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Titolo:
MATCHING ALCOHOLISM TREATMENTS TO CLIENT HETEROGENEITY - PROJECT MATCH POSTTREATMENT DRINKING OUTCOMES
Autore:
ALLEN JP; MATTSON ME; MILLER WR; TONIGAN JS; CONNORS GJ; RYCHTARIK RG; RANDALL CL; ANTON RF; KADDEN RM; LITT M; COONEY NL; DICLEMENTE CC; CARBONARI J; ZWEBEN A; LONGABAUGH RH; STOUT RL; DONOVAN D; BABOR TF; DELBOCA FK; ROUNSAVILLE BJ; CARROLL KM; WIRTZ PW; BAILEY S; BRADY K; CISLER R; HESTER RK; KIVLAHAN DR; NIRENBERG TD; PATE LA; STURGIS E; MUENZ L; CUSHMAN P; FINNEY J; HINGSON R; KLETT J; TOWNSEND M;
Indirizzi:
NIAAA,SCI COMMUN BRANCH,WILLCO BLDG,SUITE 409,6000 EXECUT BLVD BETHESDA MD 20892
Titolo Testata:
Journal of studies on alcohol
fascicolo: 1, volume: 58, anno: 1997,
pagine: 7 - 29
SICI:
0096-882X(1997)58:1<7:MATTCH>2.0.ZU;2-H
Fonte:
ISI
Lingua:
ENG
Soggetto:
CARBOHYDRATE-DEFICIENT TRANSFERRIN; APTITUDE TREATMENT INTERACTION; ADDICTION SEVERITY INDEX; SOCIAL INVESTMENT; COPING SKILLS; THERAPIES; PSYCHOTHERAPY; ORIENTATION; MODELS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Physical, Chemical & Earth Sciences
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
92
Recensione:
Indirizzi per estratti:
Citazione:
J.P. Allen et al., "MATCHING ALCOHOLISM TREATMENTS TO CLIENT HETEROGENEITY - PROJECT MATCH POSTTREATMENT DRINKING OUTCOMES", Journal of studies on alcohol, 58(1), 1997, pp. 7-29

Abstract

Objective: To assess the benefits of matching alcohol dependent clients to three different treatments with reference to a variety of clientattributes. Method: Two parallel but independent randomized clinical trials were conducted, one with alcohol dependent clients receiving outpatient therapy (N = 952; 72% male) and one with clients receiving aftercare therapy following inpatient or day hospital treatment (N=774; 80% male). Clients were randomly assigned to one of three 12-week, manual-guided, individually delivered treatments: Cognitive Behavioral Coping Skills Therapy, Motivational Enhancement Therapy or Twelve-Step Facilitation Therapy. Clients were then monitored over a 1-year posttreatment period. Individual differences in response to treatment were modeled as a latent growth process and evaluated for 10 primary matchingvariables and 16 contrasts specified a priori. The primary outcome measures were percent days abstinent and drinks per drinking day during the 1-year posttreatment period. Results: Clients attended on average two-thirds of treatment sessions offered indicating that substantial amounts of treatment were delivered, and research follow-up rates exceeded 90% of living subjects interviewed at the 1-year posttreatment assessment. Significant and sustained improvements in drinking outcomes were achieved from baseline to 1-year posttreatment by the clients assigned to each of these well-defined and individually delivered psychosocial treatments. There was little difference in outcomes by type of treatment. Only one attribute, psychiatric severity, demonstrated a significant attribute by treatment interaction: In the outpatient study, clients low in psychiatric severity had more abstinent days after 12-step facilitation treatment than after cognitive behavioral therapy. Neither treatment was clearly superior for clients with higher levels of psychiatric severity. Two other attributes showed time-dependent matching effects: motivation among outpatients and meaning-seeking among aftercare clients. Client attributes of motivational readiness, network support for drinking, alcohol involvement gender, psychiatric severityand sociopathy were prognostic of drinking outcomes over time. Conclusions: The findings suggest that psychiatric severity should be considered when assigning clients to outpatient therapies. The lack of otherrobust matching effects suggests that, aside from psychiatric severity, providers need not take these client characteristics into account when triaging clients to one or the other of these three individually delivered treatment approaches, despite their different treatment philosophies.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 05/04/20 alle ore 18:46:46