EFFECTIVENESS OF THE COMMUNITY REINFORCEMENT APPROACH

社区强化方法的有效性

• 批准号: 3111331
• 负责人: WILLIAM R. MILLER
• 金额: $ 20.33万
• 依托单位: UNIVERSITY OF NEW MEXICO
• 依托单位国家: 美国
• 财政年份: 1988
• 资助国家: 美国
• 起止时间: 1988-03-01 至 1992-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3111331
• 关键词: alcoholism /alcohol abuse chemotherapy; alcoholism /alcohol abuse prevention; alcoholism /alcohol abuse therapy; culture; disulfiram; human population study; human subject; human therapy evaluation; longitudinal human study; relapse /recurrence; therapy compliance

The proposed study is a randomized clinical trial to assess the effectiveness of two alcoholism treatment interventions first developed and evaluated by Nathan Azrin. The Disulfiram Compliance (DC) intervention involves a supporting and reinforcing "monitor" to ensure patient medication compliance. The Community Reinforcement Approach (CRA) is a broad- spectrum treatment procedure. Both have been found, in Azrin's work, to be substantially superior standard alcoholism treatment methods. The present study will replicate and extend Azrin's research, studying a culturally diverse population treated in a metropolitan public outpatient treatment facility. Disuliram- eligible patients will be assigned randomly to one of four groups: representative "generic" alcoholism treatment with or without the DC component, or the full CRA program with or without disulfiram. In a separate randomization, disulfiram-ineligible patients will be assigned to either generic treatment or CRA (without disulfiram). Methodological improvements over prior CRA research include: (1) extension of follow-up to 3 years; (2) specification of generic treatment components; (3) delivery of generic treatment by therapists committed to this approach; (4) double-blind intake assessment and single-blind follow-up assessment; (5) inclusion of a broader range of pretreatment assesement measures to enable the development of treatment matching schemas; (6) inclusion of a disulfiram-ineligible population and greter cultural diversity; and (7) evaluation of the contribution of disulfirma to the CRA program. CRA procedures are highly compatible with and exportable to traditional alcoholism treatment settings, and show promise of substantially improving overall therapeutic effectiveness, reducing long-term relapse risk and improving health and social functioning of recovering alcoholics.

拟议的研究是一项随机临床试验，旨在评估 首先两种酗酒治疗干预措施的有效性 由 Nathan Azrin 开发和评估。 双硫仑 合规性 (DC) 干预涉及支持和 加强“监控”，确保患者用药依从性。 社区强化方法 (CRA) 是一种广泛的 频谱处理程序。 两者均在阿兹林的 工作，明显优于标准酗酒治疗 方法。 本研究将复制并扩展阿兹林的研究 研究，研究在不同文化背景下接受治疗的不同文化人群 都市公立门诊治疗设施。 双硫仑- 符合条件的患者将被随机分配到四组之一： 具有代表性的“通用”酒精中毒治疗，有或没有 DC 组件，或完整的 CRA 程序（带或不带） 双硫仑。 在单独的随机分组中，双硫仑不符合资格 患者将被分配接受一般治疗或 CRA （不含双硫仑）。 与之前相比方法上的改进 CRA研究包括：（1）延长随访至3年； (2) 通用治疗成分的规范； (3) 交付 由致力于这种方法的治疗师进行一般治疗； (4) 双盲摄入评估和单盲随访 评估; (5) 纳入更广泛的预处理 评估措施以促进治疗的发展 匹配模式； (6) 纳入不符合双硫仑的药物 人口和更大的文化多样性； (7) 评估 disulfirma 对 CRA 计划的贡献。 税务局程序 与传统高度兼容并可导出 酗酒治疗环境，并显示出实质性的希望 提高整体治疗效果，减少长期 复发风险和改善健康和社会功能 戒酒者。