Category: Addictive Behaviors
Evidence of gender differences in many aspects of alcohol use disorder (AUD) has led to development of treatments tailored for women. In community settings, most therapy for AUD is delivered in open enrollment groups, where new clients are continuously enrolled into a group as space permits; however, open enrollment groups are currently understudied in the research literature. This pilot study builds on a randomized clinical trial (RCT) comparing a closed enrollment Female-Specific Cognitive Behavioral Therapy Group (G_FS-CBT) with an individual modality of the same protocol (I_FS-CBT) for treating alcohol dependence; G_FS_CBT yielded equivalent positive outcomes in drinking as I_FS_CBT, with fewer sessions attended on average. The current pilot study aims to investigate the feasibility and outcome of implementing (G_FS-CBT) adapted for an open enrollment group format for women with AUD.
Methods: Of 54 alcohol dependent women screened 27 (50%) completed an in-person clinical intake and 19 entered into an open enrollment group therapy 12-session outpatient G_FS_CBT protocol. Women could enter the group at any session and could continue to attend as many sessions as they wanted, including after completing the core 12 sessions. Daily monitoring cards were filled out by women every day to track: 1. number of drinks consumed 2. mood that day, rated on a 7-point Likert scale, 3. whether they experienced any urges to drink alcohol, and 4. if urges were reported, each urge was rated on a 7-point Likert scale in terms of intensity (urge intensity was then averaged for the day).
Results: Of 19 women who entered the group that ran in total for 10 months, average number of women per group was six and average number of sessions attended was 15.2 (SD=12.5). 10 (52.6%) women attended at least all 12 sessions, and 8 (42.1%) continued on past 12 sessions to begin again at session 1. Growth curve analyses testing change over time (while controlling for number of sessions attended) showed that women had significant improvements in mood over the course treatment (χ2 =42.01, p=.00), as well as decreases in number of drinks per drinking day (χ2 = 80.38, p=.00), number of urges to drink per urge? day (χ2 = 89.83, p=.00), and average urge intensity (χ2 = 11.66, p=.00). Number of sessions attended was a significant predictor of improved mood (χ2 = 32.84, p=.00) and decreased drinks per drinking day (χ2 = 76.07, p=.00), but not of decreased number or intensity of urge (p>.05).
Conclusions: A community-friendly open enrollment group modality female-specific cognitive behavioral therapy for alcohol dependent women was feasible and was associated with significant reduction in drinking, cravings, and improvement in mood.
Ayorkor Gaba– Senior Project Director, University of Massachusetts Medical School
Cathryn Glanton Holzhauer– Postdoctoral Research Associate, University of Massachusetts Medical School
Elizabeth Epstein– Professor, University of Massachusetts Medical School, Worcester
Sharon Cook– Project Manager, Rutgers University
Barbara McCrady– Distinguished Professor of Psychology & Director, University of New Mexico, Albuquerque, New Mexico
Postdoctoral Research Associate
University of Massachusetts Medical School