Mechanisms of Change: Alcohol Behavioral Couple Therapy

改变机制：酒精行为夫妻疗法

• 批准号: 8308538
• 负责人: BARBARA S MCCRADY
• 金额: $ 31.11万
• 依托单位: UNIVERSITY OF NEW MEXICO
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-08-10 至 2014-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8308538
• 关键词: Abstinence; Address; Aftercare; Alcohol consumption; Alcohols; Audiotape; Behavior; Behavioral; Characteristics; Code; Cognitive Therapy; Communication; Communities; Couples; Couples Therapy; Data; Databases; Development; Distress; Effectiveness; Elements; Family; Family member; Female; Foundations; Gender; Goals; Health Personnel; Individual; Intervention; Knowledge; Lead; Learning; Link; Modeling; National Institute on Alcohol Abuse and Alcoholism; Outcome; Outpatients; Patients; Principal Investigator; Randomized Clinical Trials; Recovery; Research; Series; Social support; Societies; System; Testing; Theoretical model; Treatment outcome; alcohol abuse therapy; alcohol use disorder; alcoholism therapy; behavior change; compliance behavior; coping; design; drinking; drinking behavior; effective therapy; follow-up; improved; induced pluripotent stem cell; male; motivational enhancement therapy; programs; public health relevance; satisfaction; sex; skills

DESCRIPTION (provided by applicant): Social support is an important factor in recovery from alcohol use disorders (AUDs). In particular, involving a concerned significant other (CSO) in treatment, leads to more positive outcomes. A specific form of CSO-involved treatment, Alcohol Behavioral Couple Therapy (ABCT), has strong empirical support for its efficacy. Little is known, however, about how and why ABCT leads to better outcomes of treatment. The overall objective of the proposed study is to better understand the mechanisms by which CSO-involved treatment is effective. Study aims are: (1) To see if CSO and dyadic behaviors at the beginning of ABCT predict Identified Patient (IP) drinking during treatment; (2) To see if CSO and dyadic behaviors change during ABCT; (3) To see if changes in CSO and dyadic behavior are associated with changes in IP drinking behavior during treatment; (4) To see if changes in CSO and dyadic behavior during treatment predict post-treatment IP drinking; (5)To see whether therapist behaviors predict drinking outcomes; (6) To test the effects of pretreatment and within treatments variables, including IP sex, baseline relationship functioning, and treatment compliance (attendance and homework) on treatment outcome. To accomplish these aims, existing audiotapes of 186 first session and 136 mid- treatment sessions from four randomized clinical trials of ABCT will be coded. Additional data on IP, CSO, and couple baseline characteristics, and within treatment and one-year follow-up data are available for all studies. Tapes will be coded using the Motivational Interviewing with Significant Others coding system to rate CSO and couple-level behavior; and the Treatment Integrity Rating System for ABCT to code therapist behavior. Results should contribute to improved treatment for patients with AUDS by: (1) providing information to clinicians to identify particularly positive or toxic behaviors at the start of treatment that would guide decisions about CSO-involvement in later sessions; and (2) providing information to clinicians about behaviors to target in CSO-involved treatment to maximize positive outcomes. PUBLIC HEALTH RELEVANCE: Alcohol use disorders exact a toll on the individual, family, and society. Development of more effective treatments is an important research goal. One promising approach is to involving family members in treatment - research consistently shows that family involvement leads to better outcomes. The proposed research is designed to provide better knowledge about of why family involvement is helpful in treatment, knowledge that should help clinicians to be more effective when families are involved in alcoholism treatment.

描述（由申请人提供）：社会支持是酒精使用障碍（AUD）恢复的重要因素。特别是，让一个关心的重要他人（CSO）参与治疗，会带来更积极的结果。一种特殊形式的民间社会组织参与的治疗，酒精行为夫妇治疗（ABCT），有很强的经验支持其疗效。然而，关于ABCT如何以及为什么会导致更好的治疗结果，我们知之甚少。拟议研究的总体目标是更好地了解民间社会组织参与的治疗有效的机制。研究目的是：（1）观察在ABCT开始时的CSO和二元行为是否预测治疗期间的已识别患者（IP）饮酒;（2）观察在ABCT期间CSO和二元行为是否改变;（3）观察在治疗期间CSO和二元行为的改变是否与IP饮酒行为的改变相关;（4）观察在治疗期间CSO和二元行为的改变是否预测治疗后IP饮酒;（5）观察治疗师行为是否能预测饮酒结果;（6）测试治疗前和治疗内变量（包括IP性别、基线关系功能和治疗依从性（出勤和家庭作业））对治疗结果的影响。为了实现这些目标，将对来自四项ABCT随机临床试验的186个第一次治疗和136个治疗中期治疗的现有录音带进行编码。所有研究均提供了关于IP、CSO和夫妇基线特征的其他数据，以及治疗内和1年随访数据。将使用与重要他人的动机访谈编码系统对录音进行编码，以评价CSO和夫妻行为;并使用ABCT治疗完整性评级系统对治疗师行为进行编码。研究结果应有助于改善AUDS患者的治疗：（1）为临床医生提供信息，以在治疗开始时识别特别积极或有毒的行为，这将指导在以后的会议中有关CSO参与的决定;（2）为临床医生提供有关CSO参与治疗的目标行为的信息，以最大限度地提高积极结果。 公共卫生相关性：酒精使用障碍对个人、家庭和社会造成损害。开发更有效的治疗方法是一个重要的研究目标。一个有希望的方法是让家庭成员参与治疗----研究一致表明，家庭参与会带来更好的结果。这项拟议的研究旨在更好地了解为什么家庭参与有助于治疗，这些知识应该有助于临床医生在家庭参与酒精中毒治疗时更有效。