Hur kan vi förstå alkoholisters handlande? : om tankeprocessernas roll i alkoholisters rehabilitering

Sammanfattning: Alcohol abuse is one of our greatest social and medical problems. In addition to the human suffering caused by alcohol, substantial costs to society are incurred. The purpose of this study is to try to enhance our understanding of the cognitive processes that facilitate change in individuals and to our understanding of these individuals ability to manage their own situation by focusing on their alcohol problems. A cognitive theoretical approach frames the study, and its theoretical concepts and points of departure are borrowed from attribution theory, Piaget's theory of development, and cognitive psychotherapy. A group of 146 persons, admitted to a treatment facility for alcoholics, were interviewed on three separate occasions: upon admission, upon discharge, and one year after discharge. The results of the study reveal statistically significant differences regarding individuals who re-attributed the cause of their alcoholism from internal factors (their own fault) to external factors (not their own fault), with the result that more individuals were total abstainers one year after the study in this group than in the other groups. Nevertheless, no differences could be statistically established with regard to sobriety between those who claimed to believe that alcoholism was a disease and those who did not make this claim. On the basis of these results, further interviews were held with two of the participants in the study. The follow-up period for these interviews was three years and four years. Hermeneutic principles were used to analyze the two in-depth interviews. One conclusion is that attribution theory is usable as an analytic instrument and as an explanatory model for explaining why alcoholics act in the manner they do. In addition, cognitive psychotherapy is found to be usable for further development of staff members' theoretical knowledge and attitudes with regard to treatment according to the so-called "Minnesota model". The AA disease concept is discussed in terms of metaphor. Judging from the study, the individuals' own cognitive constructions are decisive for whether the concept will have any effect or not. By means of their inner dialogue, alcoholics test their perceptions about themselves and about their alcoholism.