Achieving and maintaining gains among problem drinkers: Process and outcome results

Connors, Gerard J.; Tarbox, Arthur R.; Faillace, Louis A.

doi:10.1016/s0005-7894(05)80169-8

Cited by 41 publications

(26 citation statements)

References 19 publications

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“…Connors et al (1992) found that strategy use predicted outcomes over 12 months of follow up; however, our study demonstrated significant relationships between strategy use and alcohol consumption only early in follow-up and only with relatively heavier drinkers. A notable difference between the two studies is that the Connors et al sample appeared to have more severe drinking histories.…”

Section: Discussioncontrasting

confidence: 88%

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Use of treatment strategies in a moderated drinking program for women

Mendoza

Walitzer

Connors

2012

Addictive Behaviors

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Little is known about the extent to which individuals participating in drinking reduction interventions use the drinking reduction strategies presented during treatment. In consideration of this issue, we advanced hypotheses about the impact of baseline drinking patterns on strategy use and the relationship of strategy use to drinking patterns over time. One hundred forty-four women who participated in a 10-week drinking reduction program were monitored over an 18-month posttreatment follow-up period. Results indicated that the frequency of baseline heavy drinking days and the frequency of baseline abstinent/light drinking days negatively predicted drinking reduction strategy use during treatment. Over follow-up, strategy use decreased; however, participants who received booster sessions had higher strategy use during the initial phase of follow-up. Although cross-lagged panel analysis revealed that strategy use during treatment predicted abstinent/light days at the 6-month follow-up assessment, this effect was moderated by baseline drinking patterns. These data indicated that the use of drinking reduction strategies is predictive of subsequent reduced drinking only in the early posttreatment period and only for baseline heavier drinkers. Future research is needed to further specify the interplay of strategy use and drinking outcomes and to develop interventions designed to encourage the continued use of strategies over extended periods of time.

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Section: Discussioncontrasting

confidence: 88%

“…However, little is known about the extent to which the content of these treatment interventions relates to the outcomes observed. In one study, Connors et al (1992) found that reductions in drinking among problem drinkers in a drinking reduction program were associated with the posttreatment utilization of drinking reduction techniques.…”

Section: Introductionmentioning

confidence: 99%

Use of treatment strategies in a moderated drinking program for women

Mendoza

Walitzer

Connors

2012

Addictive Behaviors

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“…1 However, research on the effectiveness of telephone continuing care has generated mixed results, with some studies yielding positive findings 8–9 and others mixed or negative findings. 10–11 …”

Section: Introductionmentioning

confidence: 99%

Extended telephone‐based continuing care for alcohol dependence: 24‐month outcomes and subgroup analyses

et al. 2011

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Aims Determine whether 18 months of telephone continuing care improves 24 month outcomes for patients with alcohol dependence. Subgroup analyses were done to identify patients who would most benefit from continuing care. Design Comparative effectiveness trial of continuing care that consisted of monitoring and feedback only (TM) or monitoring and feedback plus counseling (TMC). Patients were randomized to treatment as usual (TAU), TAU plus TM, or TAU plus TMC, and followed quarterly for 24 months. Setting Publicly funded intensive outpatient programs (IOP) Participants 252 alcohol dependent patients (49% with current cocaine dependence) who completed 3 weeks of IOP. Measurements Percent days drinking, any heavy drinking, and a composite good clinical outcome. Findings In the intent to treat sample, group differences in alcohol outcomes out to 18 months favoring TMC over TAU were no longer present in months 19–24. Approximately 50% of participants met criteria for Good Clinical Outcomes throughout treatment and follow-up with a non-significant trend for TMC to perform better than usual care. Overall significant effects favoring TMC and TM over TAU were seen for women; and TMC was also superior to TAU for participants with social support for drinking, low readiness to change, and prior alcohol treatments. Most of these effects were obtained on at least 2 of 3 outcomes. However, no effects remained significant at 24 months. Conclusions The benefits of an extended telephone-based continuing care programme to treat alcohol dependence did not persist after the end of the intervention. A post-hoc analysis suggested that women and individuals with social support for drinking, low readiness to change, or prior alcohol treatments may benefit from the intervention.

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“…15,16 However, few studies have been done with patients with alcohol or drug use disorders, and results have been mixed. [17][18][19] This study examined the relative effectiveness of telephone-based continuing care for patients with alcohol and/or cocaine dependence who had completed a 4-week intensive outpatient program (IOP). Participants were randomized to a condition that consisted primarily of brief telephone counseling contacts combined with several group support sessions early in the protocol (TEL) or to 1 of 2 comparison conditions: individualized relapse prevention (RP) or standard 12-step-oriented group counseling (STND).…”

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confidence: 99%

The Effectiveness of Telephone-Based Continuing Care for Alcohol and Cocaine Dependence

McKay

Lynch

Shepard

et al. 2005

Arch Gen Psychiatry

163

174

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Context:Telephone-based disease management protocols have shown promise in improving outcomes in a number of medical and psychiatric disorders, but this approach to continuing care has received little study in alcohol-and drug-dependent individuals.Objective: To compare telephone-based continuing care with 2 more intensive face-to-face continuing care interventions.Design: A randomized 3-group clinical trial with a 2-year follow-up.Setting: Two outpatient substance abuse treatment programs, one community-based and the other at a Veterans Affairs medical center facility.Patients: Alcohol-and/or cocaine-dependent patients (N=359) who had completed 4-week intensive outpatient programs.Interventions: Three 12-week continuing care treatments: weekly telephone-based monitoring and brief counseling contacts combined with weekly supportive group sessions in the first 4 weeks (TEL), twice-weekly cognitive-behavioral relapse prevention (RP), and twiceweekly standard group counseling (STND). Main Outcome Measures:Percentage of days abstinent from alcohol and cocaine, total abstinence from alcohol and cocaine, negative consequences of substance use, cocaine urine toxicological results, and ␥-glutamyltransferase.Results: Participants in TEL had higher rates of total abstinence over the follow-up than those in STND (PϽ.05). In alcohol-dependent participants, 24-month ␥-glutamyltransferase levels were lower in TEL than in RP (P=.005). In cocaine-dependent participants, there was a significant groupϫ time interaction (P =.03) in which the rate of cocaine-positive urine samples increased more rapidly in RP as compared with TEL. On percentage of days abstinent or negative consequences of substance use, TEL did not differ from RP or STND. Participants with high scores on a composite risk indicator, based on cooccurring alcohol and cocaine dependence and poor progress toward achieving intensive outpatient program goals, had better total abstinence outcomes up to 21 months if they received STND rather than TEL, whereas those with lower scores had higher abstinence rates in TEL than in STND (P=.04). Conclusions:Telephone-based continuing care appears to be an effective form of step-down treatment for most patients with alcohol and cocaine dependence who complete an initial stabilization treatment, compared with more intensive face-to-face interventions. However, highrisk patients may have better outcomes if they first receive group counseling continuing care after completing intensive outpatient programs.

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Achieving and maintaining gains among problem drinkers: Process and outcome results

Cited by 41 publications

References 19 publications

Use of treatment strategies in a moderated drinking program for women

Use of treatment strategies in a moderated drinking program for women

Extended telephone‐based continuing care for alcohol dependence: 24‐month outcomes and subgroup analyses

The Effectiveness of Telephone-Based Continuing Care for Alcohol and Cocaine Dependence

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