Enhancing Therapeutic Alliances in Alcoholism Treatment

加强酒精中毒治疗的治疗联盟

• 批准号: 8233818
• 负责人: GERARD J CONNORS
• 金额: $ 62.04万
• 依托单位: STATE UNIVERSITY OF NEW YORK AT BUFFALO
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-04-01 至 2016-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8233818
• 关键词: Aftercare; Alcohol dependence; Alcohols; Clinical; Code; Development; Equipment and supply inventories; Evaluation; Feedback; Goals; Health Benefit; Individual; Knowledge; Measures; Mediator of activation protein; Methods; Outcome; Outpatients; Participant; Patients; Perception; Persons; Process; Relative (related person); Reporting; Research; Research Personnel; Services; Structure; System; Techniques; Technology; Testing; Therapeutic; Time; Training; Treatment Protocols; Treatment outcome; Work; addiction; alcohol abuse therapy; alcohol involvement; alcohol misuse; alcohol use disorder; alcoholism therapy; base; behavior change; community setting; drinking; effective therapy; follow-up; improved; innovation; treatment duration

DESCRIPTION (provided by applicant): The establishment of a therapeutic alliance between the patient and therapist is generally viewed as a central component of the behavior change process in the treatment of alcohol use disorders (AUDs). However, the majority of research serving as the basis for this conclusion has been descriptive. At this juncture, a transformative, next-step awaits the field - specifically, the development and evaluation of a contemporaneous, session by session feedback and guidance system for enhancing the therapeutic alliance in the service of improving treatment process and, ultimately, outcomes. In the proposed study, the participants will be alcohol dependent patients entering outpatient AUD treatment. Each will participate in a structured, 12- week treatment regimen of weekly individual treatment sessions. After each session, patients will complete the short form of the Working Alliance Inventory (WAI), which measures patients' perceptions of the therapeutic alliance. Two treatment conditions will be evaluated. In the experimental condition, feedback and guidance regarding the patient's reports on the therapeutic alliance will be provided to the therapist following each treatment session attended (Feedback condition). The feedback specifically will entail descriptive information on the patient's perceptions of the alliance as well as techniques and strategies that could be used by the therapist in service of enhancing the alliance or maintaining already strong alliances. In the "usual treatment" condition, no feedback on the therapeutic alliance will be provided to the therapist (No Feedback condition). Comprehensive research assessments will be conducted with patients at baseline, end of treatment, and at 3-, 6-, 9-, and 12-months post-treatment. The project's specific aims are three-fold. The first aim is to test the effects of providing feedback and guidance to therapists regarding patient perceptions of the therapeutic alliance on overall, patient-provided therapeutic alliance scores (averaged across treatment sessions attended during the 12-week treatment regimen). The second aim is to test the effects of providing feedback and guidance to therapists regarding patient perceptions of the therapeutic alliance on alcohol involvement (operationalized as percent days abstinent and drinks per drinking day) (a) during the treatment period and (b) during the 12-month follow-up period. The third aim is to test overall, patient-provided therapeutic alliance scores (averaged across treatment sessions attended during the 12-week treatment regimen) as a mediator of the proposed relationship between Feedback condition and alcohol involvement during the 12-month follow-up period. Positive results associated with providing therapists with feedback on patient perceptions of the therapeutic alliance would represent an important advance for the field. Furthermore, there would be direct transportability of the feedback technology being evaluated in this study to community settings. PUBLIC HEALTH RELEVANCE: The annual societal and personal consequences associated with alcohol misuse are profound. This study is intended to advance knowledge on strategies for enhancing the therapeutic alliance between the patient and therapist, which is anticipated to improve treatment outcomes.

描述（由申请人提供）：患者和治疗师之间建立治疗联盟通常被视为酒精使用障碍（AUD）治疗中行为改变过程的核心组成部分。然而，作为这一结论基础的大多数研究都是描述性的。在这个关头，该领域需要采取变革性的下一步——具体来说，开发和评估一个同步的、逐个会议的反馈和指导系统，以增强治疗联盟，从而改善治疗过程并最终改善结果。在拟议的研究中，参与者将是接受门诊 AUD 治疗的酒精依赖患者。每个人都将参加为期 12 周的结构化治疗方案，每周进行一次单独治疗。每次疗程结束后，患者将填写简短的工作联盟清单 (WAI)，以衡量患者对治疗联盟的看法。将评估两种治疗条件。在实验条件下，在每次参加的治疗疗程之后，将向治疗师提供有关患者关于治疗联盟的报告的反馈和指导（反馈条件）。反馈特别需要关于患者对联盟的看法的描述性信息以及治疗师可以用来增强联盟或维持已经强大的联盟的技术和策略。在“常规治疗”条件下，不会向治疗师提供有关治疗联盟的反馈（无反馈条件）。将在基线、治疗结束以及治疗后 3、6、9 和 12 个月时对患者进行全面的研究评估。该项目的具体目标有三个。第一个目的是测试向治疗师提供有关患者对治疗联盟的看法的反馈和指导对患者提供的治疗联盟整体评分（12 周治疗方案期间参加的治疗疗程的平均值）的影响。第二个目12 个月的随访期。第三个目标是测试患者提供的治疗联盟总体评分（12 周治疗方案期间参加的治疗疗程的平均值），作为 12 个月随访期间反馈状况与酒精参与之间拟议关系的中介因素。向治疗师提供患者对治疗联盟看法的反馈所带来的积极结果将代表该领域的重要进步。此外，本研究中评估的反馈技术可以直接转移到社区环境中。 公共卫生相关性：每年与酒精滥用相关的社会和个人后果是深远的。这项研究旨在增进对加强患者和治疗师之间治疗联盟的策略的了解，预计这将改善治疗结果。