A randomized controlled trial of moderation-oriented cue exposure

Objective: A randomized controlled trial was conducted to examine the effec tiveness of Moderation-Oriented Cue Exposure (MOCE) in comparison to Behavi oral Self-Control Training (BSCT). The main hypothesis was that MOCE would be more effective than BSCT among a sample of problem drinkers aiming at mo derate drinking. A subsidiary hypothesis was that MOCE would be relatively more effective than BSCT among problem drinkers with higher levels of alcoh ol dependence. Method: Clients (N = 91; 75% men) were randomly allocated to either MOCE or BSCT. Treatment was delivered in weekly sessions by two tra ined therapists, in a nested design in which therapists switched to the alt ernative treatment modality approximately halfway through the trial. Follow -up was carried out 6 months following posttreatment assessment, with 85% s uccessful contact. Results: There was no evidence for the general superiori ty of MOCE over BSCT. The subsidiary hypothesis was not confirmed. A subsam ple of clients (n = 14) showing levels of dependence at baseline above the commonly accepted cut-point for a moderation goal (Severity of Alcohol Depe ndence Questionnaire [SADQ] > 29) showed outcomes at least as favorable as those below the cut-point. The validity of self-reports of alcohol consumpt ion and problems was supported by significant relationships with liver func tion tests (gamma-glutamyl tranferase and alanine transferase). Conclusions : These results provide no grounds for the replacement of BSCT by MOCE in r outine, moderation-oriented treatment practice. Assuming they prefer it to abstinence and that it is not contra-indicated on other grounds, there seem s no reason why clients showing a higher level of dependence (SADQ = 30-45) should not be offered a moderation goal.