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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 l.jpg

Psychological Treatment for Alcohol Abuse/Alcoholism

Examples of Research Answers to Six Practical Questions



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12-month outcomes of U.S. alcoholism treatment (8329 cases) alcoholism?

  • 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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Milwaukee alcoholism?

Providence

Clinical Research UnitsProject MATCH

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Buffalo

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Seattle

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WHaven

Albuquerque

Farmington

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Charleston

Houston





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


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Investigator: Nathan Azrin disease-model counseling for alcoholism?

  • 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.


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6 Month Outcomes (Azrin) disease-model counseling for alcoholism?

Drinking days reduced by 97%


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6 Month Outcome: disease-model counseling for alcoholism?CRA in New Mexico

% Alcohol-free days

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

addiction treatment. Cambridge University Press.


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


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Investigator: Thomas Bien disease-model counseling for alcoholism?

  • 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


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6 Month Outcomes (Bien) disease-model counseling for alcoholism?


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Intoxication level when drinking (BAC) disease-model counseling for alcoholism?


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Patients totally abstinent (Bien) disease-model counseling for alcoholism?


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Investigator: Janice Brown disease-model counseling for alcoholism?

  • 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.


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3 Month Outcomes (Brown) disease-model counseling for alcoholism?

Doubled % of patients abstaining


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Investigator: Lauren Lawendowski disease-model counseling for alcoholism?

  • 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


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Adolescent patients totally abstinent from all drugs disease-model counseling for alcoholism?





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Community Reinforcement and Family Training refuses to get treatment?

CRAFT


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130 CSOs randomly assigned to one of three interventions refuses to get treatment?

  • 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.


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Treatment Engagement Rates refuses to get treatment?


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CSO Depression Scores (Beck) refuses to get treatment?


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


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Investigator: Peter Monti refuses to get treatment?

  • 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.


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6 Month Outcomes refuses to get treatment?

  • 27% fewer cases drinking and driving

  • 87% fewer new moving traffic violations

  • 58% fewer new alcohol-related injuries



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Investigator: Hans Kristenson prevented?

  • 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.