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Putting drinkers "under contract." (use of contracts to treat alcoholism)

A contract is drawn, and the parties involved prepare to sign it. This scene, typical of everyday business at a law firm, also is becoming common at the offices of a growing number of physicians. In this setting, the parties agreeing to the contracts are patients seeking to stop smoking, lose weight, or otherwise improve their health habits and lifestyles.

"Studies have shown that, if an individual writes a contract saying, 'I am going to change my behavior,' it improves the effectiveness of the agreement with the physician, especially if there is a witness," indicates Daniel Vinson, assistant professor of family and community medicine, University of Missouri-Columbia. "Contracts are clearly more effective than a physician's oral warning to change a bad habit or lifestyle."

Following this line of thought, Vinson and his colleagues at the university's School of Medicine have created a computer program that challenges problem drinkers who may be headed for alcoholism to curb or eliminate their alcohol consumption by making a written agreement with themselves and their physicians. Problem drinkers include those who do not drink enough to be diagnosed as alcoholics, but do go beyond moderation--about 10-20% of the entire population. Problem drinkers may consume a lot of alcoholic beverages and sometimes get into trouble because of their drinking. Hazardous drinkers are those heading toward alcohol-related troubles.

The Programmed Alcohol Contracting Tool (PACT) software program is simple to use and impersonal enough to be non-threatening, Vinson explains. Patients are asked to indicate on a sliding scale how much of a problem alcohol is in their lives, what others think of the situation, and how much they are ready to change. Based on the responses, PACT directs users to think about their situation, plan for altering their behavior, and/or take action to change how much they drink. For example, if the patient is ready to take action, the program offers several options, ranging from keeping track of alcohol consumption to stopping drinking for a specified number of weeks and/or attending an Alcoholics Anonymous meeting.

Users agree to reward themselves for completing the conditions. They can choose one of the computer's suggestions, such as going out to eat, or customize a reward that appeals to them. The program ends by printing a contract describing the agreement and listing the names of the parties involved, with signature lines for the patient, physician, and, perhaps, a concerned loved one.
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Publication:USA Today (Magazine)
Date:Apr 1, 1993
Words:401
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