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 Examples of Research Answers to Six Practical Questions
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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Maintaining change across three years after treatment (outpatients)
2. Is there something more effective than traditional disease-model counseling for alcoholism?
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) Drinking days reduced by 97%
6 Month Outcome: CRA in New Mexico % Alcohol-free days Source: Meyers & Miller (2001). A community reinforcement approach for addiction treatment. Cambridge University Press.
3. Is there something we can do to get our patients more motivated for change at the beginning of treatment?
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
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) Doubled % of patients abstaining
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
4. How can I help desperate family members whose loved one refuses to get treatment?
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.
5. Is there an effective treatment for adolescents in the emergency room with alcohol-related injuries?
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 • 27% fewer cases drinking and driving • 87% fewer new moving traffic violations • 58% fewer new alcohol-related injuries
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.