Efficacy of automated telephone continuing care following outpatient therapy for alcohol dependence. (February 2015)

• Record Type: Journal Article
• Authors: Rose, Gail L.; Skelly, Joan M.; Badger, Gary J.; Ferraro, Tonya A.; Helzer, John E.
• Is Part Of: Addictive behaviors. Volume 41(2015)
• Page Start: 223
• Page End: 231
• Publication Date: 2015-02
• Subjects: Continuing care -- Alcohol dependence -- Cognitive behavioral therapy -- Interactive Voice Response (IVR) -- Randomized trial; Substance abuse -- Periodicals; Alcoholism -- Periodicals; Drug addiction -- Periodicals; Nicotine addiction -- Periodicals; Smoking -- Periodicals; Gambling -- Psychological aspects -- Periodicals; Electronic journals; 362.29
• DOI: 10.1016/j.addbeh.2014.10.022
• Languages: English
• ISSNs: 0306-4603

Abstract

Abstract: Background: Relapse rates following cognitive behavioral therapy (CBT) for alcohol dependence are high. Continuing care programs can prolong therapeutic effects but are underutilized. Thus, there is need to explore options having greater accessibility. Methods: This randomized controlled trial tested the efficacy of a novel, fully automated continuing care program, Alcohol Therapeutic Interactive Voice Response (ATIVR). ATIVR enables daily monitoring of alcohol consumption and associated variables, offers targeted feedback, and facilitates use of coping skills. Upon completing 12 weeks of group CBT for alcohol dependence, participants were randomly assigned to either four months of ATIVR (n = 81) or usual care (n = 77). Drinking behavior was assessed pre- and post-CBT, then at 2 weeks, 2 months, 4 months, and 12 months post-randomization. Results: Drinking days per week increased over time for the control group but not the intervention group. There were no significant differences between groups on the other alcohol-related outcome measures. Comparisons on the subset of participants abstinent at the end of CBT (n = 72) showed higher rates of continuous abstinence in the experimental group. Effect sizes for the other outcome variables were moderate but not significant in this subgroup. Conclusions: For continuing care, ATIVR shows some promise as a tool that may help clients maintain gains achieved during outpatient treatment. However, ATIVR may not be adequate for clients who have not achieved treatment goals at the time of discharge. Highlights: Alcohol Therapeutic Interactive Voice Response is a recovery support innovation. 12-week outpatient CBT treatment was efficacious in the full sample. ATIVR outcomes were similar for both randomized groups at 4 month follow up. Clients abstinent at the conclusion of CBT benefitted more from ATIVR continuing care.