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High- and low-structure treatments for substance dependence: role of learned helplessness.

Publication ,  Journal Article
Thornton, CC; Patkar, AA; Murray, HW; Mannelli, P; Gottheil, E; Vergare, MJ; Weinstein, SP
Published in: Am J Drug Alcohol Abuse
August 2003

We studied whether pretreatment levels of learned helplessness (LH) were related to outcomes for substance-dependent individuals receiving high-structure, behaviorally oriented (HSB) or low-structure, facilitative (LSF) treatment. The subjects were 120 substance-dependent patients randomly assigned to the HSB or the LSF treatment style for up to 12 weeks of weekly individual counseling. The two groups were compared across pretreatment characteristics as well as in-treatment, end-of- treatment, and 9-month postadmission follow-up outcome measures. Outcomes reflected reduction in problem severity, abstinence, retention, dropout rate, and ratings of treatment benefit. Significant and comparable reductions in symptoms occurred for the HSB and LSF patients both during treatment and at follow-up. Comparisons of other outcomes also did not consistently favor either treatment style. However, significant and consistent interactions were observed between LH and treatment styles with respect to several outcome measures, and these effects were independent of pretreatment levels of depression, addiction severity, and readiness for treatment. Specifically, the more "helpless" patients did significantly better in HSB treatment, whereas the less "helpless" patients had better outcomes in LSF treatment. A matching approach that assigns patients to high- and low-structure treatments based on pretreatment levels of LH might improve treatment outcomes for substance-dependent patients.

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Published In

Am J Drug Alcohol Abuse

DOI

ISSN

0095-2990

Publication Date

August 2003

Volume

29

Issue

3

Start / End Page

567 / 584

Location

England

Related Subject Headings

  • Treatment Outcome
  • Substance-Related Disorders
  • Substance Abuse Treatment Centers
  • Substance Abuse
  • Severity of Illness Index
  • Self-Assessment
  • Psychiatric Status Rating Scales
  • Patient Dropouts
  • Humans
  • Helplessness, Learned
 

Citation

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Thornton, C. C., Patkar, A. A., Murray, H. W., Mannelli, P., Gottheil, E., Vergare, M. J., & Weinstein, S. P. (2003). High- and low-structure treatments for substance dependence: role of learned helplessness. Am J Drug Alcohol Abuse, 29(3), 567–584. https://doi.org/10.1081/ada-120023459
Thornton, Charles C., Ashwin A. Patkar, Heather W. Murray, Paolo Mannelli, Edward Gottheil, Michael J. Vergare, and Stephen P. Weinstein. “High- and low-structure treatments for substance dependence: role of learned helplessness.Am J Drug Alcohol Abuse 29, no. 3 (August 2003): 567–84. https://doi.org/10.1081/ada-120023459.
Thornton CC, Patkar AA, Murray HW, Mannelli P, Gottheil E, Vergare MJ, et al. High- and low-structure treatments for substance dependence: role of learned helplessness. Am J Drug Alcohol Abuse. 2003 Aug;29(3):567–84.
Thornton, Charles C., et al. “High- and low-structure treatments for substance dependence: role of learned helplessness.Am J Drug Alcohol Abuse, vol. 29, no. 3, Aug. 2003, pp. 567–84. Pubmed, doi:10.1081/ada-120023459.
Thornton CC, Patkar AA, Murray HW, Mannelli P, Gottheil E, Vergare MJ, Weinstein SP. High- and low-structure treatments for substance dependence: role of learned helplessness. Am J Drug Alcohol Abuse. 2003 Aug;29(3):567–584.
Journal cover image

Published In

Am J Drug Alcohol Abuse

DOI

ISSN

0095-2990

Publication Date

August 2003

Volume

29

Issue

3

Start / End Page

567 / 584

Location

England

Related Subject Headings

  • Treatment Outcome
  • Substance-Related Disorders
  • Substance Abuse Treatment Centers
  • Substance Abuse
  • Severity of Illness Index
  • Self-Assessment
  • Psychiatric Status Rating Scales
  • Patient Dropouts
  • Humans
  • Helplessness, Learned