Treatment response and non‐response in CBT and Network Support for alcohol disorders: targeted mechanisms and common factors

Mark D. Litt; Ronald M. Kadden; Howard Tennen

doi:10.1111/add.14224

journal article Apr 20, 2018

Treatment response and non‐response in CBT and Network Support for alcohol disorders: targeted mechanisms and common factors

Mark D. Litt

Ronald M. Kadden Howard Tennen

Addiction Vol. 113 No. 8 pp. 1407-1417 · Wiley

View at Publisher Save 10.1111/add.14224

Abstract

AbstractAimsTo determine whether mechanisms of drinking behavior change that are targeted by specific treatments mediate the effects of Packaged Cognitive Behavior Therapy (PCBT) and Network Support (NS) on abstinence rates throughout 27 months.DesignSecondary analysis of data from two Network Support Project randomized clinical trials, in which participants were assigned to either a case management control treatment (control) or NS treatment in trial 1, or to PCBT or NS treatment in trial 2.SettingAn out‐patient substance abuse treatment site at a university medical center in the United States.ParticipantsA total of 249 men and 154 women (n = 403) with alcohol use disorder.MeasurementsThe primary outcome was membership in a treatment responder class determined by growth mixture modeling (GMM) of monthly proportion days abstinent (PDA) to 27 months. Key predictors of responder class membership included network change variables, and changes in coping scores and self‐efficacy.FindingsGMM analyses indicated that a three‐class solution provided the best fit to the data: a treatment responder class comprising almost 55% of patients, a late relapsing class that showed post‐treatment gains followed by a return to baseline drinking (12.7% of patients) and a non‐responder class (32% of patients). Analyses indicated that treatment effects on responder class membership were moderated by baseline drinking (P < 0.001). PCBT effects were mediated by changes in coping scores (P < 0.05). NS treatment effects were also mediated by coping change, as well as by increases in self‐efficacy and in number of abstinent friends (P < 0.05).ConclusionsLong‐term success in Packaged Cognitive Behavior Therapy and Network Support treatments for alcohol use disorder appears to be mediated by both general mechanisms (developing coping skills and self‐efficacy) and treatment‐targeted mechanisms (developing network strategies that emphasize social support and avoiding friends who drink).

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Citations

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References

Details

Published: Apr 20, 2018
Vol/Issue: 113(8)
Pages: 1407-1417
License: View

Authors

M

Mark D. Litt

UConn Health Farmington CT USA

R

Ronald M. Kadden

UConn Health Farmington CT USA

H

Howard Tennen

UConn Health Farmington CT USA

Funding

National Institute on Alcohol Abuse and Alcoholism Award: R01 AA012827

Cite This Article

Mark D. Litt, Ronald M. Kadden, Howard Tennen (2018). Treatment response and non‐response in CBT and Network Support for alcohol disorders: targeted mechanisms and common factors. Addiction, 113(8), 1407-1417. https://doi.org/10.1111/add.14224

Treatment response and non‐response in CBT and Network Support for alcohol disorders: targeted mechanisms and common factors

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