Abstract:

A Combined Behavioral Intervention (CBI) was developed as a state-of-the-science psychotherapy to be tested in NIAAA’s multisite COMBINE study. It is a manual-guided, structured yet flexible therapy for alcohol dependence, combining evidence based behavioral treatment methods in an integrated approach. CBI begins with motivational interviewing to enhance patients’ intrinsic motivation for change. This is followed by structured assessment feedback and development of an individualized treatment plan constructed from a menu of empirically supported behavioral modules. Separate pull-out modules are also available for handling special situations that arise. Throughout CBI, the general clinical style of motivational interviewing is maintained. CBI was designed to comprise up to 20 individual outpatient sessions, but its length is flexible based on goal attainment. A quality assurance rating system has been developed to document therapist adherence from session audiotapes, and shows good inter-rater reliability. Clinical feasibility and acceptability of CBI have been excellent, with over 600 patients treated to date. A therapist manual to guide delivery of CBI is being published by NIAAA.

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