CBT by Phone to Promote Use of Alcohol Related Care and Reduce Drinking

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Abstract Numerous evidence based treatments for alcohol use disorder (AUD) have been developed, and research shows that individuals who obtain alcohol specialty care have improved drinking outcomes and are more likely to recover, yet a small percentage of individuals with AUD obtain treatment. Use of Screening, Brief Intervention, and Referral to Treatment (SBIRT) interventions is a potential strategy to increase treatment seeking, yet there is little evidence that these interventions increase participation in alcohol-related care and a lack of evidence that such care serves as a mechanism for improved drinking outcomes. The current randomized controlled trial (RCT) of a one session intervention delivered by telephone seeks to address these gaps in evidence. The specific aims are to show that research volunteers ages 18 and older with AUD who are assigned to the intervention compared to an information control condition are more likely to initiate alcohol specialty care (aim 1), have decreased frequency of alcohol use (as measured by percent days abstinent) and intensity of alcohol use (as measured by drinks per drinking day) (aim 2), and that treatment engagement serves as a mediator of the improved drinking outcomes (aim 3). Innovations include the use of an SBIRT intervention based on the theory of planned behavior and cognitive behavioral treatment principles and that the intervention was developed for phone administration from the onset and was explicitly designed to promote treatment engagement. The project is in response to PA-15-299, Alcohol Use Disorders: Behavioral Treatment, Services, and Recovery Research. It builds on a smaller efficacy trial that showed that the intervention leads to increased engagement in alcohol-related care (Stecker et al., 2012) and extends that study in several ways including through the use of a priori tests to determine efficacy of the intervention to improve drinking outcomes and that treatment engagement serves as a mediator of the improved outcomes.