Alcohol Dependence Clinical Trial
Official title:
Individualized Treatment Program for Alcohol Problems
The purpose of this study is to determine if a treatment for alcohol dependence that is specifically tailored to patients' patterns of drinking and coping strategies can result in better outcomes than more standardized treatments.
Despite the popularity of Cognitive-Behavioral Treatment (CBT) in substance use disorders,
recent findings have indicated that CBT may be no more effective than other, less
theoretically driven, treatments, and that CBT treatments often fail to result in coping
skills acquisition. In order to explore the possibility that current manual-driven modes of
CBT delivery may not be adequate to successfully teach coping skills, we are proposing a
pilot project for the development of an individualized assessment and cognitive-behavioral
treatment program (IATP) for alcohol-dependent persons, in which experience sampling
conducted via random calls to cell-phones is used to provide data to create individualized
treatment plans. Data collected during experience sampling will include momentary
assessments of patients' cognitions, affects, and coping behaviors with respect to drinking.
Participants will be 112 men and women meeting criteria for alcohol dependence, who will be
randomly assigned to either a standard packaged manual-driven cognitive-behavioral treatment
program (PCBT) like that used in Project MATCH, or to IATP. Patients in both treatments will
be asked to engage in experience sampling for two weeks prior to treatment, and for another
two weeks after treatment has ended, in order to compare in-vivo measures of coping skills
utilization, pre- and posttreatment, between the two groups. Therapy will be conducted over
12 sessions in both treatments. In IATP, the information gathered from experience sampling
will form the basis of a functional analysis of patients' drinking and drinking urges during
the monitoring period. Cognitive appraisals, moods and coping responses will be evaluated as
antecedents and consequences of drinking behavior. Therapists will use the information to
address specific cognitions, affects, and behaviors that are adaptive and maladaptive, and
will work with the patient to substitute adaptive coping tactics instead. In PCBT the
experience sampling data will not be specifically used in therapy, but will still provide
in-vivo measures of drinking and coping skills. It is hypothesized that IATP will yield
significantly better coping skills acquisition than will PCBT, and that change in coping
skills will predict better posttreatment outcomes for IATP. These results would have
implications for our delivery of treatment, and for the validity of coping skills training
for alcohol addiction.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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