Building better cognitive-behavioral therapy: Is broad-spectrum treatment more effective than motivational-enhancement therapy for alcohol-dependent patients treated with naltrexone?
Building better cognitive-behavioral therapy: Is broad-spectrum treatment more effective than motivational-enhancement therapy for alcohol-dependent patients treated with naltrexone?
复制标题
DOI：
10.15288/jsad.2007.68.238
复制
发表时间：
2007-03-01
影响因子：
3.4
通讯作者：
Swift, Robert
中科院分区：
文献类型：
--
作者：
Davidson, Dena;Gulliver, Suzy Bird;Swift, Robert
目标：目前的研究调查了治疗效果，在治疗过程中，第二代认知行为疗法的酒精中毒-广谱治疗（BST）-与动机增强疗法（MET）相比，当两者都与治疗剂量的纳洛酮（Revia）结合使用时。方法：149名酒精依赖患者完成了一项为期3个月的随机对照试验，将BST和纳洛酮与MET和纳洛酮进行比较。结果：接受BST的患者有明显高于接受MET的患者的禁欲天数百分比。BST的上级效果在与支持饮酒的相互作用中特别强，这表明BST的优势值得那些心理社会网络支持继续饮酒的患者付出额外费用。当控制戒断天数的预处理百分比时，这种影响仍然显着。结论：总的来说，这些发现表明，这是纳洛酮和BST的组合或BST的独特性质，说明BST的优越性MET和纳洛酮。该试验初始阶段的结果表明，第二代认知行为疗法（如BST）可能比MET等简短干预措施具有有意义的临床优势，至少在与纳洛酮联合使用时是如此。
Objective: The current study investigated the treatment effectiveness, during treatment, of a second-generation cognitive-behavioral therapy for alcoholism-broad-spectrum treatment (BST)-compared with motivational -enhancement therapy (MET), when both were offered in conjunction with a therapeutic dose of naltrexone (Revia). Method: One hundred forty-nine alcohol-dependent patients completed a 3-month randomized, controlled trial of BST and naltrexone versus MET and naltrexone. Results: Patients receiving BST had a significantly higher percentage of days abstinent than patients receiving MET. The superior effect of BST is particularly strong in interaction with support for drinking, suggesting that the advantage of BST is worth the additional cost for patients whose psychosocial networks are supportive of continued drinking. This effect remains significant when controlling for pretreatment percentage of days abstinent. Conclusions: In aggregate, these findings suggest that it is either the combination of naltrexone and BST or the unique properties of BST that account for BST's superiority to MET and naltrexone. The results of this initial phase of the trial suggest that a second-generation cognitive-behavioral therapy such as BST may have a meaningful clinical advantage over brief interventions such as MET, at least when combined with naltrexone.