PSYCHOTHERAPY PROCESS IN ALCOHOLISM TREATMENT MATCHING

申请人摘要：患者-治疗匹配效应的最新研究 酒精治疗产生了混合和不确定的结果。 此外，本发明还 心理治疗（例如，认知行为和动机 增强疗法）继续显示大致相同的功效， 尽管不同的理论立场和声称的机制， 变化 该项目的具体目标是确定如何治疗 有效性受到患者特征之间相互作用的影响 和心理治疗的过程。 本研究将利用患者信息的存档数据集， 来自项目MATCH的录像心理治疗，一项随机临床试验， 最初设计用于评价患者-治疗匹配效应的试验 三种社会心理学治疗方法拟议的研究将 补充项目匹配的手动治疗的分析，通过检查 所有治疗中存在的潜在过程。 来自Project MATCH的布朗大学研究单位的168名患者将被 被选中参加这项研究。患者和治疗过程维度， 显示出预测酗酒治疗效果的希望， 从称为系统性的患者-治疗匹配模型中选择 治疗选择（STS）。 项目MATCH数据可以用来测试3个这样的 与STS模型中的假设相匹配。 每个假设都指定理想 患者特征和治疗过程变量之间的关系。 关注的3个患者属性将是：（1）情绪困扰，（2） 外化应对方式;（3）心理抗拒。 对于这些患者属性中的每一个，STS模型指定治疗 这将导致最佳结果的过程。 3对应疗法 过程变量将是治疗师干预的程度 每个患者（1）尝试增加或减少患者的情绪唤醒， 水平，（2）是洞察力或行为集中，（3）是指导性或 非指令性的 STS治疗将测量治疗的这些方面 评级表，将由两名经过培训的观察员在4个选定的 为每一位患者提供治疗。每一层之间的关系 患者-治疗相互作用（例如，病人的反应和方向性 治疗干预）和酒精使用结果将在 治疗后3个月和1年随访。 这项研究将揭示有关剪裁重要性的新信息 治疗师干预寻求治疗酗酒的患者。 等 信息将大大提高酒精中毒治疗的效果。

APPLICANT'S ABSTRACT: Recent research on patient-treatment matching effects in alcohol treatment has produced mixed and inconclusive results. Further, psychotherapy treatments (e.g., cognitive behavioral and motivational enhancement therapies) continue to demonstrate roughly equivalent efficacy, despite different theoretical stances and purported mechanisms of patient change. The specific objective of this project is to identify how treatment effectiveness is impacted by the interaction between patient characteristics and the process of psychotherapy. This study will utilize an archival data set of patient information and videotaped psychotherapy treatment from Project MATCH, a randomized clinical trial originally designed to evaluate patient-treatment matching effects across 3 psychosocial treatments for alcoholism. The proposed research will compliment Project MATCH's analyses of manualized treatments by examining underlying processes present in all of the treatments. The 168 patients from Project MATCH's Brown University research unit will be selected for this study. Patient and therapy process dimensions that have shown promise for predicting the effectiveness of alcoholism treatment will be selected from a model of patient-treatment matching called Systematic Treatment Selection (STS). Project MATCH data can be used to test 3 such matching hypotheses from the STS model. Each hypothesis specifies ideal relationships between a patient characteristic and a therapy process variable. The 3 patient attributes of focus will be: (1) emotional distress, (2) an externalizing coping style, and (3) psychological reactance. For each of these patient attributes, the STS model specifies treatment processes that will result in optimal outcomes. The 3 corresponding therapy process variables will be the extent to which therapist interventions with each patient (1) attempt to increase or decrease a patient's emotional arousal level, (2) are insight or behavior focused, and (3) are directive or non-directive. These aspects of therapy will be measured by the STS Therapy Rating Scale, which will be completed by two trained observers on 4 selected therapy sessions for each patient. The relationship between each patient-therapy interaction (e.g., patient reactance and the directiveness of therapy interventions) and alcohol use outcomes will be assessed at the three-month and one year post-treatment follow-ups. This study will reveal new information about the importance of tailoring therapist interventions to patients seeking treatment for alcoholism. Such information will significantly enhance alcoholism treatment effectiveness.