Brief Intervention Versus More Extensive Treatment for Alcohol Use Disorder (AUD): Testing the Comparability Hypothesis.

objectiveThere is a substantial literature indicating that brief interventions (BIs) for alcohol use disorder (AUD) are as effective as more extensive treatments. The research assessment reactivity literature, however, suggests that the protocols used to study AUD treatments can have clinical efficacy, which may account for the observed findings. The purpose of this research was to experimentally investigate the moderation of AUD treatment effects by AUD assessment protocols.

methodParticipants were recruited from the community via advertisements (e.g., Facebook, mail, flyers). Eligible participants, providing informed consent, were randomized to one of four research conditions resulting from a two (Intervention: Motivational Enhancement Therapy [MET] or Cognitive Behavioral Coping Skills Therapy [CBT]) by two (Assessment: infrequent-alcohol/drug focused or frequent-comprehensive) factorial design and followed for 15 months after baseline assessment.

resultsAcross the entire sample, the proportion of abstinence days increased from 21.6% at baseline to 62.4% during follow-up months 13-15, and the proportion of heavy drinking days decreased from 64.9% at baseline to 18.1% during follow-up months 13-15. Although the hypothesized interaction "intervention by assessment condition" was not supported, main effects were detected for assessment condition, such that individuals assigned to the alcohol/drug-focused assessment conditions reported greater abstinence and fewer heavy drinking days than their counterparts assigned to the comprehensive assessment conditions.

conclusionsRobust BIs, such as MET, appear to yield drinking outcomes comparable to those of more extensive AUD treatments, such as CBT. In addition, reactivity to research assessments contributed to reduced alcohol use, and these effects appear to be contingent on intervention and participant characteristics.