Individual versus group female-specific cognitive behavior therapy for alcohol use disorder

Elizabeth E Epstein; Barbara S McCrady; Kevin A Hallgren; Ayorkor Gaba; Sharon Cook; Noelle Jensen; Thomas Hildebrandt; Cathryn Glanton Holzhauer; Mark D Litt

doi:10.1016/j.jsat.2018.02.003

Individual versus group female-specific cognitive behavior therapy for alcohol use disorder

J Subst Abuse Treat. 2018 May:88:27-43. doi: 10.1016/j.jsat.2018.02.003. Epub 2018 Feb 22.

Authors

Elizabeth E Epstein¹, Barbara S McCrady², Kevin A Hallgren³, Ayorkor Gaba⁴, Sharon Cook⁵, Noelle Jensen⁶, Thomas Hildebrandt⁷, Cathryn Glanton Holzhauer⁸, Mark D Litt⁹

Affiliations

¹ Center of Alcohol Studies, Rutgers University, 607 Allison Road, Piscataway, NJ 08854, United States; Department of Psychiatry, University of Massachusetts Medical School, 365 Plantation Street, Worcester, MA, 01605, United States. Electronic address: elizabeth.epstein@umassmed.edu.
² Center of Alcohol Studies, Rutgers University, 607 Allison Road, Piscataway, NJ 08854, United States; Center on Alcoholism, Substance Abuse, and Addictions, University of New Mexico, 2650 Yale Blvd. SE, Albuquerque, NM 87106, United States. Electronic address: bmccrady@unm.edu.
³ Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, 1959 NE Pacific St., Box 356560, Seattle, WA 98195, United States.
⁴ Center of Alcohol Studies, Rutgers University, 607 Allison Road, Piscataway, NJ 08854, United States; Department of Psychiatry, University of Massachusetts Medical School, 365 Plantation Street, Worcester, MA, 01605, United States. Electronic address: Ayorkor.Gaba@umassmed.edu.
⁵ Center of Alcohol Studies, Rutgers University, 607 Allison Road, Piscataway, NJ 08854, United States. Electronic address: sharonc@scarletmail.rutgers.edu.
⁶ Center of Alcohol Studies, Rutgers University, 607 Allison Road, Piscataway, NJ 08854, United States. Electronic address: nkj@rci.rutgers.edu.
⁷ Department of Psychiatry, Mt. Sinai School of Medicine, 1425 Madison Ave, Floor 6, Room 30, New York, NY 10029, United States. Electronic address: tom.hildebrandt@mssm.edu.
⁸ Department of Psychiatry, University of Massachusetts Medical School, 365 Plantation Street, Worcester, MA, 01605, United States; Veterans Affairs VISN 1 Central Western Massachusetts, 421 North Main St Leeds MA 01053, United States. Electronic address: cathryn.holzhauer@va.gov.
⁹ University of Connecticut Health Center, Division of Behavioral Sciences and Community Health, 263 Farmington Avenue, MC 3910, Farmington, CT 06030-3910, United States. Electronic address: litt@uchc.edu.

Abstract

Objectives: To test group-based Female-Specific Cognitive Behavioral Therapy (G-FS-CBT) for women with Alcohol Use Disorder (AUD) against an individual Female-Specific Cognitive Behavioral Therapy (I-FS-CBT). This aims of this paper are to describe G-FS-CBT development, content, feasibility, acceptability, group process, engagement in treatment, and within- and post-treatment outcomes.

Methods: Women with AUD (n=155) were randomly assigned to 12 manual-guided sessions of G-FS-CBT or I-FS-CBT; 138 women attended at least one treatment session.

Results: Women in G-FS-CBT attended fewer sessions (M=7.6) than women in I-FS-CBT (M=9.7; p<.001). Women in both conditions reported high satisfaction with the treatments. Independent coders rated high fidelity of delivery of both G-FS-CBT and I-FS-CBT. Therapeutic alliance with the therapist was high in both conditions, with I-FS-CBT being slightly but significantly higher than G-FS-CBT. In the first six weeks of treatment, women in both treatment conditions significantly reduced their percent drinking days (PDD) and percent heavy days drinking (PHD) by equivalent amounts, maintained through the rest of treatment and the 12month follow up with no treatment condition effects. Women reported significant improvement in all but one of the secondary outcomes during treatment; gains made during treatment in depression, anxiety, autonomy, and interpersonal problems were maintained during the follow-up period, while gains made during treatment in use of coping skills, self-efficacy for abstinence, self-care, and sociotropy deteriorated over follow up but remained improved compared to baseline.

Conclusions: Findings support the feasibility, acceptability, and efficacy of a group format for female-specific CBT for AUD, a new 12-session, single gender, community friendly, group therapy with programming specifically for women. Similar, positive outcomes for individual and group treatment formats were found for drinking, mood, coping skills, self-confidence, interpersonal functioning, and self-care.

Keywords: Alcohol use disorder; Cognitive behavior therapy; Female specific therapy; Group therapy; Women.

Publication types

Research Support, N.I.H., Extramural

MeSH terms

Adult
Alcoholism / therapy*
Cognitive Behavioral Therapy*
Female
Humans
Middle Aged
Psychotherapy, Group / methods*
Treatment Outcome*
Young Adult

Abstract

Publication types

MeSH terms

Grants and funding