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Research on Alcoholism Treatment : Methodology Psychosocial Treatment Selected Treatment Topics Research Priorities - Marc Galanter

Research on Alcoholism Treatment

Methodology Psychosocial Treatment Selected Treatment Topics Research Priorities

Hardcover Published: 31st January 2003
ISBN: 9780306472589
Number Of Pages: 438

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From the President of the Research Society on Alcoholism The sixteenth volume of Recent Developments in Alcoholism contains the latest information on the field of alcoholism treatment research. This scholarly volume includes comprehensive reviews of the methodologies available to evaluate treatment outcome, state-of-the art psychosocial interventions, and recent advances in pharmacological adjuncts to treatment that are currently available and those on the brink of application. Other sections of the book address special issues in the treatment of alcohol dependence, including the treatment of the adolescents and other unique populations, the management of tobacco dependence, and the role of spirituality in recovery, among others. The clinician will find these reviews an important resource for learning about e- dence based treatments for alcoholism, and the researcher will find the synt- sis of recent developments informative and forward looking. The research agenda for the future rests soundly on the progress to date and additional advances in the treatment of alcoholism can be predicted in the near future. Stephanie O'Malley, Ph. D. President, Research Society on Alcoholism xi Preface From the President of the American Society of Addiction Medicine This excellent volume presents investigations covering a wide spectrum of scientific issues. It is also evident that many of these articles have clinical s- nificance, ranging from assessments of disorder, monitoring clinical progress, and behavioral and pharmacological interventions.

Introduction
Research on Alcoholism Treatment
Methodology
Overview
Assessment of Alcoholic Patients: Advances and Future Challenges
Introductionp. 13
Self-Report Screening Measuresp. 14
Biochemical Markersp. 15
Self-Report Measures of Consumptionp. 17
Diagnostic Measuresp. 18
Treatment Planning Instrumentsp. 19
Cross-Cutting Issuesp. 21
Biomarkers as Aids to Identification of Relapse in Alcoholic Patients
Reasons that Relapse Should Be Recognized Earlyp. 26
The Role of Biomarkers in Relapse Recognitionp. 26
Desirable Qualities in a Biomarker of Relapsep. 27
Biomarkers of Relapsep. 27
Summary of Findings on Biomarkers of Relapsep. 29
Future Research Questionsp. 33
Recommendations to Cliniciansp. 35
Advances in Research Design and Analysis for Alcohol Treatment
Research Design and Implementationp. 39
Nonrandomized Designsp. 40
Research Efficiencyp. 41
Study of Multicomponent Therapiesp. 42
Replicability and Site Differencesp. 43
Longitudinal Research Issuesp. 43
Outcome and Utilityp. 44
Issues in the Analysis of Treatment Datap. 44
Underutilized Statistical Methodsp. 45
Statistical Methods Requiring Further Developmentp. 47
Final Remarksp. 50
Clinicians' Impact on the Quality of Substance Use Disorder Treatment
Clinicians' Impact on Substance Use Disorder Treatment Retention and Outcomep. 55
Clinicians' Professional Background Characteristicsp. 58
Matching Patients to Cliniciansp. 58
Clinicians' Recovery Statusp. 59
Adherence and Competencep. 59
Clinicians' Emotional Responses (Countertransference)p. 60
Clinicians' Interpersonal Functioning/Therapeutic Alliancep. 61
Clinicians' Personality Characteristicsp. 62
Clinicians' Beliefs about Substance Use Disorder Treatmentp. 63
Professional Practice Issuesp. 65
Clinician-Targeted Interventionsp. 65
Clinician Selection and Trainingp. 66
Methodological Issues in Studying Cliniciansp. 67
Summary and Discussionp. 68
Natural Resolution of Alcohol-Related Problems
State of Knowledgep. 78
Epidemiology of Treatment-Assisted and Natural Resolutionsp. 79
Environmental Contexts Surrounding Natural Resolutionsp. 81
Gaps in Knowledge and Research Opportunitiesp. 83
Investigating Natural Resolution across the Distribution of Problem Drinkersp. 83
Explicating Environment-Behavior Relationsp. 84
Determining Pathways to Moderation and Harm Reductionp. 85
Understanding Relations between Help-Seeking and Drinking Behavior Changep. 86
Conclusionsp. 87
Psychosocial Treatments
Overview
The Search for a Rational Basis for Treatment Selection
Overview of Models of Treatment Selectionp. 97
Treatment Selection Models Based on Single Patient Characteristicsp. 98
Single Patient Characteristics Matched to Behavioral Interventionsp. 98
Single Patient Characteristics Matched to Pharmacological Therapiesp. 102
Multidimensional Models of Patient Selectionp. 103
Matching Based on Client Resource Needs and Program Servicesp. 103
Matching Based on Clients' Changing Statusp. 104
The Prescriptive Approach to Matchingp. 106
ASAM Patient Placement Criteriap. 106
Future Prospects for Research on Treatment Selection and Matchingp. 108
Summary of Recent Trendsp. 108
Future Prospectsp. 110
Psychotherapy and Motivational Enhancement
Introductionp. 115
Psychodynamic Treatmentsp. 116
Interpersonal Psychotherapyp. 117
Cognitive Therapyp. 118
Motivational Enhancement Interventionp. 120
Historical Foundationsp. 120
Motivational Interviewing and the Stages of Changep. 121
Current Status of Motivational Enhancement Interventionsp. 122
Motivational Enhancement in the Project MATCH Studyp. 124
Summaryp. 126
Current Status and Future Directionsp. 127
Involvement of Support Networks in Treatment
Self-Help Groupsp. 135
Treatment Involvement by Members of the Natural Social Networkp. 136
Marital and Family Therapy for Alcohol Abusersp. 138
Moving Outside of the Family Unitp. 141
A Summary of Research Prioritiesp. 144
Alcoholics Anonymous and 12-Step Alcoholism Treatment Programs
Nature and Prevalence of Alcoholics Anonymousp. 150
Nature and Prevalence of 12-Step Alcoholism Treatment Programsp. 150
Evaluations of Community-Based AA Groupsp. 151
Evaluation Contextp. 151
Selected Studiesp. 152
Evaluation Research on 12-Step Oriented Professional Treatment Programsp. 154
Evaluation Contextp. 154
Selected Studiesp. 155
Potential Future Research Directionsp. 159
Process Recommendationsp. 159
Specific Content Areas for Focused Enquiryp. 160
Behavioral and Cognitive-Behavioral Treatments for Alcoholism: Research Opportunities
Cue Exposurep. 166
Gaps in Knowledgep. 166
Research Opportunitiesp. 169
Contingency Managementp. 170
Gaps in Knowledgep. 171
Research Opportunitiesp. 171
Coping Skills Trainingp. 172
Gaps in Knowledgep. 172
Research Opportunitiesp. 174
Relapse Preventionp. 174
Gaps in Knowledgep. 175
Research Opportunitiesp. 175
Behavioral Marital Therapyp. 176
Gaps in Knowledgep. 176
Research Opportunitiesp. 177
Final Notep. 177
The Community Reinforcement Approach
Community Reinforcement Approach (CRA)p. 183
CRA Descriptionp. 183
CRA Empirical Supportp. 185
Community Reinforcement and Family Training (CRAFT)p. 190
CRAFT Descriptionp. 190
CRAFT Empirical Supportp. 191
Summaryp. 193
Pharmacotherapy
Overview
Acamprosate
Overview of Clinical Trialsp. 203
Overview of Research Methodologyp. 206
Short-Term Efficacy Studiesp. 207
Six-Month Efficacy Studiesp. 208
Long-Term Efficacy Studiesp. 210
Safetyp. 212
Commentaryp. 212
Advances in the Use of Naltrexone: An Integration of Preclinical and Clinical Findings
Introductionp. 217
Mechanisms of Action of Naltrexonep. 218
Effects of Drinking Behaviorp. 220
Maintenance of Abstinencep. 220
Relapse to Heavy Drinkingp. 222
Patterns of Drinkingp. 224
Dosing Regimensp. 226
Dosep. 226
Continuous Release Formulationsp. 227
Long-Term Intermittent Naltrexone Administrationp. 228
Targeted Naltrexonep. 229
Drinking Pattern Specific Dosingp. 230
Factors Predicting Clinical Response to Naltrexonep. 231
Genetic Responsep. 231
Cravingp. 232
Other Patient Characteristicsp. 233
Interactions with Behavioral Interventionsp. 233
Reduction of Heavy Drinking in Nonalcoholic Populationsp. 234
Combination Therapyp. 235
Summaryp. 236
The Status of Serotonin-Selective Pharmacotherapy in the Treatment of Alcohol Dependence
Introductionp. 247
Abnormal Serotonergic Neurotransmission Linked to Alcohol Dependencep. 248
Historical Overview: Trials of 5-HT-Selective Agents to Reduce Excessive Drinkingp. 249
Current Status: 5-HT Clinical Trials to Treat Subtypes of Alcohol Dependencep. 251
Alcoholic Subtypes: Presence or Absence of Comorbid Psychiatric Disordersp. 252
Alcoholic Subtypes: Different Kinds of Alcohol Dependencep. 254
Conclusionsp. 257
Animal Models of Motivation for Drinking in Rodents with a Focus on Opioid Receptor Neuropharmacology
Positive Reinforcement Animal Models for Development of Medications to Treat Alcoholismp. 264
Two-Bottle Choice Procedure--Ratsp. 265
Two-Bottle Choice Procedure--Micep. 265
Limited Access Operant Self-Administration--Ratsp. 266
Limited Access Operant Self-Administration--Micep. 266
Drinking in Alcohol-Preferring Ratsp. 267
Alcohol Deprivation Effectp. 267
Conditioned Reinforcement: Discriminative Stimulus (Cue)-Induced Reinstatement of Self-Administrationp. 268
Independent Variables Used to Predict Medications for Treating Alcoholism--The [mu]-Opioid System as a Prototypep. 270
Selective Antagonistsp. 270
Effects of Opioid Antagonists on Self-Administration of Ethanol in Alcohol-Preferring Ratsp. 270
Effects of Chronic Naltrexone Administration on the Alcohol Deprivation Effectp. 271
Effects of Naltrexone on Responding to Ethanol-Associated Cuesp. 271
Molecular Genetic Manipulations--Knockout of the [mu]-Opioid Receptorp. 273
Molecular Genetic Manipulations--Knockout of the [partial differential]-Opioid Receptorp. 275
Summary and Conclusionsp. 277
Recent Development in Alcoholism: Research on Alcoholism Treatment
Overview
Outcomes of Alcohcol Treatment for Adolescents
Prevalencep. 289
Assessment and Diagnosisp. 290
Treatment Outcome Researchp. 293
Intervention Studiesp. 296
Self-Help Programsp. 296
Systems Oriented Interventionsp. 296
Brief Interventionsp. 298
Cognitive and Behavioral Therapyp. 298
Pharmacotherapyp. 299
Self-Change Effortsp. 300
Outcome Process Research for Adolescencep. 301
Developmental Factors and Family Contextp. 301
Heterogeneity of the Adolescent Treatment Populationp. 302
Relapse and Posttreatment Functioningp. 304
Summary and Conclusionsp. 307
Treatment for Alcohol-Related Problems: Special Populations: Research Opportunities
Womenp. 315
Recommendationsp. 320
The Elderlyp. 321
Alcoholp. 322
Treatmentsp. 324
Ethnicityp. 325
Treatment of Tobacco Dependence in Alcoholics
Introductionp. 335
Prevalence of Smoking in Alcoholicsp. 336
Tobacco-Caused Morbidity and Mortality in Alcoholicsp. 337
Addressing Tobacco Dependence in Addictions Treatmentp. 338
Efficacy of Behavioral Treatment for Alcoholic Smokersp. 339
Addressing Depression in the Behavioral Treatment of Alcoholic Smokersp. 342
Effect of Tobacco Dependence Treatment on Alcohol Relapsep. 343
Pharmacological Treatment of Tobacco Dependence in Alcoholicsp. 344
First-Line Pharmacotherapyp. 344
Second-Line Pharmacotherapyp. 350
Combination Pharmacotherapyp. 351
Unproven Pharmacotherapies for Tobacco Dependencep. 351
Alcohol and Psychiatric Comorbidity
Introductionp. 362
Comorbidity with Major Depressionp. 364
Comorbidity with Bipolar Disorderp. 365
Comorbidity with Anxiety Disordersp. 366
Comorbidity with Psychotic Disordersp. 367
Comorbidity with Drug Use Disordersp. 368
Conclusionsp. 369
Brief Interventions and the Treatment of Alcohol Use Disorders: Current Evidence
Introductionp. 375
Brief Intervention: The Evidence--What We Know and Don't Knowp. 376
What We Know About Brief Intervention!p. 377
What We Don't Know About Brief Intervention!p. 378
Methodological Concerns and Challengesp. 380
Other Methodological Considerationsp. 382
Review of Selected Brief Intervention Trialsp. 382
Recommendationsp. 388
Spirituality, Treatment, and Recovery
Defining Spiritualityp. 391
Spirituality and Alcoholismp. 392
Spirituality and Recoveryp. 394
Spirituality and Treatmentp. 395
AA and Treatmentp. 395
AA and Treatment Outcomep. 396
Twelve-Step Facilitation (TSF) Therapyp. 397
Beyond 12-Step Spiritualityp. 399
Spirituality and Sciencep. 401
Research Priorities for Alcoholism Treatment
Context for Setting Research Prioritiesp. 405
Impact of Prior Portfolio Reviews in Stimulating Researchp. 406
New Research Prioritiesp. 407
Mechanisms of Action of Treatmentp. 407
Combinations and Sequencing of Treatmentsp. 408
Health-Seeking Patterns and Processesp. 408
Concurrent Disorders: Medical, Drug, and Psychiatricp. 409
Help Agent Behaviorsp. 409
Crosscutting Issuesp. 410
Special Populationsp. 410
Patient-Treatment Matchingp. 411
Measurement Techniquesp. 411
Technology Transferp. 412
Mechanisms of Fundingp. 412
Summary and Conclusionsp. 413
Contents of Previous Volumesp. 415
Indexp. 433
Table of Contents provided by Ingram. All Rights Reserved.

ISBN: 9780306472589
ISBN-10: 0306472589
Series: Recent Developments in Alcoholism : Book 16
Audience: Professional
Format: Hardcover
Language: English
Number Of Pages: 438
Published: 31st January 2003
Publisher: Springer Science+Business Media
Country of Publication: US
Dimensions (cm): 25.4 x 17.8  x 3.18
Weight (kg): 1.83