Internal validity of project MATCH treatments: Discriminability and integrity
Internal validity of project MATCH treatments: Discriminability and integrity
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DOI：
10.1037/0022-006x.66.2.290
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发表时间：
1998-04-01
影响因子：
5.9
通讯作者：
Zweben, A
中科院分区：
文献类型：
--
作者：
Carroll, KM;Connors, GJ;Zweben, A
项目匹配（匹配酒精中毒治疗客户异源性）是一个多站点的合作项目，旨在评估患者在酒精中毒治疗的治疗相互作用。为了评估是否可以排除Project MATCH中独立（治疗）变量的内部有效性的主要威胁，我们调查了治疗完整性和可辨别性的几个方面。在这项研究中，1.726酒精依赖的参与者在10个地点被随机分配到3个治疗：认知行为治疗（CBT），动机增强治疗（MET）和12步促进（TSF）。参与者接受门诊治疗，或在更密集的住院或日间医院治疗后接受善后护理。对于研究的门诊和术后护理组，治疗是可区分的，因为治疗师根据手册指南实施每种治疗，很少使用与比较方法相关的技术。受试者接受了高水平的研究治疗暴露，并且获得了MET与2种更强化治疗（CBT和TSF）之间的预期治疗剂量对比。与MET或CBT相比，TSF组的参与者的匿名酗酒者参与率显著较高，而其他非研究治疗的使用率没有差异。治疗的非特异性方面，如治疗师的技巧和治疗联盟的水平在治疗条件下是可比的。
Project MATCH (Matching Alcoholism Treatments to Client Heterogeneity) is a multisite collaborative project designed to evaluate patient-treatment interactions in alcoholism treatment. To evaluate whether major threats to the internal validity of the independent (treatment) variable in Project MATCH could be ruled out, we investigated several aspects of treatment integrity and discriminability. In this study, 1.726 alcohol-dependent participants at 10 sites were randomized to 3 treatments: cognitive-behavioral treatment (CBT), motivational enhancement therapy (MET), and 12-step facilitation (TSF). Participants received treatment either as outpatients or as aftercare following a more intensive inpatient or day hospital treatment. For both the outpatient and aftercare arms of the study, treatments were discriminable in that therapists implemented each of the treatments according to manual guidelines and rarely used techniques associated with comparison approaches. Participants received a high level of exposure to their study treatments, and the intended contrast in treatment dose between MET and the 2 more intensive treatments (CBT and TSF) was obtained. Alcoholics Anonymous involvement was significantly higher for participants assigned to TSF versus MET or CBT, whereas the treatments did not differ in utilization of other nonstudy treatments. Nonspecific aspects of treatment such as therapist skillfulness and level of the therapeutic alliance were comparable across treatment conditions.