Psychological Self-Help

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56
will never know but old habits are hard for everybody to stop. How
hard? There is very contradictory evidence. Some treatment programs
claim a 90% success rate (during the treatment phase). In general,
relapse after treatment of addictive behavior is very high, 50% to 90%
(Brownell, Marlatt, Lichtenstein & Wilson, 1986). Two thirds to 3/4's of
drug and alcohol abusers relapse within three months after treatment
(Chiazzi, 1989). In one study, less than 10% of treated alcoholics
abstained for two years (Armor, Polich, & Stambul, 1978). Researchers
of weight loss projects also report disappointing results: few stay in
treatment, and 80% of those that do, gain any weight loss back within
a year. Smokers frequently quit, then relapse. Clients who stay in
these treatment programs for various problems are successful (why
else would they stay?), but thus far no program enables a high
percentage of clients to maintain their gains. So, it is hopeful (we can
change) but the final long-term results of today's "programs," even
the expensive ones, are not good enough. On the other hand, note
that about half of all former problem-drinkers have quit drinking "on
their own" (no help from a MD or AA or any treatment). You are not
powerless! But I'd recommend getting all the outside help you can, as
well as self-helping. 
Similarly, Stanley Schachter (1982) reported some interesting but
controversial findings: almost 2/3's (63%) of people who tried to lose
weight or stop smoking on their own (without professional help) were
successful! And they kept it off for years! This implied that self-help
was better than professionally run treatment programs. Subsequent
studies (Cohen, et al, 1989) showed this was not true; self-quitters
(smokers) did no better or no worse than clients in a stop smoking
clinic. But over the years, we try to help ourselves a lot more often
than we use professional programs. Thus, 85% of those trying to stop
are on their own and only 15% join a stop-smoking program. About
1/3 of all smokers have tried to stop within the last year; most failed.
Of those trying to stop sometime (or many times) between 1976 and
1986, 48% of the self-helpers and 24% of the treatment clients were
successful. Altogether 40 million Americans have stopped smoking, so
it is possible. 90% of the successful ones were on their own and most
of them had tried again and again. 70-75 million are still smoking.
There is no evidence that successful quitters used different behavior-
change methods than the relapsers; they just motivated themselves
more and kept on trying (maybe until they found an approach that
worked for them). There is hope. Again, I'll remind you: self-
administered programs (listening to a tape, reading a manual,
watching a videotape) have been just as effective as therapist-
administered programs (Scogin, Bynum, Stephens, & Calhoon, 1990).
The keys seems to be learning to be motivated and maintaining your
gains. 
Relapse prevention for addictions 
Marlatt and Parks (1982) and Marlatt and Gordon (1985) zero in on
a crucial point--the relapse. This is the point, usually after successfully
stopping smoking, drinking, avoiding studying, overeating, etc., at
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