierpiałkowska, L., & Ziarko, M. (2010). Psychologia uzależnień: alkoholizm. Warsaw: Wydawnictwa Akademickie i Profesjonalne.
Cooper, M. L. (1994). Motivations for alcohol use among adolescents: Development and validation of a four-factor model. Psychological Assessment, 6, 117-128.
Cooper, M. L. (2010). Efektywność psychoterapii i poradnictwa psychologicznego. Warsaw: Instytut Psychologii Zdrowia PTP.
Coyne, J., & Racioppo, M. (2000). Never the twain shall meet? Closing the gap between coping research and clinical intervention research. American Psychologist, 55, 655-664.
Curran, P. J. (2000). A latent curve framework for the study of developmental trajectories in adolescent substance use. In J. S. Rose, L. Chassin, C. C. Presson, & S. J. Sherman (Eds.), Multivariate applications in substance abuse research: New methods for new questions (pp. 1-42). Mahwah, NJ: Lawrence Erlbaum.
DiClemente, C. C., Carbonari, J. P., Montgomery R. P., & Hughes S. O. (1994). The Alcohol Abstinence Self-Efficacy Scale. Journal of Studies on Alcohol, 55, 141-148.
Donovan, D., Mattson, M., Cisler, R., Longabaugh, R., & Zweben, A. (2005). Quality of life as an outcome measurement in alcoholism treatment research. Journal of Studies on Alcohol, 15, 119-139.
Duncan, T., Duncan, S., Strycker, L., Li, F., & Alpert, A. (1999). An introduction to latent variable growth curve modeling: Concepts, issues, and applications. Mahwah, NJ US: Lawrence Erlbaum Associates Publishers.
Enders, C. K., & Bandalos, D. L. (2001). The relative performance of full information maximum likelihood estimates for missing data in structural equation models. Structural Equation Modeling, 8, 430-457.
Endler, N. S., & Parker, J. D. A. (1990). Coping Inventory for Stressful Situations (CISS): Manual. Toronto: Multi-Health Systems.
Folkman, S. (1997). Positive psychological states and coping with severe stress. Social Science and Medicine, 45(8), 1207-1221.
Folkman, S. (2008). The case for positive emotions in the stress process. Anxiety, Stress and Coping, 21(1), 3-14.
Foster, J. H., Marshall, E. J., Hooper, R., & Peters, T. J. (1998). Quality of life measures in alcohol dependent subjects and changes with abstinence and continued heavy drinking. Addiction Biology, 3, 321-332.
Gamble, S. A, Conner, K. R, Talbot, N. L., Yu, X. M., & Connors, G. J. (2010). Effects of pretreatment and posttreatment depressive symptoms on alcohol consumption following treatment in Project MATCH. Journal of Studies on Alcohol and Drugs, 71, 71-77.
Ginieri-Coccossis, M. , Liappas, I. A., Tzavellas, E., Triantafillou, E., & Soldatos, C. (2007). Detecting changes in quality of life and psychiatric symptomatology following an in-patient detoxification programme for alcohol-dependent individuals: The use of WHOQOL-100. In Vivo, 21(1), 99-106.
Graham, J. W. (2009). Missing data analysis: Making it work in the real world. Annual Review of Psychology, 60, 549-576.
Grant, V. V., Stewart, S. H., & Mohr, C. D. (2009). Coping-anxiety and coping-depression motives predict different daily mood-drinking relationships. Psychology of Addictive Behaviors, 23(2), 226-237.
Greenbaum, P. E., Del Boca, F. K., Darkes, J., Wang, C., & Goldman, M. S. (2005). Variation in the drinking trajectories of freshmen college students. Journal of Consulting and Clinical Psychology, 73(2), 229-238.
Grønbæk, M., & Nielsen, B. (2007). A randomized controlled trial of Minnesota day clinic treatment of alcoholics. Addiction, 102(3), 381-388.
Hartzler, B., Witkiewitz, K., Villarroel, N., & Donovan, D. (2011). Self-efficacy change as a mediator of associations between therapeutic bond and one-year outcomes in treatments for alcohol dependence. Psychology of Addictive Behaviors, 25(2), 269-278.
Heckman, T., Sikkema, K., Hansen, N., Kochman, A., Heh, V., & Neufeld, S. (2011). A randomized clinical trial of a coping improvement group intervention for HIV-infected older adults. Journal of Behavioral Medicine, 34(2), 102-111.
Hobfoll, S. E. (2006). Stres, kultura i społeczeństwo. Gdańsk: Gdańskie Wydawnictwo Psychologiczne.
Holahan, C. J., Moos, R. H., Holahan, C. K., Cronkite, R. C., & Randall, P. K. (2001). Drinking to cope, emotional distress and alcohol use and abuse: A ten-year model. Journal of Studies on Alcohol, 62(2), 190-198.
Howell, A. N., Leyro, T. M., Hogan, J., Buckner, J. D., & Zvolensky, M. J. (2010). Anxiety sensitivity, distress tolerance, and discomfort intolerance in relation to coping and conformity motives for alcohol use and alcohol use problems among young adult drinkers. Addictive Behaviors, 35(12), 1144-1147.
Hser, Y., Shen, H., Chou, C.-P., Messer, S., & Anglin, M. D. (2001). Analytic approaches for assessing long-term treatment effects: Examples of empirical applications and findings. Evaluation Review, 25, 233-262.
Humphreys, K., Mankowski, E., Moos, R. H., & Finney, J. W. (1999). Do enhanced friendships networks and active coping mediate the effect of selfhelp groups on substance use? Annals of Behavioral Medicine, 21(1), 54-60.
Ivory, N. J., & Kambouropoulos, N. (2012). Coping mediates the relationship between revised reinforcement sensitivity and alcohol use. Personality and Individual Differences, 52(7), 822-827.
Juczyński, Z. (2001). Narzędzia stosowane w promocji i psychologii zdrowia. Warsaw: PTP.
Kaczmarczyk, J. (2012). Poczucie własnej skuteczności, emocje i strategie radzenia sobie ze stresem a poczucie satysfakcji z życia u osób uzależnionych od alkoholu będących w procesie zdrowienia. Relacje mediacyjne i moderacyjne. Unpublished M.A. thesis, Institute of Clinical Psychology, University of Social Sciences and Humanities, Warsaw.
Konarski, R. (2004). Analiza zmiany z zastosowaniem analizy latentnych krzywych rozwojowych. ASK. Społeczeństwo. Badania. Metody, 13, 87-120.
Kucińska, M., & Mellibruda, J. (1997). Sposób używania alkoholu po zakończeniu lub przerwaniu terapii uzależnienia przez pacjentów uczestniczących w programie badawczym APETA. Alkoholizm i Narkomania, 3(28), 373-389.
Lahmek, P., Berlin, I., Michel, L., Berghout, Ch., Meunier, N., & Aubin, H. J. (2009). Determinants of improvement in quality of life of alcohol-dependent patients during an inpatient withdrawal programme. International Journal of Medical Sciences, 6, 160-167.
Laudet, A., & White, M. A. (2008). Recovery capital as prospective predictor of sustained recovery, life satisfaction and stress among former poly-substance users. Substance Use & Misuse, 43(1), 27-54.
Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. New York: Springer.
Levin, C., Ilgen, M., & Moos, R. H. (2007). Avoidance coping strategies moderate the relationship between self-efficacy and 5-year alcohol treatment outcomes. Psychology of Addictive Behaviors, 21(1), 108-113.
Maraun, M. D., Gabriel, S., & Martin, J. (2011). The mythologization of regression towards the mean. Theory & Psychology, 21(6), 762-784.
Markiewicz, M. (2012). Duchowość, strategie radzenia sobie ze stresem, wsparcie społeczne i style atrybucyjne a poczucie satysfakcji z życia u osób uzależnionych od alkoholu będących w procesie zdrowienia. Unpublished M.A. thesis, Institute of Clinical Psychology, University of Social Sciences and Humanities, Warsaw.
Marlatt, G. A. (1985). Coping and substance abuse: Implications for research, prevention and treatment. In S. Shiffman, & T. A. Wills (Eds.), Coping and substance abuse (pp. 54-82). New York: Academic Press.
Marlatt, G. A., & Gordon, J. (1985). Relapse prevention: Maintenance strategies in the treatment of addictive behaviors. New York: Guilford Press.
McArdle, J. J. (2009). Latent variable modeling of differences and changes with longitudinal data. Annual Review of Psychology, 60, 577-605.
Mellibruda, J. (1997). Strategiczno-strukturalna terapia uzależnienia. Alkoholizm i Narkomania, 3(28), 307-324.
Mellibruda, J., & Sobolewska-Mellibruda, Z. (2006). Integracyjna psychoterapia uzależnień. Teoria i praktyka. Warsaw: IPZ.
Mellibruda, J., & Włodawiec, B. (1997). Zmiany funkcjonowania społecznego po terapii odwykowej pacjentów uczestniczących w programie badawczym APETA. Alkoholizm i Narkomania, 3(28), 389-405.
Miller, W. R., Walters, S. T., & Bennett, M. E. (2001). How effective is alcoholism treatment in the United States? Journal of Studies on Alcohol, 62(2), 211-20.
Molenaar, P. M., & Campbell, C. G. (2009). The new person-specific paradigm in psychology. Current Directions in Psychological Science, 18(2), 112-117.
Moos, R. H., & Moos, B. S. (2006). Rates and predictors of relapse after natural and treated remission from alcohol use disorders. Addiction, 101, 212-222.
Moser, A. E., & Annis, H. M. (1996). The role of coping in relapse crisis outcome: A prospective study of treated alcoholics. Addiction, 91(8), 1101-1114.
Mroziak, B., Wójtowicz, S., & Woronowicz, B. (1999). Zmiany poczucia koherencji i stylu radzenia sobie ze stresem po podstawowym programie psychoterapii osób uzależnionych od alkoholu. Alkoholizm i Narkomania, 2(35), 225-236.
Nevitt, J., & Hancock, G. R. (2001). Performance of bootstrapping approaches to model test statistics and parameter standard error estimation in structural equation modeling. Structural Equation Modeling, 8(3), 353-377.
Norman, S. B., Tate, S. R., Willkins, K. C., Cummins, K., & Brown, S. A. (2010). Posttraumatic stress disorder's role in integrated substance dependence and depression treatment outcomes, Journal of Substance Abuse Treatment, 38(4), 346-355.
Orford, J., Hodgson, R., Copello, A., Behv, J., Smith, M., Black, R., Fryer, K., Handforth, L., Alwyn, T., Kerr, C., Thistlethwaite, G., & Slegg, G. (2006). The clients’ perspective on change during treatment for an alcohol problem: qualitative analysis of follow-up interviews in the UK Alcohol Treatment Trial. Addiction, 101(1), 60-68.
Park, C. L., & Levenson, M. R. (2002). Drinking to cope among college students: Prevalence, problems and coping processes. Journal of Studies on Alcohol, 63, 486-497.
Parnowski, T., & Jernajczyk, W. (1977). Inwentarz Depresji Becka w ocenie nastroju osób zdrowych i chorych na choroby afektywne. Psychiatria Polska, 11(4), 417-421.
Project MATCH Research Group (1997). Matching alcoholism treatments to client heterogeneity: Project MATCH posttreatment drinking outcomes. Journal of Studies on Alcohol, 58, 7-29.
Raytek, H., Morgan, T., & Chung, N. (2005). Interwencje poznawczo-behawioralne w nadużywaniu alkoholu i uzależnieniu od alkoholu. In M. Reinecke, & D. Clark (Eds.), Psychoterapia poznawcza w teorii i praktyce (pp. 367-397). Gdańsk: GWP.
Schwarzer, R., Boehmer, S., Luszczynska, A., Mohamed, N. E., & Knoll, N. (2005). Dispositional self-efficacy as a personal resource factor in coping after surgery. Personality and Individual Differences, 39(4), 807-818.
Veenstra, M. Y., Lemmens, P. M., Friesema, I. M., Tan, F. S., Garretsen, H. L., Knottnerus, J., & Zwietering, P. J. (2007). Coping style mediates impact of stress on alcohol use: A prospective population-based study. Addiction, 102(12), 1890-1898.
Willinger, U., Lenzinger, E., Hornik, K., Fischer, G., Schönbeck, G., Aschauer, H. N., & Meszaros, K. (2002). Anxiety as predictor of relapse in detoxified alcohol-dependent patients. Alcohol and Alcoholism, 37(6), 609-612.
Wojnar, M., Slufarska, A., & Klimkiewicz, A. (2007). Nawroty w uzależnieniu od alkoholu. Część 3: Społeczno-demograficzne i psychologiczne czynniki ryzyka. Alkoholizm i Narkomania, 20(1), 81-102.
Published
2019-04-04
Section
Articles