PSYCHOLOGICAL INTERVENTIONS FOR DRUG-ABUSE - A CRITIQUE AND SUMMATION OF CONTROLLED-STUDIES

Empirical evaluations of treatments for abuse of substances other than alcohol are reviewed and critiqued. Methodological strengths and deficits of treatment-outcome studies are delineated, and interpretation of reported results is considered in light of these factors. In large part, intervention strategies for which controlled outcome evaluations exist can be divided into those conceptualized along classical conditioning lines (e.g., extinction and stimulus avoidance) and those derived from operant learning principles (e.g., contingency contracting and community reinforcement). Whereas stimulus-avoidance techniques appear to be relatively more effective than pure extinction trials in reducing drug use, the efficacy of operant methods has been most strongly supported. Moreover, componential treatment packages in which contingent reinforcement is applied to both reductions in drug use and increases in stimulus-avoidance behaviors evince the most dramatic effects. Additional research that addresses the methodological shortcomings of contemporary studies is needed.