Individualized Assessment and Treatment for Alcoholism

描述（由申请人提供）：尽管认知行为治疗（CBT）在物质使用障碍中很受欢迎，但最近的研究结果表明，CBT可能并不比其他理论驱动的治疗更有效，并且CBT治疗通常不能导致应对技能的习得。为了探索当前手工驱动的CBT交付模式是否足以成功地教授应对技能的可能性，我们提出了一个针对酒精依赖者的个性化评估和认知行为治疗项目（IATP）的试点项目，其中通过随机拨打手机进行经验抽样，为创建个性化治疗计划提供数据。在经验抽样期间收集的数据将包括对患者饮酒的认知、影响和应对行为的瞬间评估。

DESCRIPTION (provided by applicant): Despite the popularity of Cognitive-Behavioral Treatment (CBT) in substance use disorders, recent findings have indicated that CBT may be no more effective than other, less theoretically driven, treatments, and that CBT treatments often fail to result in coping skills acquisition. In order to explore the possibility that current manual-driven modes of CBT delivery may not be adequate to successfully teach coping skills, we are proposing a pilot project for the development of an individualized assessment and cognitive-behavioral treatment program (IATP) for alcohol-dependent persons, in which experience sampling conducted via random calls to cell-phones is used to provide data to create individualized treatment plans. Data collected during experience sampling will include momentary assessments of patients' cognitions, affects, and coping behaviors with respect to drinking. Participants will be 112 men and women meeting criteria for alcohol dependence or alcohol abuse, who will be randomly assigned to either a standard packaged manual-driven cognitive-behavioral treatment program (PCBT) like that used in Project MATCH, or to IATP. Patients in both treatments will be asked to engage in experience sampling for two weeks prior to treatment, and for another two weeks after treatment has ended, in order to compare in-vivo measures of coping skills utilization, pre- and post treatment, between the two groups. Therapy will be conducted over 12 sessions in both treatments. In IATP, the information gathered from experience sampling will form the basis of a functional analysis of patients' drinking and drinking urges during the monitoring period. Cognitive appraisals, moods and coping responses will be evaluated as antecedents and consequences of drinking behavior. Therapists will use the information to address specific cognitions, affects, and behaviors that are adaptive and maladaptive, and will work with the patient to substitute adaptive coping tactics instead. In PCBT the experience sampling data will not be specifically used in therapy, but will still provide in-vivo measures of drinking and coping skills. It is hypothesized that IATP will yield significantly better coping skills acquisition than will PCBT, and that change in coping skills will predict better post treatment outcomes for IATP. These results would have implications for our delivery of treatment, and for the validity of coping skills training for alcohol addiction.