Introduction: Alcohol use during abstinence-oriented residential treatment programs has been shown to be associated with poor alcohol use outcomes at follow-up. There is evidence that drinking is related to various factors such as patients' general control beliefs and alcohol-related self-efficacy as well as external control of alcohol use and temptation situations to drink. The aim is to investigate how those trait and state variables and number of external control of alcohol use by program's staff are related to alcohol use during abstinence-oriented residential treatment programs for alcohol dependent patients.
Method: In total, 509 patients with alcohol dependence who entered one of two residential abstinence-oriented treatment programs for alcohol dependence were included in the study. After detoxification patients completed a standardized diagnostic procedure including interviews and questionnaires assessing socio-demographic and psychological characteristics such as general control beliefs, self-efficacy, and temptation. Number of drinking events was assessed by breath analyzer testing and by self-report during treatment. The two residential programs were either assigned to high or low control program according to the average number of testing per patient.
Results: Patients with low internal locus of control in programs with low external control had used more likely alcohol during treatment (45.9%) compared to patients with high internal locus of control attending programs with high external control (16.7%). Frequencies of alcohol use were in between if one of the two control conditions was low and the other was high. Regression analysis revealed a significant interaction effect between internal and external control suggesting that patients with high internal locus of control and high frequency of controls by staff showed the least once alcohol use during treatment. No effects were found for self-efficacy and temptation.
Conclusion: As alcohol use during treatment most likely is associated with poor treatment outcome, external control may improve treatment outcome and support particularly patients with low internal locus of control that show the highest risk for alcohol use during treatment. High external control may complete high internal control to improve alcohol use prevention while in treatment.
