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Relapse Prevention in Alcohol Aftercare: effects on drinking outcome, change process, and aftercare attendance
Authors:JOANNE R ITO  DENNIS M DONOVAN  JUDY J HALL
Institution:Center for Health Promotion, University of Texas Health Science Center, Houston, Texas;Department of Psychiatry and Behavioural Sciences, Alcohol and Drug Dependence Treatment Programme, University of Washington and Seattle Veterans Administration Medical Center, Seattle, WA, U.S.A.;Department of Psychology, Emory University, Atlanta, GA, U.S.A.
Abstract:Aftercare contributes to improved drinking outcome, yet maintenance has been overlooked as a point for intervention. This project evaluated the effect of cognitive-behavioural relapse prevention (RP) and interpersonal process (IP) aftercare groups for recently hospitalized alcoholics, consisting of eight weekly 90 min sessions delivered by three co-therapy teams conducting one group in each condition. Six cohorts of patients were assigned to conditions (N=39) and assessed at pretreatment, post-treatment, and 6 month follow-up. RP and IP resulted in comparable improvement/outcome on alcohol consumption, alcohol-related impairment, cognitive coping, drinking days, time to first drink, abstinence, and aftercare attendance. In secondary analyses, improvement on temptation was attributed to RP, on behavioural coping to IP, and effects on self-efficacy appeared marginally related to greater short term improvement for RP. The lack of differential outcome is discussed with respect to inadequate power, possible ceiling effects in outcome, the brevity of the follow-up period, and the possibility that treatments may have been more similar in implementation than intended. Suggestions for improving aftercare and relapse prevention research are presented.
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