Within- and Post-Session Change Mechanisms in Treatment for Alcohol Use Disorders

酒精使用障碍治疗中和治疗后的改变机制

• 批准号: 7786429
• 负责人: Molly Magill
• 金额: $ 13.77万
• 依托单位: BROWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-05-01 至 2015-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7786429
• 关键词: Affect; Aftercare; Alcohol abuse; Alcohol consumption; Alcohol or Other Drugs use; Alcohols; Area; Behavior; Behavioral; Belief; Categories; Characteristics; Client; Clinical; Clinical Research; Clinical Trials; Code; Cognitive Therapy; Consultations; Coping Behavior; Data; Dependence; Development; Diagnostic; Dimensions; Distal; Doctor of Philosophy; Effectiveness; Elements; Equation; Extramural Activities; Foundations; Future; Goals; Heterogeneity; Intervention; Knowledge; Language; Lead; Literature; Measurement; Mediating; Mediation; Mentored Patient-Oriented Research Career Development Award; Mentors; Mentorship; Meta-Analysis; Methods; Modeling; Mollies; Motivation; National Institute on Alcohol Abuse and Alcoholism; Outcome; Pathway interactions; Process; Psychotherapy; Public Health; Research; Research Proposals; Research Support; Research Training; Sampling; Science; Scientist; Self Efficacy; Seminal; Social Workers; Specific qualifier value; Substance Addiction; Testing; Therapeutic; Training; Training Activity; Translations; Treatment Factor; Treatment outcome; Universities; addiction; alcohol abuse therapy; alcohol intervention; alcohol use disorder; behavior change; career; case finding; clinical practice; common treatment; coping; cost; design; drinking; drinking behavior; experience; follow-up; improved; knowledge base; motivational enhancement therapy; novel; psychosocial; public health relevance; skills

DESCRIPTION (provided by applicant): The goal of this proposal is to prepare the candidate, Molly Magill, Ph.D., for a career as an independent clinical scientist specializing in the study of mechanisms of behavior change in psychosocial treatment for alcohol use disorders. Dr. Magill is a clinical social worker who has focused her career on substance use treatment at the level of science and practice. The candidate's experiences to date have led to a belief that research on change mechanisms can enhance the knowledge that is gained from clinical trials research. This is the case for findings of treatment outcome equivalence or difference. Such information can lead to greater treatment efficiency by identifying common treatment factors, treatment-specific ingredients, and thus, dissemination priorities. Dr. Magill has a beginning foundation in this area of research, but there are important gaps in her academic and research training. With advanced training in: (1) the design of change process research with an emphasis on observational measurement development and (2) the statistical analysis of change mechanisms with an emphasis on longitudinal methods, Dr. Magill will contribute to this area of study and to the improvement of psychosocial treatment for alcohol use disorders. The proposed Training Plan will occur at the Brown University Center for Alcohol and Addiction Studies under the mentorship of Dr. Robert Stout, with co-mentorship provided by Dr. Richard Longabaugh and Dr. Timothy Apodaca and consultation provided by Dr. Kathleen Carroll and Dr. Carlo DiClemente. The proposed Research Plan will directly apply skills that arise from training activities. Specifically, it will employ observational coding methods on longitudinal Project MATCH session data to inform knowledge of within-treatment mechanisms in aftercare for alcohol use disorders. The proposed Primary Aims will examine the construct of behavior change language (statements of commitment, ability, taking steps) with two novel sub-dimensions (regarding drinking, regarding coping) that are expected to be particularly useful for modeling common factor hypotheses about client post-session proximal and distal change behavior. The proposed Secondary Aims will draw from the general psychotherapy and addictions literature to examine two therapist common factor predictors (support of client self-efficacy, skills focus) of client mechanisms. The proposed Research Plan is well integrated with the proposed Training Goals, it has the potential to inform clinical practice, and it will ground subsequent research on common factors of client proximal and distal behavior change in treatment for alcohol use disorders. PUBLIC HEALTH RELEVANCE: Alcohol use is a substantial public health issue that has resulted in countless societal and familial costs. Research on change process mechanisms can improve our understanding of how to best treat alcohol problems. Findings from the proposed research will not only inform future methods in this area of study, but will also provide data on predictors of client change that cut across three established treatments for alcohol abuse and dependence.

描述（由申请人提供）：本提案的目标是准备候选人，莫莉马吉尔，博士，作为一名独立的临床科学家，专门研究酒精使用障碍的心理社会治疗中的行为改变机制。马吉尔博士是一名临床社会工作者，她的职业生涯主要集中在科学和实践层面的物质使用治疗上。候选人迄今为止的经验使他们相信，对变化机制的研究可以增强从临床试验研究中获得的知识。这是治疗结果等效性或差异的结果。这些信息可以通过确定共同的治疗因素、治疗特定成分，从而确定传播优先事项，提高治疗效率。马吉尔博士在这一研究领域有一个开始的基础，但在她的学术和研究培训方面有重要的差距。受过以下方面的高级培训：（1）变化过程研究的设计，重点是观察测量的发展和（2）变化机制的统计分析，重点是纵向方法，马吉尔博士将有助于这一领域的研究和改善酒精使用障碍的心理社会治疗。拟议的培训计划将在罗伯特·斯托特博士的指导下在布朗大学酒精和成瘾研究中心进行，由理查德·朗格博博士和蒂莫西·阿波达卡博士共同指导，由凯瑟琳·卡罗尔博士和卡洛·迪克莱门特博士提供咨询。拟议的研究计划将直接应用培训活动中产生的技能。具体而言，它将采用纵向项目匹配会话数据的观察编码方法，以告知酒精使用障碍善后治疗中的治疗机制的知识。拟议的主要目标将研究行为改变语言（承诺，能力，采取措施的声明）的结构与两个新的子维度（关于饮酒，关于应对），预计将特别有用的建模共同因素假设客户端会话后近端和远端的变化行为。拟议的次要目标将借鉴一般心理治疗和成瘾文献，以检查两个治疗师的共同因素预测（支持客户的自我效能，技能的重点）的客户端机制。拟议的研究计划与拟议的培训目标很好地结合在一起，它有可能为临床实践提供信息，并将为后续研究奠定基础，研究酒精使用障碍治疗中客户近端和远端行为变化的常见因素。 酒精使用是一个重大的公共卫生问题，导致了无数的社会和家庭成本。对改变过程机制的研究可以提高我们对如何最好地治疗酒精问题的理解。拟议研究的结果不仅将为这一研究领域的未来方法提供信息，而且还将提供关于客户变化预测因素的数据，这些预测因素涉及三种既定的酒精滥用和依赖治疗方法。