Dataset Information

Alcohol Behavioral Couple Therapy: In-session behavior, active ingredients and mechanisms of behavior change.

ABSTRACT: OBJECTIVE:Alcohol Behavioral Couple Therapy (ABCT) is an efficacious alcohol treatment. The purpose of the study was to describe patient and partner language and therapist behavior during therapy sessions and test a proposed causal model linking active ingredients of ABCT as measured by therapist behaviors, hypothesized mechanisms of behavior change as measured by in-session patient and partner language, and alcohol use outcomes. METHOD:Data came from couples in four ABCT clinical trials (N?=?188; 86 males, 102 females, and their partners). Patient and partner verbal behaviors in session one and a mid-treatment session were coded using the System for Coding Couples' Interactions in Therapy-Alcohol. Therapist behavior was coded using the Couples Treatment Integrity Rating System. Percent days abstinent was calculated from daily drinking data for the first and second half of treatment and six months post-treatment. RESULTS:Therapists delivered an adequate level of the ABCT interventions during treatment. During treatment, couples increased positive behaviors, talked less about drinking, and decreased their amount of motivational language. Therapist behaviors did not predict patient or partner behaviors during treatment or drinking outcomes. Partner advice in the first session predicted poorer drinking outcomes. At mid-treatment, patient behaviors as a block, and specific behaviors of contemptuousness toward their partner and sustain talk, predicted poorer drinking outcomes. CONCLUSIONS:During ABCT, patients decrease their drinking, and patient and partner behaviors change in predicted ways. Partner advice, patient contemptuousness, and patient sustain talk predicted poorer outcomes. Analyses of within-session verbal behavior did not support the hypothesized mechanisms for change for ABCT.

SUBMITTER: McCrady BS

PROVIDER: S-EPMC6478165 | biostudies-literature | 2019 Apr

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Alcohol Behavioral Couple Therapy: In-session behavior, active ingredients and mechanisms of behavior change.

McCrady Barbara S BS Tonigan J Scott JS Ladd Benjamin O BO Hallgren Kevin A KA Pearson Matthew R MR Owens Mandy D MD Epstein Elizabeth E EE

Journal of substance abuse treatment 20190125

<h4>Objective</h4>Alcohol Behavioral Couple Therapy (ABCT) is an efficacious alcohol treatment. The purpose of the study was to describe patient and partner language and therapist behavior during therapy sessions and test a proposed causal model linking active ingredients of ABCT as measured by therapist behaviors, hypothesized mechanisms of behavior change as measured by in-session patient and partner language, and alcohol use outcomes.<h4>Method</h4>Data came from couples in four ABCT clinical ...[more]

PMID: 30797386

Similar Datasets

Project description:Posttraumatic stress disorder (PTSD) is a prevalent condition associated with intimate relationship problems, and intimate relationship factors have been shown to affect individual PTSD treatment outcomes.To compare cognitive-behavioral conjoint therapy for PTSD (a manualized couple therapy delivered to patients with PTSD and their significant others to simultaneously treat PTSD symptoms and enhance relationship satisfaction) with a wait-list condition.Randomized controlled trial of heterosexual and same-sex couples (n = 40 couples; n = 80 individuals) in which one partner met criteria for PTSD according to the Clinician-Administered PTSD Scale, conducted from 2008 to 2012 in a Department of Veterans Affairs outpatient hospital setting in Boston, Massachusetts, and a university-based research center in Toronto, Ontario, Canada. Symptoms of PTSD, comorbid conditions, and relationship satisfaction were collected by blinded assessors at baseline, at mid treatment (median, 8.00 weeks [range, 1.71-20.43 weeks] after baseline), and at posttreatment (median, 15.86 weeks [range, 7.14-38.57 weeks] after baseline). An uncontrolled 3-month follow-up (median, 38.21 weeks [range, 28.43-50.57 weeks] after baseline) was also completed.Couples were randomly assigned to take part in the 15-session cognitive-behavioral conjoint therapy for PTSD protocol immediately (n = 20) or were placed on a wait list for the therapy (n = 20).Clinician-rated PTSD symptom severity was the primary outcome and was assessed with the Clinician-Administered PTSD Scale. Intimate relationship satisfaction, assessed with the Dyadic Adjustment Scale, patient- and partner-rated PTSD symptoms, and comorbid symptoms were secondary outcomes.PTSD symptom severity (score range, 0-136) was significantly more improved in the couple therapy condition than in the wait-list condition (mean change difference, -23.21; 95% CI, -37.87 to -8.55). Similarly, patients' intimate relationship satisfaction (score range, 0-151) was significantly more improved in couple therapy than in the wait-list condition (mean change difference, 9.43; 95% CI, 0.04-18.83). The time × condition interaction effect in the multilevel model predicting PTSD symptoms (t37.5 = -3.09; P = .004) and patient-reported relationship satisfaction (t68.5 = 2.00; P = .049) revealed superiority of the couple therapy compared with the wait list. Treatment effects were maintained at 3-month follow-up.Among couples in which one partner was diagnosed as having PTSD, a disorder-specific couple therapy, compared with a wait list for the therapy, resulted in decreased PTSD symptom severity and patient comorbid symptom severity and increased patient relationship satisfaction.clinicaltrials.gov Identifier: NCT00669981.

Project description:Background: For patients with coronary artery disease (CAD), smoking is an important risk factor for the recurrence of a cardiovascular event. Motivational interviewing (MI) may increase the motivation of the smokers to stop smoking. Data on MI for smoking cessation in patients with CAD are limited, and the active ingredients and working mechanisms of MI in smoking cessation are largely unknown. Therefore, this study was designed to explore active ingredients and working mechanisms of MI for smoking cessation in smokers with CAD, shortly after a cardiovascular event. Methods: We conducted a qualitative multiple case study of 24 patients with CAD who participated in a randomized trial on lifestyle change. One hundred and nine audio-recorded MI sessions were coded with a combination of the sequential code for observing process exchanges (SCOPE) and the motivational interviewing skill code (MISC). The analysis of the cases consisted of three phases: single case analysis, cross-case analysis, and cross-case synthesis. In a quantitative sequential analysis, we calculated the transition probabilities between the use of MI techniques by the coaches and the subsequent patient statements concerning smoking cessation. Results: In 12 cases, we observed ingredients that appeared to activate the mechanisms of change. Active ingredients were compositions of behaviors of the coaches (e.g., supporting self-efficacy and supporting autonomy) and patient reactions (e.g., in-depth self-exploration and change talk), interacting over large parts of an MI session. The composition of active ingredients differed among cases, as the patient process and the MI-coaching strategy differed. Particularly, change talk and self-efficacy appeared to stimulate the mechanisms of change "arguing oneself into change" and "increasing self-efficacy/confidence." Conclusion: Harnessing active ingredients that target the mechanisms of change "increasing self-efficacy" and "arguing oneself into change" is a good MI strategy for smoking cessation, because it addresses the ambivalence of a patient toward his/her ability to quit, while, after the actual cessation, maintaining the feeling of urgency to persist in not smoking in the patient.

Project description:BackgroundThe behavior change technique taxonomy v1 (BCTTv1; Michie and colleagues, 2013) is a comprehensive tool to characterize active ingredients of interventions and includes 93 labels that are hierarchically clustered into 16 hierarchical clusters.ObjectiveThe aim of this study was to identify the active ingredients in electronic health (eHealth) interventions targeting patients with poorly controlled type 2 diabetes mellitus (T2DM) and relevant outcomes.MethodsWe conducted a scoping review using the BCTTv1. Randomized controlled trials (RCTs), studies with or pre-post-test designs, and quasi-experimental studies examining efficacy and effectiveness of eHealth interventions for disease management or the promotion of relevant health behaviors were identified by searching PubMed, Web of Science, and PsycINFO. Reviewers independently screened titles and abstracts for eligibility using predetermined eligibility criteria. Data were extracted following a data extraction sheet. The BCTTv1 was used to characterize active ingredients of the interventions reported in the included studies.ResultsOf the 1404 unique records screened, 32 studies fulfilled the inclusion criteria and reported results on the efficacy and or or effectiveness of interventions. Of the included 32 studies, 18 (56%) were Web-based interventions delivered via personal digital assistant (PDA), tablet, computer, and/or mobile phones; 7 (22%) were telehealth interventions delivered via landline; 6 (19%) made use of text messaging (short service message, SMS); and 1 employed videoconferencing (3%). Of the 16 hierarchical clusters of the BCTTv1, 11 were identified in interventions included in this review. Of the 93 individual behavior change techniques (BCTs), 31 were identified as active ingredients of the interventions. The most common BCTs identified were instruction on how to perform behavior, adding objects to the environment, information about health consequences, self-monitoring of the outcomes and/or and prefers to be explicit to avoid ambiguity. Response: Checked and avoided of a certain behavior Author: Please note that the journal discourages the use of parenthesis to denote either and/or and prefers to be explicit to avoid ambiguity. Response: Checked and avoided "and/or" and prefers to be explicit to avoid ambiguity. Response: Checked and avoided, and feedback on outcomes of behavior.ConclusionsOur results suggest that the majority of BCTs employed in interventions targeting persons with T2DM revolve around the promotion of self-regulatory behavior to manage the disease or to assist patients in performing health behaviors necessary to prevent further complications of the disease. Detailed reporting of the BCTs included in interventions targeting this population may facilitate the replication and further investigation of such interventions.

Project description:Background: During the menopausal transition, women often experience physical (e.g., vasomotor symptoms) and emotional (e.g., anxiety and depression) difficulties that significantly impact functioning and overall quality of life. Although sexual concerns (e.g., decreased sexual desire, orgasm), are reported by up to 87% of peri- and post-menopausal women, and are associated with adverse impact on functioning and distress, treatment options that directly target this area are limited, and most often involve medication (e.g., hormone replacement). Effectiveness of these treatments is often defined as improvements in physical symptoms, however, associated psychological and emotional symptoms rarely, if at all, improve. Cognitive behavioral therapy (CBT) has been proposed as a low-risk treatment for menopausal symptoms with studies showing improvement in frequently reported symptoms (e.g., vasomotor symptoms, depression, anxiety, sleep). Sexual concerns, however, have either not been directly targeted at all in current CBT protocols, or the very few protocols that include sexual concerns, demonstrated modest gains in sexual desire. Methods: This protocol paper outlines the development, design, and implementation of a newly developed CBT for sexual concerns trial during perimenopause (CBT-SC-Peri). Although sexual concerns are prevalent during both the peri- and post-menopausal periods, we will be evaluating the effectiveness of a CBT-SC protocol specifically for perimenopausal women as a means of early intervention. The clinical sample will comprise 82 women aged 40–60 years currently in perimenopause, as per the Stages of Reproductive Aging Workshop (STRAW) definition, and medication stable (if applicable). To ensure participants are experiencing clinically significant sexual concerns, a baseline cut-off score of 26 or lower on the Female Sexual Functioning Index will be utilized. Exclusion criteria include participants with psychotic disorders, or current substance and/or alcohol dependence, or severely depressed/suicidal. The CBT-SC-Peri is a weekly, four session treatment, lasting up to 90 min per session and includes psychoeducation and cognitive and behavioral strategies designed to challenge unhelpful beliefs and promote healthy sexual behaviors. As this is an individual CBT protocol, content will be tailored to address the specific problems relevant for each participant. Eligible women will be placed directly into treatment or on a 4-week waitlist and reassessed prior to starting treatment. The primary outcome (sexual satisfaction), as well as secondary outcomes (desire, arousal, relationship satisfaction, body image, vasomotor symptoms, depression, and anxiety) are assessed at baseline, post-waitlist (for those on waitlist), and post-treatment. Discussion: To our knowledge, this will be the first study to investigate the efficacy of a CBT protocol (CBT-SC-Peri) specifically aimed at improving sexual concerns experienced during perimenopause. If effective, this form of treatment may not only be preferred by some, but necessary for others as consumer demand increases for non-pharmacological treatments for perimenopausal symptoms. Further, this protocol can be integrated into perimenopausal care and will be made available by dissemination to healthcare practitioners. Clinical Trial Registration: Trial # NCT04922385 and Accessible at: https://clinicaltrials.gov/ct2/show/NCT04922385?term=NCT04922385anddraw=2andrank=1.

Dataset Information

Alcohol Behavioral Couple Therapy: In-session behavior, active ingredients and mechanisms of behavior change.

Publications

Alcohol Behavioral Couple Therapy: In-session behavior, active ingredients and mechanisms of behavior change.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure