The goal of this research is to determine which of the three treatments described below is more effective for alcohol problems. Each treatment will involve 12 individual outpatient sessions with a counselor or therapist, each session being about one hour. About 207 participants will be recruited. You are being asked to participate because you have indicated that you have a significant drinking problem and that you wish to seek treatment for that problem.
Three treatments are being studied: Case Management; Packaged CBT (PCBT); and Individualized Assessment and Treatment Program (IATP). All of these treatments have been used to help people manage alcohol problems, but there is not much research on Case Management or IATP. The second treatment described below, PCBT, is used extensively and is effective for many people. We are testing all of these in one study. The three treatments we are studying are as follows:
- One type of treatment will consist of Case Management (CaseM), in which you would be referred for services in the community that will help you deal with the problems in your life that tend to make it harder for you to stay abstinent. Examples of these kinds of problems might be depression, trouble finding a job, or finding a new place to live. CaseM involves 12 individual weekly sessions with a counselor. Case Management would help you with those problems of living so that you could concentrate on staying sober.
- The second type of treatment is Packaged Cognitive-Behavioral Treatment (PCBT), which is intended to address difficulties with managing situations in which drinking is likely. PCBT involves 12 individual weekly sessions with a counselor. These sessions help you learn how to manage situations in which drinking is likely. Different topics are covered at each session. Skills that may be taught include managing cravings, problem solving, refusing drinks, anger management, assertiveness, developing social support networks, and resolving relationship problems.
- The third type of treatment will be an Individualized Assessment and Treatment Program (IATP). This treatment involves 12 individual weekly sessions in which the therapist uses detailed recordings of your thoughts, feelings, behaviors, and situations to determine exactly what is contributing to your drinking, and how best to help you stay sober. Sessions focus on helping you to develop and use the skills that will work best for you.