This study will replicate and test for generalization of key findings from earlier studies. In most studies, patients show high levels of abstinence shortly after treatment, but as time passes abstinence gradually decreases, and drinking increases. In two independent randomized treatment studies it has now been shown that when marital treatment is added to behavioral treatment for alcoholism, outcome levels stabilize and even improve slightly over time. Furthermore, correlational patterns suggest that there are strong associations between sustained drinking improvement and long-term improvement in marital functioning. These findings, which are consistent with other work on maintaining treatment effects, are of special importance because they provide information about ways to make lasting improvements in patients' lives. We will extend and generalize these findings by extending the followups in an ongoing research project in which the treatment maintenance effect has already been replicated. In addition to confirming the original results with a longer followup interval, we will also test whether the original results, which apply only to married couples, can be generalized to unmarried patients who have a treatment partner. Furthermore, we will test a more general patient-treatment matching hypothesis that treatment interventions that bring about improvements in an area of life important to the individual patient, whether that area involves interpersonal relationships or vocational functioning, are more likely to lead to sustained improvement in drinking and other areas of outcome. Detailed information over long periods of time on treatment participation, use of social supports and relationships within and outside the home will allow testing of hypotheses about the active ingredients associated with stable long-term improvements in patients' lives.
| Stout, R L; Brown, P J; Longabaugh, R et al. (1996) Determinants of research follow-up participation in an alcohol treatment outcome trial. J Consult Clin Psychol 64:614-8 |
| Stout, R L; Wirtz, P W; Carbonari, J P et al. (1994) Ensuring balanced distribution of prognostic factors in treatment outcome research. J Stud Alcohol Suppl 12:70-5 |
