MATCHING PATIENTS TO TREATMENT FOCUS

最近的治疗结果研究的评论者同意 几个结论。 接受酒精中毒治疗的人 平均水平的人比那些没有的人有更好的结果。 然而，目前治疗干预的稳健性 有限，改善是暂时的。 此外，所有这些 干预措施的效果大致相同。 大部分 结果的解释差异可归因于患者， 治疗因素。 因此，寻求更大的 效能感正在从社会心理变量转向 生物学 另一种观点认为，心理社会干预可以 坚固耐用。 匹配的假设是， 对患者的治疗匹配将显示出增强的 结果。 这项研究旨在测试短期和长期的疗效， 社区强化方法（CRA），通过与 一个单独的重点方法（IFA），都在一个 在部分医院环境中的标准社会学习计划。 是 假设CRA对患者最有效 社会功能较差，而IFA将是最 对心理功能较差的患者有效。 是 进一步假设，这两个不同的影响， 针对心理障碍患者的项目将减少 随着时间的推移，虽然差别待遇对那些 社会功能失调的人会增加。 测试这些 匹配假设患者随机分配到两个 治疗计划将随访两年 治疗，在四个月时进行随访 时间间隔，并收集更广泛的信息， 治疗后两年。

Most recent reviewers of treatment outcome research agree on a few conclusions. People receiving alcoholism treatment on the average have outcomes a little better than those who don't. However the robustness of current treatment interventions is limited and improvement is transitory. Moreover, all such interventions are about equally (in) effective. Most of the explained variance in outcomes is attributable to patient, rather than treatment factors. This being so the search for greater efficacy is turning away from psychosocial variables and toward biology. An alternative view is that psychosocial interventioins can be robust and durable. The matching hypothesis is that appropriate matching of treatments to patients will reveal enhanced outcomes. The study aims to test the short and long-term efficacy of the Community Reinforcement Approach (CRA) by comparing it with an Individual Focus Approach (IFA), both administered within a standard social learning program in a partial hospital setting. It is hypothesized that the CRA will be most effective with patients with poorer social functioning, while the IFA will be most effective for patients with poorer psychological functioning. It is further hypothesized that the differential effects of the two programs on psychologically dysfunctional patients will diminish over time, while the differential treatment effects for those who are socially more dysfunctional will increase. To test these matching hypotheses patients randomly assigned to the two treatment programs will be followed up for two years after treatment, conducting follow-up interviews at four month intervals, and gathering more extensive information at one and two years after treatment.