Active Ingredients of Treatment and Client Mechanisms of Change in Behavioral Treatments for Alcohol Use Disorders: Progress 10 Years Later.
BACKGROUND
The current review revisits the article entitled: "Active Ingredients: How and Why Evidence-Based Alcohol Behavioral Treatment Interventions Work" published in Alcoholism: Clinical and Experimental Research. This work summarized proceedings from a 2004 Symposium of the same name that was held at the Annual Meeting of the Research Society on Alcoholism (RSA). A decade has passed, which provides occasion for an evaluation of progress. In 2014, an RSA symposium titled Active Treatment Ingredients and Client Mechanisms of Change in Behavioral Treatments for Alcohol Use Disorders: Progress 10 Years Later did just that.


METHODS
The current review revisits state-of-the-art research on the 3 treatments examined 10 years ago: cognitive behavioral therapy, alcohol behavior couples therapy, and 12-step facilitation. Because of its empirically validated effectiveness and robust research agenda on the study of process outcome, motivational interviewing has been selected as the fourth treatment modality to be discussed. For each of these 4 treatments, the reviewers provide a critical assessment of current theory and research with a special emphasis on key recommendations for the future.


RESULTS
Noteworthy progress has been made in identifying active ingredients of treatments and mechanisms of behavior change in these 4 behavioral interventions for alcohol and other drug use disorders. Not only have we established some of the mechanisms through which these evidence-based treatments work, but we have also uncovered some of the limitations in our existing frameworks and methods.


CONCLUSIONS
Further progress in this area will require a broader view with respect to conceptual frameworks, analytic methods, and measurement instrumentation.
Center for Alcohol and Addiction Studies, Brown University, Providence, Rhode Island.
Molly
M
Magill
Yale University School of Medicine, New Haven, Connecticut.
Brian D
BD
Kiluk
Center on Substance Abuse, Alcoholism, and Addictions, University of New Mexico, Albuquerque, New Mexico.
Barbara S
BS
McCrady
Center on Substance Abuse, Alcoholism, and Addictions, University of New Mexico, Albuquerque, New Mexico.
J Scott
JS
Tonigan
Center for Alcohol and Addiction Studies, Brown University, Providence, Rhode Island.
Richard
R
Longabaugh
D019973:Alcohol-Related Disorders / Q000523:psychology* / Q000628:therapy*; D015928:Cognitive Behavioral Therapy; D019546:Couples Therapy; D019317:Evidence-Based Medicine; D006801:Humans; D062405:Motivational Interviewing; D012657:Self-Help Groups
Active Treatment Ingredients; Alcohol Use Disorders; Evidence-Based Treatments; Mechanisms of Behavior Change; Process Research