Subject reactivity effects and alcohol treatment outcome research

Objective: Attributions regarding alcohol treatment research protocols infl uencing clinical outcomes have persisted for more than 25 years. Although w ell-designed alcohol treatment outcome studies typically involve frequent, and often comprehensive, research assessment protocols, procedures are seld om in place to control or account for possible subject reactivity to the re search protocol. This article presents a theoretical basis for a relationsh ip between research protocols and treatment outcomes. Method: The article r eviews the relevant alcohol treatment outcome literature and presents a "we ight of evidence" regarding subject reactivity effects and alcohol treatmen t outcome research assessment protocols. Also, the FRAMES (feedback, respon sibility, advice, menu, empathy and self-efficacy) model was coupled with s elf-regulation theory to provide a theoretical explanation of how research assessment protocols might contribute to clinically relevant behavioral cha nge. Results: Researcher attributions, empirical investigations and theoret ical considerations all provide evidence that is consistent with the existe nce of subject reactivity to research assessment protocols. Conclusions: Re commendations are made regarding interpretation of data collected as part o f an alcohol treatment outcome study, control of potential subject reactivi ty confounding variables and directions for future research.