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Psychological Treatment for Alcohol Abuse/Alcoholism Examples of Research Answers to Six Practical Questions 1. How effective is the psychological treatment of alcoholism? 12-month outcomes of U.S. alcoholism treatment (8329 cases) 24% continuously abstinent

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psychological treatment for alcohol abuse alcoholism

Psychological Treatment for Alcohol Abuse/Alcoholism

Examples of Research Answers to Six Practical Questions

12 month outcomes of u s alcoholism treatment 8329 cases
12-month outcomes of U.S. alcoholism treatment (8329 cases)
  • 24% continuously abstinent
  • Among those not totally abstinent:
    • 87% reduction in alcohol consumption
    • Most (75%) days abstinent
    • 60% reduction in alcohol-related problems
  • <2% mortality

Source: Miller, Walters & Bennett (2001). How effective is alcoholism treatment? Journal of Studies on Alcohol, 62, 211-220.

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2 is there something more effective than traditional disease model counseling for alcoholism

2. Is there something more effective than traditional disease-model counseling for alcoholism?

slide9

Investigator: Nathan Azrin

  • Patients in outpatient treatment for alcoholism
  • Location: Illinois
  • Treatment: Community reinforcement approach
  • Comparison: Traditional counseling
  • Follow-up: 6 months

Source: Azrin, N. (1976). Improvements in the community reinforcement approach to alcoholism. Behaviour Research and Therapy, 34:339-348.

6 month outcomes azrin
6 Month Outcomes (Azrin)

Drinking days reduced by 97%

6 month outcome cra in new mexico
6 Month Outcome: CRA in New Mexico

% Alcohol-free days

Source: Meyers & Miller (2001). A community reinforcement approach for

addiction treatment. Cambridge University Press.

slide12

3. Is there something we can do to get our patients more motivated for change at the beginning of treatment?

slide13

Investigator: Thomas Bien

  • Veterans entering outpatient treatment for alcoholism at a VA medical center
  • Location: New Mexico
  • Treatment: 1 session of motivational interviewing at intake
  • Comparison: Usual intake with encouragement
  • Follow-up: 6 months

Source: Bien, Miller & Boroughs (1993). Motivational interviewing with alcohol outpatients. Behavioural and Cognitive Psychotherapy, 21:347-356

slide17

Investigator: Janice Brown

  • Patients entering private inpatient treatment for alcoholism
  • Location: New Mexico
  • Treatment: 1 session of motivational interviewing at intake
  • Comparison: Usual intake without MI
  • Follow-up: 3 months post-discharge

Source: Brown & Miller (1993). Impact of motivational interviewing on participation and outcome in residential alcoholism treatment. Psychology of Addictive Behaviors, 7: 211-218.

3 month outcomes brown
3 Month Outcomes (Brown)

Doubled % of patients abstaining

slide19

Investigator: Lauren Lawendowski

  • Adolescents entering public outpatient treatment for substance abuse
  • Location: New Mexico
  • Treatment: 1 session of motivational interviewing at intake
  • Comparison: Usual intake without MI
  • Follow-up: 3 months post-discharge
  • Source: Lawendowski, L. (1997). Motivational interviewing with adolescents presenting for outpatient substance abuse treatment. PhD. Dissertation, Department of Psychology, University of New Mexico
130 csos randomly assigned to one of three interventions
130 CSOs randomly assigned to one of three interventions
  • Al-Anon Facilitation Therapy (AFT)
  • Johnson Institute Intervention (JII)
  • Community Reinforcement (CRAFT)

Source: Miller, Meyers & Tonigan (1999). Engaging the unmotivated in treatment for alcohol problems: A comparison of three strategies for intervention through family members. Journal of Consulting and Clinical Psychology, 67: 688-697.

slide28

5. Is there an effective treatment for adolescents in the emergency room with alcohol-related injuries?

slide29

Investigator: Peter Monti

  • Adolescents brought to emergency room, injured and intoxicated
  • Location: Rhode Island
  • Treatment: 1 session of motivational interviewing (35-40 min) in the ER
  • Comparison: ER treatment as usual
  • Follow-up 6 months
  • Source: Monty, Colby & O’Leary (2001). Adolescents, alcohol and substance abuse: Reaching teens through brief interventions. New York: Guilford Press.
6 month outcomes
6 Month Outcomes
  • 27% fewer cases drinking and driving
  • 87% fewer new moving traffic violations
  • 58% fewer new alcohol-related injuries
slide32

Investigator: Hans Kristenson

  • Men aged 46-49 participating in a health study, with elevated liver enzymes
  • Location: Sweden
  • Treatment: Brief behavioral counseling
  • Comparison: Risk notification by mail
  • Follow-up: 5 years
  • Source: Kristenson et al. (1983). Identification and intervention of heaby drinking in middle-aged men: Results and follow-up of 24-60 months of long-term study with randomized controls. Alcoholism: Clinical and Experimental Research, 7: 203-209.
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