Аннотация:
Background. The article considers and proposes the author’s method of psychotherapy for persons with alcohol dependence syndrome who are prone to aggressive behavior. The approach is based on an integrated model of psychotherapeutic assistance to alcohol addicts and is aimed at overcoming anosognosia, reducing anxiety, overcoming psychological defenses, breaking patterns of addictive and aggressive behavior, and developing positive attitudes and skills of prosocial interaction. The application of the method makes it possible to increase the effectiveness of psychosocial rehabilitation in patients with alcohol dependence, to form sustainable remissions of high quality, and to ensure the stability of results in the long-term period.
Methods. The study sample included 198 men with alcohol dependence syndrome (F10.2) aged 21 to 60 years, mean age 40.7±8.9 years, alcohol intake averaged 13.5 years. The results were approved by the minutes of the meeting on ethics No. 2 dated August 13, 2019 of the ethics committee of the State Institution «Republican Scientific and Practical Center for Mental Health». The purpose of the method of psychotherapy of persons with alcohol dependence syndrome prone to aggressive behavior was to overcome dependent, aggressive and illegal behavior in persons with alcohol dependence syndrome. The method of psychotherapy for persons with alcohol dependence syndrome prone to aggressive behavior (MPAP) consists of 12 psychotherapeutic modules, which are implemented in stages, designed for 36 sessions, from 60 to 120 minutes each. Classes are held on average twice a week. The main form of work is group psychotherapy, groups of 8-10 people. Forms of work include theoretical and practical parts. At the end of each module, a self-report sheet is drawn up, which is filled in by the patient and allows you to evaluate the effectiveness of the work done. To test the method of psychotherapy for persons with alcohol dependence syndrome prone to aggressive behavior, the following methods were used: «Questionnaire propensity to aggression Bass-Perry»; Test questionnaire «Research of volitional self-regulation»; Scale of readiness for behavior change and desire for treatment «SOCRATES»; Questionnaire for the study of the stages of psychotherapy «URICA». The main group I was formed by the method of targeted selection; it included patients with alcohol dependence syndrome, who are in the penitentiary system at the age of 21 to 60, who underwent psychotherapy (100 patients); comparison group II included patients with alcohol dependence syndrome, who are in the penitentiary system, aged 21 to 60 years, undergoing a standard program of medical and social readaptation (98 patients). Statistical analysis of the data was carried out using SPSS 19.0. To assess the differences between two independent samples, the Mann-Whitney U-test was used to compare two independent samples and the Wilcoxon T-test to compare two dependent samples with each other (before and after psychotherapy) in terms of the level of symptom severity.
Results. The results of the follow-up assessment carried out after six months in the main group of people who underwent MAP in comparison with the indicators of the comparison group showed the presence of statistically significant differences in all the studied indicators: a decrease in the level of the general indicator of aggression; increasing the level of development of volitional self-regulation; increased willingness to change behavior and desire for treatment and the choice of the stage of psychotherapy at the level of retention of the results obtained (p<0.01). The new skills obtained in the process of MAP in alcohol dependent persons confirmed the correctness of the chosen integrative approach and the effectiveness of psychotherapeutic interventions in minimizing the aggressive and illegal behavior of persons with alcohol dependence in the short and subsequent long-term period.
Ключевые слова:
aggressive behavior, alcohol addiction, psychotherapy method.