Jon Morgenstern1, Alexis Kuerbis2, Sijing Shao3, Hayley Treloar Padovano4, Svetlana Levak5, Nehal P Vadhan6, Kevin G Lynch7. 1. Center for Addiction Services and Psychotherapy Research, Northwell Health, 1010 Northern Blvd. Suite 311, Great Neck, NY 11021, United States of America. Electronic address: jmorgeste@northwell.edu. 2. Silberman School of Social Work, Hunter College, City University of New York, 2180 Third Avenue, New York, NY 10035, United States of America. Electronic address: ak1465@hunter.cuny.edu. 3. Center for Addiction Services and Psychotherapy Research, Northwell Health, 1010 Northern Blvd. Suite 311, Great Neck, NY 11021, United States of America. Electronic address: shaosijing@gmail.com. 4. Department of Psychiatry and Human Behavior, Center for Alcohol and Addiction Studies, BOX G-S121-4, Providence, RI 02912, United States of America. Electronic address: hayley_treloar@brown.edu. 5. Center for Addiction Services and Psychotherapy Research, Northwell Health, 1010 Northern Blvd. Suite 311, Great Neck, NY 11021, United States of America. Electronic address: slevak@northwell.edu. 6. Center for Addiction Services and Psychotherapy Research, Northwell Health, 1010 Northern Blvd. Suite 311, Great Neck, NY 11021, United States of America. Electronic address: nvadhan@northwell.edu. 7. Department of Psychiatry, University of Pennsylvania, Suite 370, 3440 Market Street, Philadelphia, PA 19104, United States of America. Electronic address: lynch3@mail.med.upenn.edu.
Abstract
BACKGROUND: Adaptive interventions, sometimes referred to as "stepped care", are those interventions in which the type or dosage of treatment offered to patients is tailored to baseline clinical presentation and then adjusted over time in response to patient progress or lack thereof. Currently, no adaptive brief interventions exist specifically for alcohol use disorder (AUD). METHOD: This study used a sequential multiple assignment randomized trial design with 160 individuals with AUD recruited both locally and nationally who had a goal to reduce or abstain from drinking. Participants received brief advice (BA) and then the study reassessed them three weeks later; the study randomized those who did not respond to BA, defined as reducing their drinking to low-risk guidelines, to two session of motivational interviewing (MI) or more BA. The study then reassessed participants at week 8. The study re-randomized nonresponders to receive either MI alone or MI plus behavioral self-control therapy (BSCT), also referred to as coping skills therapy, and evaluated participants at week 13. RESULTS: Overall, participants receiving any BSCT made the greatest reductions in drinking. Participants who received MI at week 4 and BSCT at week 8 outperformed all other groups. CONCLUSION: Findings reveal that prolonged treatment, more sessions, and/or a specific combination of MI and BSCT provided optimal outcomes. Future research should determine whether such an algorithm holds across heterogenous groups of individuals with AUD.
BACKGROUND: Adaptive interventions, sometimes referred to as "stepped care", are those interventions in which the type or dosage of treatment offered to patients is tailored to baseline clinical presentation and then adjusted over time in response to patient progress or lack thereof. Currently, no adaptive brief interventions exist specifically for alcohol use disorder (AUD). METHOD: This study used a sequential multiple assignment randomized trial design with 160 individuals with AUD recruited both locally and nationally who had a goal to reduce or abstain from drinking. Participants received brief advice (BA) and then the study reassessed them three weeks later; the study randomized those who did not respond to BA, defined as reducing their drinking to low-risk guidelines, to two session of motivational interviewing (MI) or more BA. The study then reassessed participants at week 8. The study re-randomized nonresponders to receive either MI alone or MI plus behavioral self-control therapy (BSCT), also referred to as coping skills therapy, and evaluated participants at week 13. RESULTS: Overall, participants receiving any BSCT made the greatest reductions in drinking. Participants who received MI at week 4 and BSCT at week 8 outperformed all other groups. CONCLUSION: Findings reveal that prolonged treatment, more sessions, and/or a specific combination of MI and BSCT provided optimal outcomes. Future research should determine whether such an algorithm holds across heterogenous groups of individuals with AUD.
Authors: Raymond F Anton; Stephanie S O'Malley; Domenic A Ciraulo; Ron A Cisler; David Couper; Dennis M Donovan; David R Gastfriend; James D Hosking; Bankole A Johnson; Joseph S LoCastro; Richard Longabaugh; Barbara J Mason; Margaret E Mattson; William R Miller; Helen M Pettinati; Carrie L Randall; Robert Swift; Roger D Weiss; Lauren D Williams; Allen Zweben Journal: JAMA Date: 2006-05-03 Impact factor: 56.272
Authors: Jon Morgenstern; Thomas W Irwin; Milton L Wainberg; Jeffrey T Parsons; Frederick Muench; Donald A Bux; Christopher W Kahler; Susan Marcus; Jay Schulz-Heik Journal: J Consult Clin Psychol Date: 2007-02
Authors: Jürgen Rehm; Gerhard E Gmel; Gerrit Gmel; Omer S M Hasan; Sameer Imtiaz; Svetlana Popova; Charlotte Probst; Michael Roerecke; Robin Room; Andriy V Samokhvalov; Kevin D Shield; Paul A Shuper Journal: Addiction Date: 2017-02-20 Impact factor: 6.526