Interactions between psychotherapy procedures and patient attributes that predict alcohol treatment effectiveness: a preliminary report.
This study examined interactions between patient attributes and therapist interventions on alcoholism treatment outcome. Process analyses of an early psychotherapy session from either cognitive-behavioral (CBT) or family systems (FST) therapy and baseline patient information (N=47) were used to measure theory-based therapy and patient variables. Hierarchical linear regression was used to test the effect of each patient-therapy interaction on changes in drinking behavior. Two disordinal interactions were predictors of alcohol use during the maintenance phase of treatment. Patients high in emotional distress did best when their therapy addressed emotional experiences, and the converse was observed for patients low in distress. Patients high in reactance had better drinking outcomes when their therapy was nondirective, and patients low in reactance improved more with directive therapy. In contrast to the interactions between patient attributes and the therapy process, the interactions between patient attributes and treatment model (CBT versus FST) were not reliable predictors of alcohol use.
Center for Alcohol and Addiction Studies, Brown University, Providence, RI 02912, USA. mitchell_karno@brown.edu
Mitchell P
MP
Karno
Larry E
LE
Beutler
T Mark
TM
Harwood
D000223:Adaptation, Psychological; D000328:Adult; D000339:Affect; D000437:Alcoholism / Q000523:psychology* / Q000534:rehabilitation*; D000704:Analysis of Variance; D015928:Cognitive Behavioral Therapy; D005196:Family Therapy; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D013811:Psychotherapeutic Processes; D013315:Stress, Psychological / Q000523:psychology