The aim of secondary prevention in alcoholism treatments are (a) to attract problem drinkers earlier into treatment and (b) to treat them at a minimal cost without sacrificing effectiveness. Alcoholism treatments in North America are principally designed for the chronic alcoholic and treatment programs for secondary prevention are rare. A large proportion (estimates range between 15 and 30%) of adults in North America drink at a hazardous level (80g. or more of ethanol daily). Conventional alcoholism programs have largely attracted the more chronic cases, which represent a minority of the problem drinking population. A few programs for secondary prevention which have been implemented show rates of success (between 60-80%) which are much higher than those typically reported by traditional alcoholism programs. This is the case when success was defined as including those abstinent plus those drinking moderately without apparent problems. This project will assess the relative effectiveness of three strategies, based on previously evaluated treatment methods. Although all strategies can be considered brief, they differ in intensity of therapist involvement (from 1 hour to approximately 6 hours total), and in the amount to which clients are expected to complete homework assignments. Clients, 105 problem drinkers, will be carefully screened, so as to ensure their alcohol problem is at a relatively early stage. They will be randomly assigned to one of the following conditions: (A) Therapist Based, in which clients are instructed in 6 weekly 1-hour sessions to attain a goal of moderation or abstinence and to develop problem solving strategies for high risk situations; (B) Bibliotherapy, in which clients are given instructions in two 30-minute sessions to follow a """"""""self-help"""""""" manual; (C) Offering guidelines for safe drinking, in which clients receive in two 30-minute sessions an explanation of the basic steps for achieving moderation or abstinence. These steps are outlined in a leaflet the client receives. Intake, and 3, 6 and 12 month follow up assessments will be conducted independently of the therapists and investigators. The main dependent measures will be quantity and frequency of drinking. Ancillary measures will be obtained on employment, marital and legal status. Objective corroborators of self-reported alcohol consumption are included. Finally, an estimate of cost effectiveness for program success will be made.
| Sanchez-Craig, M; Wilkinson, D A; Davila, R (1995) Empirically based guidelines for moderate drinking: 1-year results from three studies with problem drinkers. Am J Public Health 85:823-8 |
| Sanchez-Craig, M; Neumann, B; Souza-Formigoni, M et al. (1991) Brief treatment for alcohol dependence: level of dependence and treatment outcome. Alcohol Alcohol Suppl 1:515-8 |
| Sanchez-Craig, M; Leigh, G; Spivak, K et al. (1989) Superior outcome of females over males after brief treatment for the reduction of heavy drinking. Br J Addict 84:395-404 |
