Origins, issues and options in the development of the combined behavioral intervention.
OBJECTIVE
The aim of the investigators was to develop a moderate intensity comprehensive behavioral treatment based on the principles of motivational interviewing and Cognitive Behavioral Therapy that, within the confines of a standardized abstinence-oriented treatment, would provide a broad spectrum of modules to assist those seeking treatment to achieve reduction of problematic drinking.


METHODS
The core issue of how to deliver a flexible therapy tailored to the needs of individual clients while at the same time providing a standardized treatment protocol for a randomized clinical trial provided the dilemma out of which this unique standardized protocol arose. By using a single decision tree, client choice, combined with limited options, we were able to reconcile these conflicting demands.


RESULTS
Key decisions that were made in developing the treatment protocol and the thinking leading to these decisions are described.


CONCLUSIONS
Understanding these key issues and the factors that led to the decisions made will assist would-be users in their own clinical and/or clinical research needs.
Longabaugh
Richard
R
Center for Alcohol and Addiction Studies, Brown Medical School, Box G-Butler Hospital, Providence, Rhode Island 02912, USA. Richard_Longabaugh@brown.edu
Zweben
Allen
A
Locastro
Joseph S
JS
Miller
William R
WR
D000437:Alcoholism / Q000188:drug therapy / Q000628:therapy*; D001521:Behavior Therapy / Q000379:methods*; D003131:Combined Modality Therapy; D004358:Drug Therapy / Q000379:methods*; D017408:Guidelines as Topic; D006801:Humans; D016032:Randomized Controlled Trials as Topic / Q000592:standards