MATCHING PATIENTS TO TREATMENT FOCUS

大多数治疗结果研究的最新审查者都同意 几乎没有什么结论。在医院接受酒精中毒治疗的人 普通人的结果要比那些没有结果的人好一点。 然而，当前治疗干预措施的稳健性是 有限和改善是暂时的。而且，所有这些 干预措施的效果大致相同(无效)。大多数 解释的结果差异可归因于患者，而不是 而不是治疗因素。在这样的情况下，对更大的 效能正在从心理社会变量转向 生物学。 另一种观点认为，心理社会干预可以 坚固耐用。匹配的假设是适当的 治疗与患者的匹配将显示增强 结果。 这项研究的目的是测试该药的短期和长期疗效。 社区强化方法(CRA)与 个人焦点方法(IFA)，两者都在 部分医院环境下的标准社交学习项目。它是 假设CRA对患者最有效 社会功能较差，而IFA将是最 对心理功能较差的患者有效。它是 进一步假设两者的不同影响 针对心理障碍患者的计划将会减少 随着时间的推移，区别对待对那些 社会功能更加失调的人将会增加。为了测试这些 匹配假说的患者随机分配到这两个 治疗计划将在两年后进行随访 治疗，在四个月后进行随访访谈 间隔，并收集更广泛的信息在一个和 治疗两年后。

Most recent reviewers of treatment outcome research agree on a few conclusions. People receiving alcoholism treatment on the average have outcomes a little better than those who don't. However the robustness of current treatment interventions is limited and improvement is transitory. Moreover, all such interventions are about equally (in) effective. Most of the explained variance in outcomes is attributable to patient, rather than treatment factors. This being so the search for greater efficacy is turning away from psychosocial variables and toward biology. An alternative view is that psychosocial interventioins can be robust and durable. The matching hypothesis is that appropriate matching of treatments to patients will reveal enhanced outcomes. The study aims to test the short and long-term efficacy of the Community Reinforcement Approach (CRA) by comparing it with an Individual Focus Approach (IFA), both administered within a standard social learning program in a partial hospital setting. It is hypothesized that the CRA will be most effective with patients with poorer social functioning, while the IFA will be most effective for patients with poorer psychological functioning. It is further hypothesized that the differential effects of the two programs on psychologically dysfunctional patients will diminish over time, while the differential treatment effects for those who are socially more dysfunctional will increase. To test these matching hypotheses patients randomly assigned to the two treatment programs will be followed up for two years after treatment, conducting follow-up interviews at four month intervals, and gathering more extensive information at one and two years after treatment.