Matching alcoholism treatments to client heterogeneity: Treatment main effects and matching effects on drinking during treatment

TitleMatching alcoholism treatments to client heterogeneity: Treatment main effects and matching effects on drinking during treatment
Publication TypeJournal Article
Year of Publication1998
AuthorsProject MATCH Research Group,
JournalJournal of Studies on Alcohol
Date PublishedNov
Publication Languageeng
ISBN Number0096-882X (Print)0096-882X (Linking)
Accession Number9811084
Keywords*Patient Selection, Adaptation, Psychological, Aftercare/standards, Alcoholism/*therapy, Ambulatory Care/standards, Analysis of Variance, Antisocial Personality Disorder/complications, Cognition Disorders/complications, Cognitive Therapy/methods/standards, Female, Follow-Up Studies, Humans, Linear Models, Male, Motivation, Patient Participation, Prognosis, Psychotherapy/methods/*standards, Self-Help Groups/*standards, Severity of Illness Index, Social Support, Temperance/statistics & numerical data, Treatment Outcome

OBJECTIVE: This article examines client drinking and related psychosocial functioning during the course of alcoholism treatment. It focuses on (1) the main effects of the three Project MATCH treatments, (2) the prognostic value of client attributes employed in the matching hypotheses, and (3) the attribute by treatment interaction effects. METHOD: Clients recruited from outpatient settings (n = 952) or from aftercare settings (n = 774) were randomized to one of the following treatments: Motivational Enhancement Therapy (MET), Cognitive Behavioral Therapy (CBT) and Twelve-Step Facilitation (TSF). Alcohol consumption and psychosocial functioning during treatment were assessed at the end of the 12-week treatment phase. RESULTS: During the treatment phase, small but statistically significant differences among treatments were found only in the outpatient arm on measures of alcohol consumption and alcohol-related negative consequences. Forty-one percent (41%) of CBT and TSF clients were abstinent or drank moderately without alcohol-related consequences, compared with 28% of MET clients. Tests of 10 a priori primary client-treatment matching hypotheses failed to find any interaction effects that had an impact on drinking throughout the treatment phase. CONCLUSIONS: In the outpatient setting there appears to be a temporary advantage to assigning individuals to CBT or TSF rather than MET. When there is a need to quickly reduce heavy drinking and alcohol-related consequences, it appears that CBT or TSF should be the treatment of choice.

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