The COMBINE study of 2003 examined how behavioral modification and medication affected treatment outcome in people struggling with alcohol misuse. As a follow-up to that study, Katie Witkiewitz of the Department of Psychology at Washington State University evaluated the effectiveness of drink abstinence training as a component of COMBINE. Individuals with alcohol dependence can learn how to adaptively handle stressful situations without alcohol by developing drink refusal skills. But existing research in this area has yet to clarify why drink refusal skills increase abstinence. One theory is that individuals who possess the skills to effectively refuse alcohol increase their self-efficacy, perhaps due to cognitive changes that result from drink refusal training.
To better understand how drink refusal training helps alcohol-dependent individuals receiving cognitive behavioral interventions (CBI), and to what extent, Witkiewitz conducted a follow-up study on 776 individuals who were part of COMBINE. She found that after 16 weeks of training, participants had significant increases in abstinence. She also discovered that the participants who received the drink refusal training showed greater increases in self-efficacy than those who received CBI alone. Overall, drink refusal training was directly related to higher levels of abstinence at the conclusion of treatment. But Witkiewitz also realized that the participants who were receiving the drink refusal training actually saw increases in self-efficacy as early as 10 weeks into treatment. Positive changes in abstinence and self-efficacy were also maintained at 1-year follow-up.
Witkiewitz believes these findings are significant and should prompt researchers to focus on recognizing change during treatment as well as after treatment to measure the effectiveness of the treatment and how it influences particular behaviors and thoughts related to drinking abstinence. She noted that consistent with prior research, this most recent study demonstrates that any drink abstinence intervention that improves self-efficacy could positively affect treatment outcomes. Witkiewitz added, “Future research could examine whether self-efficacy is a specific mediator of skills training or whether significant changes in abstinence self-efficacy is a general mechanism of change following alcohol treatment.”
Witkiewitz, K., Donovan, D. M., Hartzler, B. (2012, January 30). Drink Refusal Training as Part of a Combined Behavioral Intervention: Effectiveness and Mechanisms of Change. Journal of Consulting and Clinical Psychology. Advance online publication. doi: 10.1037/a0026996
© Copyright 2012 GoodTherapy.org. All rights reserved.
The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.