The Peniston & Kulkosky Treatment for Chemical Dependence: a Replication, and Assessment of the Importance of the Electroencephalograph (EEG) Biofeedback Component of the Protocol

This thesis is primarily a replication of Peniston and Kulkoskys' (1989; 1990) treatment (PKT) study which reported successful outcomes for alcoholics using an alpha/theta electroencephalograph (EEG) biofeedback protocol. The PKT protocol consists of 6 temperature biofeedback sessions of training increased hand temperature, followed by 30 sessions of training, via EEG biofeedback, increases in alpha/theta band amplitude. The latter sessions included visualizations of personality and physiology changes, and visualisations of scenes where alcohol is refused. Another aim of this study was to determine whether the EEG biofeedback element of the protocol was superior in outcomes to the subject simply listening to monotonous sounds. In addition to three months of therapeutic community treatment, one experimental group of 15 subjects received the PKT protocol, the other received a modified version excluding EEG biofeedback, and a control group of 14 subjects had no additional treatment. Post-treatment follow up revealed significant improvements for all three groups in key psychometric instruments. These were the Multiaxial Personality Inventory (MCMI-II), Situational Confidence Questionnaire (SCQ), Life Purpose Questionnaire (LPQ), and, at follow up, Addiction Severity Index (ASI). The control group changed in fewer MCMI-II scales, and had a higher treatment drop out rate. At follow up the groups' abstinence rates, using Peniston and Kulkoskys' measure, were also similar. However, when more sensitive relapse measures were applied, the PKT groups' relapse results were about twice those of the control group. This was significant for male subjects' mean number of days using substances, whereas female subjects' abstinence rates were high in all three groups. This therapeutic modality enhances therapeutic community treatment outcomes in a small sample of subjects, a result not common in the literature. It merits further investigation and implementation in a New Zealand setting.