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Related Experiment Videos

Problem drinkers: evaluation of a stepped-care approach.

F C Breslin1, M B Sobell, L C Sobell

  • 1Centre for Addiction and Mental Health, Toronto, Canada. cbreslin@arf.org

Journal of Substance Abuse
|February 26, 2000
PubMed
Summary

Identifying treatment nonresponse in problem drinkers is key. A stepped-care model showed that initial drinking levels predict outcomes, but supplemental interventions did not improve results for nonresponders.

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Area of Science:

  • Addiction Medicine
  • Psychology
  • Public Health

Background:

  • Problem drinking affects many individuals not severely dependent on alcohol.
  • Stepped-care models offer a structured approach to treatment, adapting intensity based on patient response.
  • Previous research has not fully evaluated stepped-care models for alcohol use disorders.

Purpose of the Study:

  • To evaluate a stepped-care model for treating problem drinkers.
  • To determine if supplemental interventions improve outcomes for initial treatment nonresponders.
  • To identify predictors of treatment nonresponse within a stepped-care framework.

Main Methods:

  • A four-session motivational outpatient treatment was initially provided.
  • Treatment nonresponse was defined by weekly alcohol consumption exceeding 12 drinks.

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  • Outcomes were assessed at six-month follow-up for responders, nonresponders, and nonresponders receiving supplemental treatment.

    • Main Results:

    • Within-treatment drinking patterns effectively identified treatment nonresponders.
    • A supplemental intervention did not significantly alter posttreatment drinking outcomes.
    • Treatment responders and nonresponders sought additional help at similar rates.

    Conclusions:

    • The study provides a methodology for evaluating stepped interventions in alcohol treatment.
    • Initial drinking levels are valuable indicators for identifying nonresponse in stepped-care models.
    • Further research should focus on the needs of nonresponders and help-seeking behaviors.