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Social learning theory postulates that chronic alcohol abusers may have deficits in ability to cope with stressful situations, and these deficits may be associated with relapse after treatment. Attempts to study the hypothesized deficits have been hampered by methodological problems. Therefore, a behavior analytic procedure was used to develop 10 categories of situations based on over 600 drinking situations elicited from alcoholics. Role plays were developed for each of these categories, and samples of alcoholics in treatment were asked to respond as if they were trying not to drink. Videotaped responses were behaviorally rated by trained judges for skill and anxiety, and subjects completed self-report ratings of urge to drink, anxiety, difficulty and skill after each role play. Good interrater reliabilities and internal consistency were found across three samples of alcoholics, with virtually no gender differences. Previous and current investigations show the validity and utility of this instrument. The Alcohol Specific Role Play Test therefore shows promise as a means of assessing alcoholics' reactions to high-risk situations.

Responses of alcohol abusers and social drinkers were compared on general and alcohol-specific problem situations using role-play methodology. Multiple responses were assessed including behavioral observational ratings, self-reports and psychophysiologic measures. There were few differences between groups in responses to the general situations. Alcohol abusers had higher urges to drink than did the social drinkers in both the general and the alcohol-specific situations. However, in response to the alcohol-specific situations, the alcohol abusers, compared to the social drinkers, were rated by judges as significantly less skillful, and they displayed more self-reported anxiety, had a higher frequency of occurrence of problem situations in the natural environment and reported greater perceived realism of the alcohol-specific situations. Psychophysiologic measures did not differentiate between the groups. Results are discussed with respect to the importance of situation specificity in understanding the precipitants of drinking and their treatment implications.

To evaluate three promising social learning approaches to the treatment of alcoholism, 69 male alcoholics in standard inpatient treatment participated in either a communication skills training group (CST), a communication skills training group with family participation (CSTF) or a cognitive behavioral mood management training group (CBMMT). Alcoholics who received CST or CSTF drank significantly less alcohol per drinking day during 6-month follow-up than those in CBMMT. The groups did not differ in abstinence rates or latency to relapse. All groups improved in skill and anxiety on the extensive battery of process measures, including role-play tests of general and alcohol-specific coping skills, but those in CST improved most in skill in alcohol-specific high-risk role plays and in ability to relax after the role plays. Alcoholics' skill, response latency, anxiety and urge to drink during alcohol-specific role plays were highly correlated with treatment outcome, demonstrating the importance of including comprehensive process measures in treatment outcome research. Implications for patient-treatment matching and future research are discussed.

The relationship of various irrational beliefs to alcohol dependence, urges to drink, anxiety and drinking after treatment was investigated for 63 male alcoholics, using Jones' Irrational Beliefs Test (IBT). Alcohol dependence was most strongly associated with problem avoidance. Urges to drink, anxiety and difficulty during alcohol-related role-plays were strongly correlated with problem avoidance and dwelling on negative events. The IBT was unrelated to pretreatment drinking measures but did predict 6-month posttreatment drinking (n = 48) which suggests these beliefs can mediate treatment response. Feeling doomed by the past was the best predictor of both frequency of drinking and average quantity consumed during follow-up. Treatment implications include targeting specific beliefs for intervention.