Cognitive-behavioral treatment for alcohol dependence: a review of evidence for its hypothesized mechanisms of action

Objective. This review examined support for the hypothesis that cognitive-b ehavioral treatment (CBT) for alcohol dependence works through increasing c ognitive and behavioral coping skills. Method. Ten studies were identified that examined the hypothesized mechanisms of action of CBT. These studies i nvolved random assignment (or its near equivalent) of participants to CBT a nd at least one comparison condition. Results. Although numerous analyses o f the possible causal links have been conducted to evaluate whether CBT wor ks through increasing coping, the results indicate little support for the h ypothesized mechanisms of action of CBT. Conclusions. Research has not yet established why CBT is an effective treatment for alcohol dependence. Negat ive findings may reflect methodological flaws of prior studies. Alternative ly, findings may indicate one or more conceptual assumptions underlying CBT require revision.