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Network support for drinking, Alcoholics Anonymous and long-term matching effects
R Longabaugh1, P W Wirtz, A Zweben
1Brown University, Center for Alcohol & Addiction Studies, Providence, RI 02912, USA.
Aims:
(1) To examine the matching hypothesis that Twelve Step Facilitation Therapy (TSF) is more effective than Motivational Enhancement Therapy (MET) for alcohol-dependent clients with networks highly supportive of drinking 3 years following treatment; (2) to test a causal chain providing the rationale for this effect.
Design:
Outpatients were re-interviewed 3 years following treatment. ANCOVAs tested the matching hypothesis.
Setting:
Outpatients from five clinical research units distributed across the United States.
Participants:
Eight hundred and six alcohol-dependent clients.
Intervention:
Clients were randomly assigned to one of three 12-week, manually-guided, individual treatments: TSF, MET or Cognitive Behavioral Coping Skills Therapy (CBT).
Measurements:
Network support for drinking prior to treatment, Alcoholics Anonymous (AA) involvement during and following treatment, percentage of days abstinent and drinks per drinking day during months 37-39.
Findings:
(1) The a priori matching hypothesis that TSF is more effective than MET for clients with networks supportive of drinking was supported at the 3 year follow-up; (2) AA involvement was a partial mediator of this effect; clients with networks supportive of drinking assigned to TSF were more likely to be involved in AA; AA involvement was associated with better 3-year drinking outcomes for such clients.
Conclusions:
(1) In the long-term TSF may be the treatment of choice for alcohol-dependent clients with networks supportive of drinking; (2) involvement in AA should be given special consideration for clients with networks supportive of drinking, irrespective of the therapy they will receive.