Single-session behavioral activation for alcohol use disorder: a randomized controlled pilot trial

Brief psychotherapy interventions for alcohol use disorder (AUD) focus on increasing motivation to reduce alcohol-use, rather than strategies for changing alcohol-use behaviors. Behavioral activation, an action-oriented, client-centered psychotherapy addresses this gap though reinforcement of value-based, substance-free activities. We examined preliminary efficacy of a single-session behavioral activation intervention ("ultrabrief behavioral activation", UBA) for people with mild-moderate AUD. UBA was studied in a randomized controlled parallel-group pilot trial with an assessment-only control group (N = 40). Alcohol-use was assessed at baseline and at follow-up visits up to 3 months. Participants in the UBA and control group exhibited reduced percent drinking days, drinks per drinking day, and average amount of alcohol consumed. The most pronounced difference between groups occurred for percent drinking days at the two-week follow-up visit (d = -0.53, p = 0.064). Behavioral activation and value-consistency increased while anhedonia decreased in the intervention group. UBA warrants further investigation as a therapeutic tool to close the gap between brief motivational intervention and prolonged psychotherapy courses for AUD.