Different Goals, Different Needs: The Effects of Telephone- and Text Message-Based Continuing Care for Patients with Different Drinking Goals After Residential Treatment for Alcohol Use Disorder.

AIMS: Drinking goal has emerged as a promising predictor variable for alcohol-related outcomes. Many patients with alcohol use disorder (AUD) choose another drinking goal than abstinence after residential AUD treatment program. We aimed to examine the effects of an abstinent drinking goal (ADG) and conditional abstinence drinking goal (CADG) 6 months after residential treatment on drinking outcomes in patients with severe AUD and investigate the effectiveness of telephone-based (TEL) or text message-based (TEX) continuing care according to the individual drinking goal. METHODS: A total of 240 patients from two specialized residential treatment programs for AUD were included in the study. Patients were randomly assigned to high-frequency (nine contacts) or low-frequency (two contacts) TEL, TEX (nine contacts), or control group (no contact) from treatment discharge to the 6-month follow-up. RESULTS: Patients with an ADG were significantly more often abstinent (58%) at the 6-month follow-up compared to patients with a CADG (32.1%), and in the case of relapse, showed a significantly longer time to the first drink. Patients with a CADG of the high-frequency TEL showed a tendency to be more abstinent at the 6-month follow-up and reported significantly higher alcohol-related self-efficacy compared to the CADG patients of the control group. CONCLUSIONS: Patients with CADG are more vulnerable to relapse, and therefore may benefit more from high-frequency telephone contacts to deal with alcohol-related problems and reach their goal. In the case of relapse, the high-frequent contacts may help patients stay connected to health services, preventing chronification and facilitating recovery from AUD.

Telephone- and Text Message-Based Continuing Care After Residential Treatment for Alcohol Use Disorder: A Randomized Clinical Multicenter Study.

BACKGROUND: Alcohol use disorder (AUD) is characterized by extremely high rates of postresidential treatment relapse, and as such, continuing care to prevent relapse has become an important element in AUD treatment. In this regard, research has yielded heterogeneous evidence on telephone-based (TEL) and text message-based (TEX) continuing care. We aimed to compare the effectiveness of TEL and TEX continuing care provided in different frequencies by psychotherapists for patients from residential treatments in mitigating the occurrence of posttreatment relapse in patients who completed a 12-week abstinence-oriented residential treatment program for AUD. METHODS: A total of 240 patients from 2 residential treatment programs for AUD were included in the study. Patients were randomly assigned to high- (10 contacts) or low-frequency (3 contacts) TEL, TEX (10 contacts) continuing care, or control group (1 contact) from discharge to 6-month follow-up. The TEL was intended to be supportive and consisted of several cognitive behavioral therapy components, whereas the TEX was based on behavioral self-monitoring techniques and additional calls in case of relapse or as needed. Sociodemographic, clinical, and alcohol-specific variables at residential treatment discharge and at 5-month follow-up were assessed through interviews and questionnaires. RESULTS: Compared with the control group, patients in the high-frequency TEL were significantly more likely to be abstinent at 6-month follow-up and, in case of relapse, showed a tendency toward a longer time to first drink. Moreover, the high-frequency TEL and TEX groups had significantly higher alcohol-related self-efficacy 6 months after residential treatment. CONCLUSION: High-frequency proactive telephone contact by psychotherapists known to the patient may help patients to surmount the vulnerable phase after residential treatment and, in case of relapse, might help patients stay connected to health services, which in turn prevents chronification and facilitates recovery from AUD.

Trail Making Test: Normative Data for Patients with Severe Alcohol Use Disorder.

Background: Patients with alcohol use disorders (AUD) often show cognitive impairment, particularly in executive functions that has been linked to poor treatment outcomes. The Trail Making Test (TMT) is the most widely used neuropsychological test to investigate executive functions with available normative data. However, no such norms exist for patients with AUD, although there is extensive evidence that TMT performance is altered in AUD patients. Purpose: To provide normative data for patients with AUD and compare the performance of AUD patients with already existing normative data from healthy subjects. Methods: Data of 494 recently detoxified patients with AUD who entered an abstinence-oriented residential treatment program were analyzed. Patients completed a standardized diagnostic procedure and the TMT Parts A and B at treatment admission. Results: AUD patients' performance on the TMT was impaired compared to the normative data of healthy individuals and decreased with increasing age and lower levels of education, with stronger effects in Part B assessing more complex executive functioning. Alcohol-related variables showed no direct associations with TMT performance. Conclusions: The results replicate the association of age and education with TMT performance, suggesting that AUD may be associated with impaired cognitive functioning earlier in life in abstinent patients shortly after withdrawal from alcohol compared to healthy individuals. The presented normative data for patients with AUD particularly improve the examination of executive deficits, and may enable clinicians to evaluate patients' cognitive functioning in treatment more precisely.