Adaptive Treatment for Alcohol Dependence
| Status: | Completed |
|---|---|
| Conditions: | Psychiatric |
| Therapuetic Areas: | Psychiatry / Psychology |
| Healthy: | No |
| Age Range: | 18 - 75 |
| Updated: | 4/21/2016 |
| Start Date: | February 2009 |
| End Date: | December 2013 |
Primary objective #1: Determine the relative effectiveness of MI-IOP and MI-PC in the full
study sample with regard to treatment engagement over weeks 1-12 and alcohol use over weeks
1-24.
Hypothesis 1: An intervention that explores several possible treatment options with the
patient and provides the chosen option (e.g., MI-PC) will produce higher rates of treatment
engagement than an intervention focused on engagement in IOP only (e.g., MI-IOP).
Hypothesis 2: An intervention that explores several possible treatment options with the
patient and provides the chosen option (e.g., MI-PC) will produce better alcohol use
outcomes than an intervention focused on engagement in IOP only (MI-IOP).
Secondary analysis 1: Among the Non-engaged patients, determine rates of selection of each
of the three options in MI-PC, retention rates within each option, and alcohol use outcomes
in each option.
Secondary analysis 2: Among the Engaged patients, determine rates of selection of each of
the three options in MI-PC, retention rates within each option, and alcohol use outcomes in
each option.
Primary objective #2: Determine whether the relative effectiveness of MI-IOP and MI-PC
varies as a function of engagement group, with regard to treatment engagement over weeks
1-12 and alcohol use outcomes over weeks 1-24.
Hypothesis 1: The predicted main effect on retention favoring MI-PC over MI-IOP will be
significantly larger among patients in the Non-engaged group than among those in the Engaged
group.
Hypothesis 2: The predicted main effect on cocaine use outcomes favoring MI-PC over MI-IOP
will be significantly larger among patients in the Non-engaged group than among those in the
Engaged group.
study sample with regard to treatment engagement over weeks 1-12 and alcohol use over weeks
1-24.
Hypothesis 1: An intervention that explores several possible treatment options with the
patient and provides the chosen option (e.g., MI-PC) will produce higher rates of treatment
engagement than an intervention focused on engagement in IOP only (e.g., MI-IOP).
Hypothesis 2: An intervention that explores several possible treatment options with the
patient and provides the chosen option (e.g., MI-PC) will produce better alcohol use
outcomes than an intervention focused on engagement in IOP only (MI-IOP).
Secondary analysis 1: Among the Non-engaged patients, determine rates of selection of each
of the three options in MI-PC, retention rates within each option, and alcohol use outcomes
in each option.
Secondary analysis 2: Among the Engaged patients, determine rates of selection of each of
the three options in MI-PC, retention rates within each option, and alcohol use outcomes in
each option.
Primary objective #2: Determine whether the relative effectiveness of MI-IOP and MI-PC
varies as a function of engagement group, with regard to treatment engagement over weeks
1-12 and alcohol use outcomes over weeks 1-24.
Hypothesis 1: The predicted main effect on retention favoring MI-PC over MI-IOP will be
significantly larger among patients in the Non-engaged group than among those in the Engaged
group.
Hypothesis 2: The predicted main effect on cocaine use outcomes favoring MI-PC over MI-IOP
will be significantly larger among patients in the Non-engaged group than among those in the
Engaged group.
3. Secondary objective #1: Examine outcomes on three secondary measures: percent days
abstinent from all substances, nega¬tive consequences of alcohol use, and HIV high risk
behaviors.
Hypothesis 1: Outcomes on the secondary measures will be better in MI-PC than in MI-IOP.
4. Secondary objective #2: Test hypotheses concerning potential mediators of the predicted
main effect favoring MI-PC over MI-IOP.
Hypothesis 1: The predicted advantage of MI-PC over MI-IOP will be mediated by greater
increases in motivation, self-efficacy, commitment to abstinence, and self-help involvement
in MI-PC.
5. Secondary objective #3: Test hypotheses concerning effect of additional MI intervention
after initial non-engagement persists through 12 weeks.
Hypothesis 1: A second telephone MI intervention will produce higher rates of subsequent
engagement and less alcohol use than no further MI.
abstinent from all substances, nega¬tive consequences of alcohol use, and HIV high risk
behaviors.
Hypothesis 1: Outcomes on the secondary measures will be better in MI-PC than in MI-IOP.
4. Secondary objective #2: Test hypotheses concerning potential mediators of the predicted
main effect favoring MI-PC over MI-IOP.
Hypothesis 1: The predicted advantage of MI-PC over MI-IOP will be mediated by greater
increases in motivation, self-efficacy, commitment to abstinence, and self-help involvement
in MI-PC.
5. Secondary objective #3: Test hypotheses concerning effect of additional MI intervention
after initial non-engagement persists through 12 weeks.
Hypothesis 1: A second telephone MI intervention will produce higher rates of subsequent
engagement and less alcohol use than no further MI.
Inclusion Criteria:
- meet DSM-IV criteria for lifetime alcohol dependence and have used alcohol in the
prior 6 months;
- be > 18 years of age;
- be judged clinically appropriate for IOP (e.g., no current psychotic disorder or
evidence of severe dementia, and no acute medical problem requiring inpatient
treatment;
- have no regular IV heroin use during the past year;
- have access to a telephone;
- be willing to be randomized and participate in research;
- be required to be metropolitan area residents, and
- be able to provide the name, verified telephone number, and address of at least two
contacts who can provide locator information on the patient during follow-up. We will
include patients with dependence on other substances, provided that they are alcohol
dependent and meet other inclusion criteria.
Exclusion Criteria:
- have a current psychotic disorder (as assessed with the psychotic screen from the
MINI) or evidence of dementia severe enough to prevent participation in outpatient
treatment;
- have acute medical problem requiring immediate inpatient treatment; or
- are currently participating in methadone or other forms of DA treatment, other than
IOP.
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