# Individualized Assessment and Treatment Program for Alcoholism: Treatment and Mechanisms

> **NIH NIH R01** · UNIVERSITY OF CONNECTICUT SCH OF MED/DNT · 2020 · $560,304

## Abstract

Our 2009 R-21 pilot project developed a cognitive-behavioral treatment for alcohol use disorders that employs
cellphone-based experience sampling (ES) to collect detailed patient data in near real-time, and uses those
data to direct treatment for each patient based on his/her specific patterns of drinking and specific coping
actions during actual high-risk situations. ES data included situations, thoughts and feelings antecedent to
drinking episodes, and any use of coping skills. The object was to create a CB treatment that was more
relevant for each patient and more effective than current treatments. In our initial study the Individualized
Assessment and Treatment Program (IATP) yielded better drinking rates at posttreatment, and more adaptive
changes in coping, than a conventional manualized CBT program. Moreover, changes in drinking were partly
mediated by pre-to-posttreatment changes in coping with high-risk situations. Questions unanswered included:
1. Because the pilot study only collected data pre and posttreatment, with no follow-ups, it is not clear
 whether use of coping skills reduced drinking, or whether reduced drinking led to more adaptive coping.
2. We do not know which coping skills or other factors drive outcomes in the long-term.
 To answer these and other questions we propose to enroll 207 patients in a full-scale trial of IATP with
extended follow-ups to examine determinants of outcomes over time. IATP will be compared to a more
conventional packaged CB treatment (PCBT), and to a Case Management Control condition (CaseM), in a
dismantling design. In addition to coping, we intend to evaluate a number of other possible treatment
mechanisms suggested by the literature including motivation, self-efficacy, self-control, social support, alliance
with the therapist, AA involvement, mindfulness, and utilization of other treatment services.
 By specifically training coping skills for use in high-risk for drinking situations, we will be able to assess how
skills per se contribute to initiation and long-term maintenance of behavior change. The use of ES during
treatment will allow us to determine what patients are actually doing, in close to real time, to initiate and
maintain their own sobriety. The use of ES in the follow-up period will allow us to determine whether coping
skills that were active in initiation of reduced drinking continue to be active in the long-term, as well as the
extent to which other mechanisms may come into play. In this way we can develop a clearer picture than ever
before of the processes that affect outcomes of CBT, and will enable clinicians to focus more precisely on the
most relevant mechanisms of change. Comparing IATP with PCBT will test effects of tailoring skills. The use of
CaseM will control for the general effects of study participation (i.e., “common factors”), especially therapist
support. The study builds on pilot data and on procedures that have already been developed but not fully
tested. This w...

## Key facts

- **NIH application ID:** 9976405
- **Project number:** 5R01AA024729-05
- **Recipient organization:** UNIVERSITY OF CONNECTICUT SCH OF MED/DNT
- **Principal Investigator:** MARK D. LITT
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $560,304
- **Award type:** 5
- **Project period:** 2016-08-01 → 2022-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9976405

## Citation

> US National Institutes of Health, RePORTER application 9976405, Individualized Assessment and Treatment Program for Alcoholism: Treatment and Mechanisms (5R01AA024729-05). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9976405. Licensed CC0.

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