Network support for drinking, Alcoholics Anonymous and long-term matching effects
Network support for drinking, Alcoholics Anonymous and long-term matching effects
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DOI：
10.1046/j.1360-0443.1998.93913133.x
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发表时间：
1998-09-01
期刊：
影响因子：
6
通讯作者：
Stout, RL
中科院分区：
文献类型：
--
作者：
Longabaugh, R;Wirtz, PW;Stout, RL
目标。(I)检验配对假设，即在治疗3年后，对于具有高度支持饮酒网络的酒精依赖客户，十二步促进疗法（TSF）比动机增强疗法（MET）更有效；(2)检验因果链，为这种效应提供基本原理。设计。门诊患者在治疗3年后再次接受访谈。ANCOVAs测试了匹配假设。设置。来自五个临床研究单位的门诊病人分布在美国各地。参与者：86名酒精依赖者。干预。患者被随机分配到三种为期12周的、人工指导的个体化治疗：TSF、MET或认知行为应对技能疗法（CBT）。测量。治疗前对饮酒的网络支持，治疗期间和治疗后戒酒协会（RA）的参与，37-39个月期间每个饮酒日戒酒天数的百分比。发现。(1)在3年的随访中，TSF比MET对具有饮酒支持网络的客户更有效的先验匹配假设得到支持；(2)嗜酒者涉入是这种效应的部分中介；被分配到TSF的有饮酒支持网络的客户更有可能参与AA；参加嗜酒者互戒会与这类客户3年的饮酒结果有较好的关系。结论。(I)长期而言，TSF可能是具有饮酒支持网络的酒精依赖客户的首选治疗方法；(2)对于那些有饮酒支持网络的客户，无论他们接受何种治疗，都应特别考虑他们是否参加嗜酒者互戒会。
Aims. (I) To examine the matching hypothesis that Twelve Step Facilitation Therapy (TSF) is more effective than Motivational Enhancement Therapy (MET) for alcohol-dependent clients with networks highly supportive of drinking 3 years following treatment; (2) to test a causal chain providing the rationale for this effect. Design. Outpatients were re-interviewed 3 years following treatment. ANCOVAs tested the matching hypothesis. Setting. Outpatients from five clinical research units distributed across the United Scares. Participants: Eight hundred and six alcohol-dependent clients. Intervention. Clients were randomly assigned to one of three 12-week, manually-guided, individual treatments: TSF, MET or Cognitive Behavioral Coping Skills Therapy (CBT). Measurements. Network support for drinking prior to treatment, Alcoholics Anonymous (RA) involvement during and following treatment, percentage of days abstinent and drinks per drinking day during months 37-39. Findings. (I) The a priori matching hypothesis that TSF is more effective than MET for clients with networks supportive of drinking was supported at the 3 year follow-up; (2) AA involvement was a partial mediator of this effect; clients with networks supportive of drinking assigned to TSF were more likely to be involved in AA; AA involvement was associated with better 3-year drinking outcomes far such clients. Conclusions. (I) In the long-term TSF may be the treatment of choice for alcohol-dependent clients with networks supportive of drinking; (2) involvement in AA should be given special consideration for clients with networks supportive of drinking, irrespective of the therapy they will receive.