Applying Treatment Research Technologies in New Settings (Morgenstern, PI)

Despite dramatic progress in treatment research, most alcoholics are treated "with tools and techniques developed over 50 years ago" (Gordis, 1991 pg.-173). The task of increasing knowledge transfer has been given high priority by NIAAA, but efforts have met with mixed success, at least as regards directly influencing real-world treatment practices. Controlled clinical trials have demonstrated the effectiveness of several treatments for alcohol problems. However, the overwhelming majority of alcohol treatment delivered in this country continues to use intervention strategies with limited evidence of effectiveness. Technology transfer is an important strategy for bridging the gap between research and practice and for translating treatments with established effectiveness for use in the field. No study has evaluated the feasibility and effectiveness of applying methods for training therapists in clinical trials (manuals and therapist training procedures) in order to broaden the repertoire of alcoholism counselors or increase their effectiveness. Few studies have examined whether implementing research based alcohol treatments in real world settings can improve outcome. This proposed study attempts to address these questions. "Front-line" counselors from two alcohol treatment programs will be randomly assigned to receive Cognitive Behavioral Coping Skills Treatment (CBCST) training or an attention placebo control training. Cognitively trained counselors will then be assigned to deliver CBCST under conditions of high or low treatment standardization. Patients will be randomly assigned to one of three conditions: Manualized CBCST (high standardization), Real World CBCST (low standardization), or Traditional Treatment. The content of treatment delivered will be monitored using videotaping of sessions. Patients will be assessed at intake, at the end of treatment and six and 12 months following treatment. Differences on outcome and process variables will be assessed for the two groups of patients receiving CBCST versus those receiving traditional treatment