Adapting Alcohol Behavioral Couple Therapy for Service Members in Post-Deployment

对部署后的服役人员进行酒精行为夫妻治疗

• 批准号: 9041242
• 负责人: Elizabeth Ellen Epstein
• 金额: $ 19.14万
• 依托单位: UNIV OF MASSACHUSETTS MED SCH WORCESTER
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-05-15 至 2017-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9041242
• 关键词: Adapting; Alcohol; Behavioral; Couple; Therapy

DESCRIPTION (provided by applicant): This R34 proposal, "Adapting Alcohol Behavioral Couple Therapy for Service Members in Post-Deployment," in response to PA-13-078, "Behavioral & Integrative Treatment Development Program," seeks to adapt and test a well-established civilian Alcohol Behavioral Couple Therapy (ABCT) approach (McCrady & Epstein, 2009) to meet the unique needs and challenges facing returning service members from Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF), and Operation New Dawn (OND). Among the two million personnel who have served in OIF/OEF/OND, up to 38% report alcohol problems, 50% report marital violence, 25% suffer from depression and/or thoughts of suicide, 31% have Post Traumatic Stress Disorder (PTSD), and 19-22% have Traumatic Brain Injury (TBI). For the 65% of solders re-integrating into marital relationships, these alcohol and related problems are associated with significant discord. Our proposed manual-guided treatment protocol, ABCT_Military, will deliver our existing core sets of (a) abstinence-based, alcohol-related interventions, and (b) couple interventions, but with adaptations in content, illustration, and delivery, to make the treatment palatable and relevant to post-deployment service members. Four new optional modules will be developed to address issues exacerbated by and aggravating problem drinking among soldiers and their families following return from theater; the modules are designed to help couples cope with symptoms of: 1. Intimate Partner Violence; 2. Depression; 3. PTSD, and 4.TBI. Specific Aims in the current proposal are: (1)To modify our existing, ABCT_civilian model to treat soldiers in post deployment, and develop optional content modules to address relevant co-morbid challenges in this population in a 15 session outpatient format; (2) To test feasibility and preliminary efficacy of the treatment protocol using a Stage 1a successive cohort design, and (3) To complete a Stage 1b small Randomized Controlled Trial (RCT) comparing Treatment as Usual (TAU) to TAU+ABCT_Military. To achieve these aims, male and female OIF/OEF/OND service members who are in post-deployment or separated from active service, are drinking excessively, and are married or in a committed relationship with a partner willing to participate in the treatment, will be recruited through the Massachusetts Statewide Advocacy for Veterans' Empowerment (SAVE) program, which provides referrals to over 700 service men and women annually across all branches of the military. After manual development and iterative testing on two cohorts of 6 couples each (Stage 1a), 44 couples in the small RCT (stage 1b) will be randomly assigned to either TAU (n=22 couples) or TAU + ABCT_Military (n=22 couples), then will complete a follow up interview post treatment. The

描述（由申请人提供）：该R34建议，“适应寄生后服务成员的酒精行为夫妇疗法”，响应PA-13-078，“行为和综合治疗开发计划”，试图适应和测试良好的平民酒精行为疗法（ABCT和EPSTEIN），并挑战独特的自由，并挑战独特的自由，以满足独特的自由，以与2009年相遇，以便以2009年的挑战，以便以2009年的挑战，以便以下情况（OEF），伊拉克自由行动（OIF）和新黎明行动（OND）。在曾在OIF/OEF/OND任职的200万工作人员中，高达38％的人报告酒精问题，50％的人报告婚姻暴力，25％患有抑郁症和/或自杀念头，31％的人患有创伤后应激障碍（PTSD），而19-22％的人患有创伤性脑损伤（TBI）。对于65％的焊料重新整合到婚姻关系中，这些酒精和相关问题与明显的不和谐有关。我们提出的手动指导治疗方案ABCT_MILITAIL将提供我们现有的（a）基于禁欲的，与酒精相关的干预措施以及（b）夫妇干预措施的核心集，但要适应内容，插图和交付，以使治疗可口且与后部署后服务成员相关。将开发四个新的可选模块，以解决从剧院返回后士兵及其家人中饮酒加剧并加剧问题的问题；这些模块旨在帮助夫妻应对以下症状：1。亲密伴侣暴力； 2。抑郁； 3。PTSD和4.TBI。当前建议中的具体目的是：（1）修改我们现有的ABCT_CIVIVILIAN模型，以治疗部署后的士兵，并开发可选的内容模块，以应对15个会话门诊格式中相关的合并挑战； （2）使用第1A期连续的队列设计测试治疗方案的可行性和初步疗效，（3）完成了1B阶段的1B小型随机对照试验（RCT），将治疗与往常（TAU）与TAU+ABCT_MILTALITY进行比较。为了实现这些目标，在部署后或与积极服务分开的男女OIF/OEF/OEF/OND服务成员过度饮酒，已婚或与愿意参加治疗的伴侣建立了坚定的关系， 可以通过马萨诸塞州全州倡导退伍军人的授权（Save）计划招募，该计划每年在军方所有分支机构中每年向700多名服务男女推荐。在对两组6对夫妇（第1A阶段）进行手动开发和迭代测试之后，小RCT（第1B期）中的44对夫妇将随机分配给TAU（n = 22对夫妇）或Tau + Abct_miltartion（N = 22个夫妻），然后将完成治疗后的后续访谈。这