Self assessment of relapse risk and assertiveness in relation to treatment outcome of female alcoholics.

Prior to and following social-skills training during a three months inpatient treatment, 145 female alcoholics indicated for various situations involving social pressure to drink alcohol (a) how difficult it would be for them not to drink (Relapse Risk) and (b) the degree of discomfort they expected (Specific Assertiveness). In addition, General Assertiveness situations, not related to alcohol, were evaluated. Patients who relapsed three months after treatment evaluated the situations more difficult to deal with and creating more discomfort than abstaining patients, although the groups did not differ in their self-rated assertiveness in non-alcohol-related situations. All ratings improved throughout the training, but the differences between outcome groups were similar before and after. When patients were excluded who had relapsed already during treatment, Relapse Risk but not Specific Assertiveness still discriminated between outcome groups. The prognostic power of the Risk rating seems to reflect a general efficacy expectation evident in a strong relation to patients' conviction of being able to stay abstinent, stated already at admission.