Rm. Kadden et al., Prospective matching of alcoholic clients to cognitive-behavioral or interactional group therapy, J STUD ALC, 62(3), 2001, pp. 359-369
Citations number
35
Categorie Soggetti
Public Health & Health Care Science","Clinical Psycology & Psychiatry
Objective: In earlier work, client sociopathy and global psychopathology we
re effective variables for treatment matching: clients low on both sociopat
hy and severity of psychopathology were likely to benefit from interactiona
l group therapy whereas those scoring high on either of these dimensions be
nefited more from a coping skills intervention. The present study assessed
whether outcomes improve further when clients are assigned to group treatme
nts prospectively based on a matching strategy derived from the previous fi
ndings. Method: All participants (N = 250, 66% men) met criteria for alcoho
l dependence or abuse. About half were prospectively assigned to either cog
nitive-behavioral (CB) coping skills training or interactional therapy; tho
se with higher levels of psychiatric severity or sociopathy were given CB a
nd those who were low on both dimensions were given interactional therapy.
The other half were randomly assigned to those treatments, replicating the
procedure of the earlier study. Outcome data were collected at the conclusi
on of treatment and at 3-month intervals for 1 year following. Results: Pro
spective matching of clients to treatment did not produce superior drinking
outcomes compared to random treatment assignment. Randomly assigned client
s were more likely to be abstinent at the end of treatment, but this effect
disappeared at later follow-ups. Prospectively matched clients had fewer n
egative consequences of drinking than did those assigned randomly (unmatche
d). Neither sociopathy nor psychiatric severity was particularly effective
for matching. Conclusions: The matching effects from our previous study wer
e not replicated. Nevertheless, prospective matching did reduce the negativ
e consequences of drinking, consistent with our previous results.