Senior Research Scientist
Research Professor, Psychology
Alcoholism treatment outcome evaluation; relapse prevention; secondary prevention of alcohol problems.
| Maisto | Dearing
The working relationship between the patient and therapist during treatment for an alcohol use disorder will be studied to examine its influence on treatment effectiveness and post-treatment functioning.
The establishment of a therapeutic alliance between the patient and therapist is generally viewed as a central component of the behavior change process in the treatment of alcohol use disorders (AUDs). In this study, the therapeutic alliance, from the perspective of the patient, will be studied regularly over the course of outpatient treatment and its relationship to treatment variables (such as attendance) and posttreatment functioning (including drinking behavior) evaluated. The study is intended to advance knowledge on therapeutic alliances, the enhancement of which is anticipated to improve treatment outcomes. Co-investigators include Drs. Stephen A. Maisto of Syracuse University, Ronda L. Dearing, and Joseph Lucke. Funded by a grant of $2,445,873 from NIAAA, 2012-2016.
Mindfulness-Based Stress Reduction (MBSR) has been shown to be efficacious in increasing the ability to cope with stress and in enhancing coping and psychological well-being. In this study, MBSR was evaluated in a clinical setting with alcohol dependent patients. In phase one of this study, an eight-session treatment manual for conducting group-based MBSR was adapted for use in the context of a standardized 10-session treatment-as-usual (TAU) for alcohol dependent men and women. In phase two, a pilot clinical trial was conducted to examine the effects of adding MBSR to TAU for alcohol dependent outpatients. The outcomes were compared to the outcomes for patients receiving TAU plus a series of Health and Lifestyle Lectures (TAU + HLL). Co-investigators include Drs. Kimberly S. Walitzer, Nancy J. Smyth, UB School of Social Work, and Craig R. Colder, UB Department of Psychology. Funded by a grant of $1,977,241 from NIAAA, 2007-2012.
This study investigated the dissemination and “real world” effectiveness of a motivational interviewing-(MI)-based preparatory procedure designed to reduce early attrition from alcoholism outpatient treatment. In order to study dissemination and adoption of the procedure, 150 New York State Office of Alcoholism and Substance Abuse Services (OASAS) alcoholism outpatient clinics were randomly assigned to one of three dissemination conditions. Researchers examined the clinic sites’ rates of client retention and client treatment outcome prior to and following dissemination. Funded by a grant of $2,670,633 from NIAAA, 2004-2011.
This project used a multi-modal measurement approach to the assessment of impulse control before, during, and after a cognitive behavioral treatment for alcohol dependence. Since it is likely that the decision to initiate drinking is indicative of a momentary lapse in impulse control for individuals with an alcohol disorder, this study 1) investigated whether changes in impulse control during treatment are related to alcohol use during treatment, as compared to pre-treatment and 2) whether changes in impulse control during treatment result in changes in post-treatment alcohol use, as compared to pre-treatment. A two-group design consisting of a Standard Assessment Group and a Frequent Assessment Group was used with men and women who met DSM-IV criteria for alcohol dependence to examine the multi-dimensional nature of the impulsivity construct. Results yet to be published will better define the role of impulse control as a potential mechanism of behavioral change and inform the development of subsequent avenues of investigation on this mechanism in the treatment of alcohol use disorders. Results will also provide information about refining existing treatments as well as developing new treatment methods. Dr. Houston’s co-investigators are Drs. Ronda L. Dearing and Gerard J. Connors of RIA, and Dr. Gregory G. Homish of UB’s Department of Health Behavior. Funded by a grant of $416,063 from NIAAA, 2007-2010.
The aims of this research are to look at factors that predict who continues to drink following alcohol and mental health treatment versus those individuals who are able to maintain abstinence from alcohol. We anticipate that some of the important factors affecting these relationships will include the extent and severity of psychiatric symptoms, how long the alcohol problem has existed, how regularly dual-diagnosis treatment is attended, and the types of coping skills project participants have to deal with difficult situations involving alcohol or other drugs. This four-year study will result in a better understanding of the kinds of factors that are most likely to lead to continued problem drinking among severely mentally ill individuals and in turn, help in the design of treatment programs that better meet the needs of this population. Dr. Clara Bradizza's co-investigators are Drs. Gerard Connors and Paul Stasiewicz of RIA and Stephen Maisto, Syracuse University. Funded by a grant of $1,567,083 from NIAAA, 2002-2007.
In this project, women heavy drinkers without histories of severe physical dependence on alcohol participated in a group-based intervention focusing on reducing alcohol consumption. Some participants were exposed to intervention enhancements: life-skills training and/or post-intervention booster sessions. Participants were monitored for an 18-month period following the intervention. In terms of alcohol use, women responded positively to treatment. Participants showed significant reductions in drinking throughout the 18 months after treatment. The treatment enhancements (life management skills and booster sessions) led to significantly improved drinking outcomes among women who were heavier drinkers at pretreatment. There were no significant effects of the treatment enhancements among women who were lighter drinkers at pretreatment. In addition, participants reported significant decreases in drinking consequences and improvements in several domains of life functioning. Funded by a grant of $917,074 from NIAAA, 1990-95.
In this two-year investigation, alcohol-dependent patients participating in a 12-week outpatient treatment program were assessed over the course of treatment on their perceptions of the therapeutic alliance (therapist perceptions also will be assessed). The project is examining the within-treatment, week-to-week relationship between the ratings of the therapeutic alliance (as perceived by the patient and therapist) and the patient's alcohol involvement (percent days abstinent and drinks per drinking day) during treatment. The project also is examining profiles of the therapeutic alliance (as perceived by the patient and therapist) over the course of treatment in relation to alcohol involvement during treatment and during a six-month follow-up period. Results from this study will be used to characterize the interplay of the therapeutic alliance with alcohol involvement during and following an outpatient treatment episode. The data are expected to provide direction and foundation for future systematic research on the therapeutic alliance as a mechanism of change in the treatment of alcohol use disorders. Co-investigators include Kurt H. Dermen, PhD and Stephen A. Maisto of Syracuse University. Funded by a grant of $416,063 from NIAAA, 2007-2010.
The research team matched and mismatched clients to inpatient vs. outpatient alcoholism treatment in a community field setting based on their drinking problem severity and cognitive functioning measures. Treatment consisted of 21 days of primary (inpatient or outpatient) care and 6 months of outpatient aftercare. Participants subsequently were followed for 18 months postprimary care. The results will contribute to the existing knowledge-base on efficient and effective client placement criteria. Robert Whitney, MD, of the Erie County Medical Center (ECMC), Division of Chemical Dependency Unit collaborated with RIA scientists. Funded by a grant of $2,364,815 from NIAAA, 2002-2008.