The search for mechanisms of behavior change in evidence-based behavioral treatments for alcohol use disorders: overview.

National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, 5635 Fishers Lane, Bethesda, MD 20892, USA.
Alcoholism Clinical and Experimental Research (Impact Factor: 3.31). 11/2007; 31(10 Suppl):1s-3s. DOI: 10.1111/j.1530-0277.2007.00487.x
Source: PubMed

ABSTRACT Over the past three decades, the main question of interest to alcohol treatment researchers has concerned the main effects of a particular behavioral intervention or what works. Increasingly, alcohol treatment researchers are turning their attention to the underlying psychological, social, and even neurophysiologic processes or "active ingredients" that are driving therapeutic change.
The articles contained in this supplement to Alcoholism: Clinical and Experimental Research grew out of invited presentations given at a one-day satellite session immediately preceding the 28th Annual Meeting of the Research Society on Alcoholism (RSA). The conference was a collaborative effort of the Center on Alcoholism, Substance Abuse, and Addiction at the University of New Mexico, the Center on Addiction and Substance Abuse at Columbia University, Brown University, and the National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health.
The conference featured a mix of full-length presentations on conceptual and methodological issues, reports of original research findings, and lively discussion among speakers and conference participants. Understanding mechanisms of behavior change will benefit the field by identifying the key aspects of therapy that must be present for maximum effect, irrespective of the specific technique being applied; provide a new way to approach patient-treatment interactions; and lay the groundwork for understanding how change is affected by social and other extratreatment factors.
Although not a new topic to the field, understanding mechanisms of behavior change has begun to capture the interest of an increasing number of alcohol treatment researchers. Understanding behavior change is an exceedingly complex enterprise and innovative thinking and creative research designs will be required to advance the field.

  • [Show abstract] [Hide abstract]
    ABSTRACT: Carbon microphones are non linear and time varying devices, so that their response curve widely depends on the type of excitation signal, To carry our measurements well correlated with the real performance, the transducers must be excitated by a signal as close as possible to real voice. For the artificial signals already proposed, the attention was practically concentrated on both waveform behaviour and long-time characteristics. The speech-like signal here presented, in addition to previous items, also accounts for syllabic-rate of real speech, showing an envelope very similar to real voices. Sensitivity frequency characteristics and distortion measured on 4 microphones (3 carbon and 1 linear) using this signal are presented.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: ABSTRACT Background: Adolescent substance use treatment outcome research generally shows small to moderate effects in reducing substance use, with no specific "brand" of treatment emerging as clearly superior to any other, and treatment gains that fade over time. The relatively weak and temporary effects of treatment call for improving the potency and durability of intervention effects. In response to this call, this critical narrative review summarizes research on mechanisms of change for both adults and adolescents in substance use treatment, with a particular focus on reviewing what is known regarding "how" adolescent substance use treatment works. Methods: A comprehensive review of the adolescent (ages 11-18) substance use treatment literature was conducted to identify empirical studies that examined mediators of intervention effects. Relevant databases (e.g., PsychINFO, Medline) were searched using key words (e.g., "mediator"), and relevant articles from reference sections of identified studies and review papers were considered. Results: Studies of mechanisms of psychotherapy change are rare in the adult, and particularly adolescent, substance use treatment outcome literature. The four adolescent studies that examined substance use treatment mechanisms found that positive social support, motivation to abstain, and positive parenting behaviors mediated treatment effects. To date, research has not supported therapy-specific mechanisms of change, finding instead that "common" processes of change largely account for improvements in outcome across distinct "brands" of treatment. Conclusions: The lack of empirical support for treatment-specific mechanisms of change may be due to the need for greater precision in defining and measuring treatment-specific causal chains. Future directions include neuroscience approaches to examining changes in brain functioning that are associated with treatment response and recovery and examining mechanisms in adaptive treatment designs, which can accommodate individual differences in targets for intervention and response to treatment.
    Substance Abuse 06/2014; 35(4). DOI:10.1080/08897077.2014.925029 · 1.62 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Alcohol use often co-occurs with one or more other behavioral health risk factors that can place women and their offspring at heightened risk for morbidity and mortality. Women with co-occurring alcohol use and behavioral health risk factors, such as tobacco use, illicit drug use, and mental illness are especially vulnerable. These women are not only at increased risk for hazardous reproductive outcomes, but also physical and psychological illness, disability and premature death, interpersonal conflicts, violence and legal problems, unemployment, and poverty. Despite evidence that co-occurring multiple behavioral health risk factors are prevalent and often associated with more severe adverse health outcomes and higher social economic costs, a majority of health promotion and intervention programs are designed to target only one risk factor of concern. Given that