Therapeutic Alliance as a Change Mechanism in Alcoholism Treatment

治疗联盟作为酒精中毒治疗的变革机制

• 批准号: 7341025
• 负责人: GERARD J CONNORS
• 金额: $ 26.75万
• 依托单位: STATE UNIVERSITY OF NEW YORK AT BUFFALO
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-08-10 至 2009-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7341025
• 关键词: Alcohol dependence; Alcohols; Attitude; Classification; Clinical; Clinical Trials; Data; Development; Dichlorodiphenyldichloroethane; Effectiveness; Emotional Bonds; Evaluation; Foundations; Future; Goals; Individual; Knowledge; Operative Surgical Procedures; Outcome; Outpatients; Participant; Patient Self-Report; Patients; Pattern; Positioning Attribute; Rate; Research; Schedule; Specific qualifier value; Techniques; Therapeutic; TimeLine; Treatment Protocols; Week; alcohol abuse therapy; alcohol misuse; alcohol use disorder; base; behavior change; day; drinking; follow-up; theories; treatment program

DESCRIPTION (provided by applicant): Several distinctive treatments for alcohol use disorders (AUDs) are available that have a supporting empirical foundation, suggesting the operation of one or more common factors that are curative, even though they are not apparently emphasized by the theory of change underlying a particular treatment. In seeking to identify and specify common underlying mechanisms of change, this developmental/exploratory application focuses on the therapeutic alliance between the patient and therapist, a mechanism with considerable potential for furthering our understanding of how behavior change occurs. In this context, the therapeutic alliance represents a collaborative relationship that consists of an emotional bond and shared attitudes regarding the tasks and goals of the treatment endeavor. The participants will be 72 alcohol dependent patients entering a 12-week outpatient alcoholism treatment program. Assessments of the therapeutic alliance and alcohol involvement since the previous treatment session, based on patient self-reports, will be conducted after each treatment session. Assessment of the therapeutic alliance will be gathered from the therapist as well. In this way, a continuous timeline of the therapeutic alliance (assessed from the view of both the patient and therapist) and the patient's alcohol involvement will be available for analysis. In addition, comprehensive research assessments will be conducted with patients at baseline, end of treatment, and 3- and 6-months posttreatment. The project's specific aims are two-fold. The first aim is to examine the within-treatment week-to-week relationship between ratings of the therapeutic alliance (as perceived by the patient and therapist) and alcohol involvement (operationalized as percent days abstinent {PDA} and drinks per drinking day {DDD}) during treatment. The second aim is to examine profiles of the therapeutic alliance (as rated by the patient and therapist) over the course of treatment in relation to alcohol involvement during treatment and during the 6-month follow-up period. The results of these analyses will be used to characterize the interplay of the therapeutic alliance with alcohol involvement during and following an outpatient treatment episode. It is anticipated that the data to be gathered in this project will provide direction and foundation for additional systematic research on the therapeutic alliance as a mechanism of change in AUD treatment.The annual societal and personal consequences associated with alcohol misuse are profound. This study is intended to advance knowledge about the mechanisms of change common to effective treatments for alcohol use disorders. Future research then will be in a position to evaluate whether or how the therapeutic alliance can be mobilized to enhance behavior change.

描述（由申请人提供）：针对酒精使用障碍（AUD）有几种独特的治疗方法，它们具有支持性的经验基础，表明一个或多个具有治疗作用的常见因素的作用，尽管特定治疗背后的变化理论并未明显强调这些因素。在寻求识别和明确共同的潜在变化机制时，这种发展/探索性应用侧重于患者和治疗师之间的治疗联盟，这是一种具有巨大潜力的机制，可以进一步加深我们对行为变化如何发生的理解。在这种情况下，治疗联盟代表了一种协作关系，由情感纽带和对治疗工作的任务和目标的共同态度组成。参与者将是 72 名酒精依赖患者，他们将参加为期 12 周的门诊酒精中毒治疗计划。每次治疗结束后，将根据患者的自我报告对自上次治疗以来的治疗联盟和酒精参与情况进行评估。对治疗联盟的评估也将从治疗师那里收集。通过这种方式，治疗联盟的连续时间线（从患者和治疗师的角度进行评估）和患者的酒精参与情况将可供分析。此外，还将在基线、治疗结束以及治疗后 3 个月和 6 个月时对患者进行全面的研究评估。该项目的具体目标有两个。第一个目标是检查治疗期间治疗联盟评级（患者和治疗师所感知的）与酒精参与度（以戒酒百分比天数 {PDA} 和每个饮酒日饮酒量 {DDD} 表示）之间的每周关系。第二个目标是检查治疗过程中治疗联盟的概况（由患者和治疗师评分）与治疗期间和 6 个月随访期间的酒精参与相关。这些分析的结果将用于表征门诊治疗期间和之后治疗联盟与酒精参与的相互作用。预计该项目收集的数据将为治疗联盟作为 AUD 治疗变化机制的进一步系统研究提供方向和基础。每年与酒精滥用相关的社会和个人后果是深远的。这项研究旨在增进对酒精使用障碍有效治疗常见变化机制的了解。未来的研究将能够评估是否或如何动员治疗联盟来促进行为改变。