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Desire to stop drinking could be more important than therapy

The positive outcomes of therapy for alcoholism may have less to do with the therapy itself and more to do with participants' determination to quit. These are the findings of a study published today in the Open Access journal, BMC Public Health, which provides a new analysis of previous data from Project MATCH, a clinical trial of three common forms of therapy used for the treatment of alcoholism. This analysis shows that the participants in the trial who attended all sessions did scarcely better than those who received no treatment. This contradicts previous analyses, which concluded that all three therapies for alcoholism were very effective.

The results highlight the importance of selection bias the distortion of a statistical analysis by self-selection of participants. Individuals who come forward to take part in trials such as Project MATCH might be more likely to have positive outcomes. "Alcoholics who decide to enter treatment are likely to reduce drinking. Those who decrease their drinking are more likely to remain in treatment", explain Robert Cutler and David Fishbain from the department of psychiatry and behavioural sciences at the University of Miami, the authors of the study.

A fundamental principle underlying the treatment of alcoholism, and other addictions, is that psychosocial therapy - therapy involving both group meetings and personalised sessions with psychologists - is effective.

Cutler and Fishbain re-examined data from Project MATCH a large trial carried out in the late 1990's, which concluded that therapy for alcoholism produced excellent outcomes, although the results were controversial and inconclusive.

Project MATCH assessed the effectiveness of three different therapies: Cognitive Behavioural Therapy (CBT), Motivational Enhancement Therapy (MET) and Twelve Step Facilitation (TSF). Cutler and Fishbain investigated the relationship between the number of therapy sessions attended and how successful pr
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Contact: Juliette Savin
juliette@biomedcentral.com
44-207-631-9931
BioMed Central
13-Jul-2005


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