TREATMENT CONTEXT

TREATMENT CONTEXT

The research design and the various family-treatment modalities of the Addicts and Families Program(AFP) have been described irl Chapter 2 and Appendix C and are not germane to this chapter. Rather, our concern here is with the means used for getting the families actually involved in treatment. Again, the study demanded that (1) the addict, (2) both parents or parent surrogates,* and, whenever possible, (3) siblings, attend an (initial) Family Evaluation Session before being assigned to a family-treatment group. For theo-retical reasons (Chapters 1 and 6) and purposes of research design,''' wives, while usually included in treatment, were not required to attend the evaluation exercise. This session included videotaped family interaction tasks and family perceptions tests. Each member age 12 or over was paid 810.00 for participating. The therapists did not know beforehand to which treatment group the families they were recruit-ing would be (randomly) assigned. These stipulations, while perhaps more stringent than those of most clinical programs, had their benefits. Although they made our job more difficult, they also pro-hibited us from either taking the easy way out and settling for partial family representation, or excluding family members who we later determined were crucial for the success of treatment. Further, we had to recruit a high percentage of families in order both (1) to meet the requirements for a certain number of cases within the grant period, and (2) to avoid the criticism that our sample was nonrepresentative because we had skimmed off the "easy," -compliant" families.

Initial recruitment efforts were made with 125 families. Of these, 33 were deemed ineligible for the study, usually because the IP was not addicted at intake. This left 92 families with which full engage‑

ment attempts were made.

At the outset of the study we anticipated that our biggest prob-lem would be in retaining these families beyond one or two family sessions—the dropout issue. In this we were wrong. First, 94% of those who attended the Family Evaluation Session continued with treatment. Second, once they were -hooked," the majority of families tended to be fairly conscientious in their attendance, especially when compared with results reported elsewhere in the literature. Even the treatment group with the least optimal retention potential averaged six sessions, that is, 64% of their prescribed number of sessions '65' ""; attendance rates for the other two treatment groups were 88%, and 94%. What we did not foresee was the inordinate amount of difficulty we would have in simply getting the family members in for the initial Family Evaluation Session (since, at the time, almost none of the literature on engaging addicts' families had been published). Recruit-ment became one of the most demanding aspects of our work. This unexpected hurdle forced us to reconsider our situation and attempt to be innovative. The substance of this chapter is derived from our responses and experiences in the face of this dilemma.