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较少的治疗更有效，并且CBT治疗通常无法获得应对技能。为了探讨目前手动驱动的CBT交付模式可能不足以成功地教应对技能的可能性，我们提出了一个试点项目，为酒精依赖者制定个性化的评估和认知行为治疗计划（IATP），其中通过随机呼叫手机进行的经验抽样被用来提供数据，以创建个性化的治疗计划。经验采样期间收集的数据将包括对患者饮酒认知、影响和应对行为的瞬时评估。 参与者将是112名符合酒精依赖或酒精滥用标准的男性和女性，他们将被随机分配到一个标准的包装手动驱动的认知行为治疗计划（PCBT），如项目匹配中使用的，或IATP。将要求两种治疗的患者在治疗前两周进行经验采样，并在治疗结束后再进行两周，以比较两组之间治疗前和治疗后应对技能利用的体内测量。在两种治疗中，治疗将进行12次以上。在IATP中，从经验采样中收集的信息将构成监测期间患者饮酒和饮酒冲动的功能分析的基础。 认知评价、情绪和应对反应将作为饮酒行为的前因和后果进行评估。治疗师将使用这些信息来解决适应性和适应不良的特定认知、情感和行为，并与患者合作以替代适应性应对策略。在PCBT中，经验采样数据将不会专门用于治疗，但仍将提供饮酒和应对技能的体内测量。据推测，IATP将产生显着更好的应对技能收购比PCBT，应对技能的变化将预测更好的治疗后的结果IATP。这些结果将对我们提供治疗，以及应对技能培训的有效性酒精成瘾。

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.