This proposal evaluates two unilateral interventions designed to promote the adjustment of family and significant others (FSOs) of cocaine abusers: Nar-Anon and Significant Other Reinforcement Training (SORT). Both interventions help FSOs to manage the problems of being involved with a cocaine abuser and encourage the cocaine abuser to seek help. Nar-Anon focuses on the first of these two objectives, providing education and peer support and helping members use the self-help principles of 12-step programs. SORT, adapted from an effective intervention applied to the FSOs of alcoholics (Sisson & Azrin, 1986), focuses on the second objective, teaching FSOs to apply behavioral reinforcement principles to modify the cocaine abuse, and adding a third objective of improving their relationship with the cocaine abuser by teaching communication skills. The study will compare the effectiveness of Nar-Anon and SORT in a random assignment two group design on: a) promoting the adjustment of the FSO on measures of psychological health, social functioning, and adjustment within the relationship, and b) promoting treatment entry, reducing substance use, and improving substance use, and improving the reported social functioning of the cocaine abuser.We expect that both interventions will produce significant improvements in the FSOs psychological health and social functioning, but that SORT will show greater improvements in the FSOs adjustment within the relationship, as well as the perceived social functioning of the cocaine abuser. Further, SORT will lead to more frequent treatment entry of the cocaine abuser than Nar-Anon and greater reductions in the reported cocaine use of the substance abuser. Developing and assessing unilateral interventions for FSOs of cocaine abusers is important for two reasons. First, unilateral interventions can directly benefit FSOs by reducing the negative effects of cocaine abuse. Second, by training FSOs to act as change agents, these interventions can reduce drug use and increase the likelihood of the cocaine abuser entering treatment, thus providing an important new form of outreach to cocaine abusers. Assessing the interventions chosen here is particularly worthwhile because 12 step programs, while popular, infrequently have been evaluated and empirical evaluations of SORT allows a systematic replication of a successful unilateral intervention using a potentially more troubled population.
| Kirby, Kimberly C; Dugosh, Karen Leggett; Benishek, Lois A et al. (2005) The Significant Other Checklist: measuring the problems experienced by family members of drug users. Addict Behav 30:29-47 |
| Hudson, Clifton R; Kirby, Kimberly C; Firely, Monica L et al. (2002) Social adjustment of family members and significant others (FSOs) of drug users. J Subst Abuse Treat 23:171-81 |
| Kirby, K C; Marlowe, D B; Festinger, D S et al. (1999) Community reinforcement training for family and significant others of drug abusers: a unilateral intervention to increase treatment entry of drug users. Drug Alcohol Depend 56:85-96 |
