United Kingdom Alcohol Treatment Trial (UKATT): Hypotheses, design and methods

The United Kingdom Alcohol Treatment Trial (UKATT) is intended to be the la rgest trial of treatment for alcohol problems ever conducted in the UK. UKA TT is a multicentre, randomized, controlled trial with blind assessment, re presenting a collaboration between psychiatry, clinical psychology, biostat istics, and health economics. This article sets out, in advance of data ana lysis, the theoretical background of the trial and its hypotheses, design, and methods. A projected total of 720 clients attending specialist services for treatment of alcohol problems will be randomized to Motivational Enhan cement Therapy (MET) or to Social Behaviour and Network Therapy (SBNT), a n ovel treatment developed for the trial with strong support from theory and research. The trial will test two main hypotheses, expressed in null form a s: (1) less intensive, motivationally based treatment (MET) is as effective as more intensive, socially based treatment (SBNT); (2) more intensive, so cially based treatment (SBNT) is as cost-effective as less intensive, motiv ationally based treatment (MET). A number of subsidiary hypotheses regardin g client-treatment interactions and therapist effects will also be tested. The article describes general features of the trial that investigators cons idered desirable, namely that it should: (1) be a pragmatic, rather than an explanatory, trial; (2) be an effectiveness trial based on 'real-world' co nditions of treatment delivery; (3) incorporate high standards of training, supervision and quality control of treatment delivery; (4) pay close atten tion to treatment process as well as treatment outcome; (5) build economic evaluation into the design at the outset. First results from UKATT are expe cted in 2002 and the main results in 2003.