title: Efficacy of automated telephone continuing care following outpatient therapy for alcohol dependence.
abstract: BACKGROUND
  Relapse rates following cognitive behavioral therapy (CBT) for alcohol dependence are high. Continuing care programs can prolong therapeutic effects but are underutilized. Thus, there is need to explore options having greater accessibility.
  
  
  METHODS
  This randomized controlled trial tested the efficacy of a novel, fully automated continuing care program, Alcohol Therapeutic Interactive Voice Response (ATIVR). ATIVR enables daily monitoring of alcohol consumption and associated variables, offers targeted feedback, and facilitates use of coping skills. Upon completing 12weeks of group CBT for alcohol dependence, participants were randomly assigned to either four months of ATIVR (n=81) or usual care (n=77). Drinking behavior was assessed pre- and post-CBT, then at 2weeks, 2months, 4months, and 12months post-randomization.
  
  
  RESULTS
  Drinking days per week increased over time for the control group but not the intervention group. There were no significant differences between groups on the other alcohol-related outcome measures. Comparisons on the subset of participants abstinent at the end of CBT (n=72) showed higher rates of continuous abstinence in the experimental group. Effect sizes for the other outcome variables were moderate but not significant in this subgroup.
  
  
  CONCLUSIONS
  For continuing care, ATIVR shows some promise as a tool that may help clients maintain gains achieved during outpatient treatment. However, ATIVR may not be adequate for clients who have not achieved treatment goals at the time of discharge.
authors.affiliation: Department of Psychiatry, University of Vermont, Burlington, VT 05401, USA. Electronic address: gail.rose@vtmednet.org.
authors.forename: Gail L
authors.initials: GL
authors.lastname: Rose
authors.affiliation: Department of Medical Biostatistics, University of Vermont, Burlington, VT 05401, USA.
authors.forename: Joan M
authors.initials: JM
authors.lastname: Skelly
authors.affiliation: Department of Medical Biostatistics, University of Vermont, Burlington, VT 05401, USA.
authors.forename: Gary J
authors.initials: GJ
authors.lastname: Badger
authors.affiliation: Department of Psychiatry, University of Vermont, Burlington, VT 05401, USA.
authors.forename: Tonya A
authors.initials: TA
authors.lastname: Ferraro
authors.affiliation: Department of Psychiatry, University of Vermont, Burlington, VT 05401, USA.
authors.forename: John E
authors.initials: JE
authors.lastname: Helzer
mesh_terms: D000437:Alcoholism / Q000628:therapy*; D015928:Cognitive Behavioral Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D012008:Recurrence; D013689:Telephone; D016896:Treatment Outcome; D014707:Vermont
keywords: Alcohol dependence; Cognitive behavioral therapy; Continuing care; Interactive Voice Response (IVR); Randomized trial