A SMOKING CESSATION TREATMENT INVESTIGATION: A REPLICATION AND ASSESSMENT OF THERAPIST EFFECT

JEAN PARKER DELAHUNT, Purdue University

Abstract

The purpose of this study was to replicate a smoking cessation treatment package (Delahunt & Curran, 1976) shown to be successful in achieving and maintaining smoking reduction and abstinence by developing a therapist manual and training a therapist to apply the treatment procedures. The assessment of therapist effect was conducted using the dependent measures of cigarette consumption and a group processes scale. For replication of the original treatment package, female subjects (N = 24) who had smoked at least 20 cigarettes a day for a minimum of one year were assigned to two treatment groups and one "expectation" control group of 8 subjects each. Treatment group one was led by a female therapist who was trained in applying the treatment procedures. Treatment group two was led by a male therapist (J. Delahunt) who had conducted the combined treatment group in the previous study. Both therapists used the therapist manual developed for this study to operationalize delivery of treatment procedures. After subjects were assigned to groups, one-way analyses of variance was conducted on age, years having smoked, baseline smoking rate, and scores on several psychological scales. None of the analyses showed a significant difference between groups. Treatment subjects were given manuals that contained rationales for treatment, specific treatment procedures, and homework assignments. Each group met for six one and a half-hour sessions over a three-week period. At each session, monitoring cards and saliva samples were collected. At the end of the third and fifth sessions, subjects and therapists were administered the Group Environment Scale (Moos, Insel & Humphrey, 1974). Follow-up data were collected at ten days, one month, three months, and six months after the quit day. The principal dependent measure was the number of cigarettes smoked per day as a percentage of the baseline rate. While the untreated control group maintained a consistent mean smoking rate from baseline through six-month follow-up, treatment group one, led by the trained female therapist, produced an overall reduction rate of 38 per cent and an abstinence rate of 25 per cent. These results were slightly higher than those produced by typical smoking cessation treatments (Elliott & Denney, 1978). Treatment group two, led by the male therapist (in the previous study), produced an overall reduction rate of 75 per cent and an abstinence rate of 62.5 per cent. These results were quite close to but slightly higher than those produced in the previous study and were evidence that the goal of replication was achieved. Evidence that differences in group processes between treatment groups contributed to the significant differences in treatment outcome was provided by data from the Group Environment Scale, and it was concluded that the more successful therapist was less controlling and more non-directive which coincided with the theoretical purpose of the self-control and negative practice components of the treatment package. Several predictor variables (order and organization subscale scores of the Group Environment Scale and Effective Cognitive Dissonance measure scores) were isolated and shown to be significantly related to treatment outcome. Based upon these findings, recommendations were made for refining therapist training and delivery of the combined treatment package procedures to enhance generalization across therapists and treatment outcome.

Degree

Ph.D.

Subject Area

Psychotherapy

COinS