Focused versus broad-spectrum behavior therapy for problem drinkers.

Abstract

The relative effectiveness of focused versus broad-spectrum approaches in teaching moderation to problem drinkers was evaluated. Of 56 clients randomly assigned to treatment conditions, 45 began treatment and 41 (21 men and 20 women) completed enough sessions to be regarded as treated in one of four groups: (a) bibliotherapy, in which clients received self-help materials but no treatment sessions, (b) behavioral self-control training (BSCT), consisting of six weekly sessions, (c) BSCT plus 12 sessions of relaxation, communication, and assertion training, or (d) BSCT plus 12 weeks of individually tailored broad-spectrum modules. Multimodal assessment was used to evaluate drinking behavior, life problems, and general functioning. All groups showed significant improvement on drinking measures, a trend confirmed by collateral reports. Bibliotherapy clients spent more hours per week intoxicated than other groups did, but no other significant group differences were observed. A pattern of general improvement on other dimensions was noted, with no differences among groups. In vivo breath testing was found to be unhelpful as an assessment procedure. The degree to which therapists showed accurate empathy proved to be a good predictor of client outcome.

The use of motivational interviewing techniques to enhance the efficacy of guided self-help behavioral weight loss treatment

“…It is possible then that the empathic, reflective listening style adopted by MI therapists could at least partly explain MI's efficacy. Miller's group has conducted a number of studies suggesting that therapist empathy is directly related to treatment outcome (Miller & Baca, 1983;Miller, Benefield, & Tonigan, 1993;Miller, Taylor, & West, 1980). Another study indicated that general therapist interpersonal skill predicts patient engagement in MI sessions, even when therapists use specific techniques that are not consistent with MI (e.g., confronting patients) .…”

The therapeutic relationship in cognitive-behavioral therapy: Patient perceptions and therapist responses

“…Therapist warmth, empathy, and a positive relationship bond are most strongly associated with treatment outcome when the patient's perceptions of these qualities are considered (Lambert & Bergin, 1994;Orlinsky et al, 1994). Even in specific behavioral therapies, patients who view their therapist as warm and empathetic will be more involved in their treatment and ultimately, have a better outcome (e.g., Holtzworth-Munroe, Jacobson, DeKlyen, & Whisman, 1989;Miller, Taylor, & West, 1980;Williams & Chambless, 1990). According to Orlinsky et al (1994), these conclusions are based on literally hundreds of empirical results and can be considered scientific "facts" (p. 361).…”

The BRENDA Model: Integrating Psychosocial Treatment and Pharmacotherapy for the Treatment of Alcohol Use Disorders

“…46 This uniformity suggests that common elements shared by all effective psychotherapies-including therapist empathy toward the patient and formation of a strong therapeutic alliance-have an impact on both compliance and positive outcomes. 47 A study involving problem drinkers conducted by Miller et al 48 showed that therapist empathy had a 0.82 correlation with improved drinking outcomes at 6-month follow-up. Empathy is thought to facilitate formation of a therapeutic alliance, defined by Connors et al 49 as "a collaborative relationship that consists of an emotional bond and shared attitudes regarding the tasks and goals of the treatment endeavor."…”