Effect of Psychoeducation on Motivation to Change in Traumatized Alcoholics

Many people suffering from alcohol dependence have a history of exposure to stressful life situations, such as childhood physical or emotional misuse. Often, there's a functional relationship between drinking and emotional problems related to past traumatic experiences, i.e. drinking to forget. However, alcohol treatment often does not include interventions to support patients to cope better with past life experiences. On the other hand, most alcoholics are poorly motivated to participate in long-term rehabilitative treatments after detoxification. In the proposed study, the investigators will study the effects of a brief psycho-educational group intervention during detoxification treatment on motivation to change and the willingness to accept further treatment.

The investigators will use a group comparison design (intervention versus "TAS" control group). In month 1, patients take part in Treatment as Usual (TAS), including a unspecific information group. In month 2, the information group is replaced by the psychoeducational group (intervention). Ward staff selects patients for the groups, irrespective of intervention or TAS. Selection criteria are: absence of severe withdrawal and cognitive impairment. Absence of severe co-morbid psychiatric disorder (e.g. schizophrenia or suicidal crisis). The group sessions will take place in groups of up to 15 patients and will include 4 structured sessions (45 min each). Main content if the intervention group is to highlight and discuss the association between stress, Posttraumatic Stress Disorder and drinking. Patients will also be informed about the different treatment options available in the region.

At entry, patients are asked to fill in the German versions of the University of Rhode Island Change Assessment (URICA; McConnaughy, Prochaska, & Velicer, 1983; German: Heidenreich, Hoyer & Fecht; 2001) and the Trauma History Questionnaire (THQ; Green, 1996; German: Maercker, 2002). At discharge, patients are asked to fill in the URICA.

The investigators expect that specific information on the association between stress and drinking will increase the patients' motivation to participate in further treatment.

Study Overview

• Status: Completed
• Conditions: Alcoholic Intoxication, Chronic
• Intervention / Treatment: Behavioral: Psychoeducation

• Study Type: Interventional
• Enrollment (Actual): 50
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Germany
  • Reichenau, Germany, 78479
    • Center for Psychiatry Reichenau

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 70 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Alcohol Dependence
• Regular admission to detoxification unit

Exclusion Criteria:

• Severe withdrawal
• Severe cognitive impairment
• Severe comorbid psychiatric conditions (schizophrenia, suicidal crisis)

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: Non-Randomized
• Interventional Model: Factorial Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
No Intervention: Treatment as Ususal; Patients participate in the Treatment as Usual including a non-specific information group.
Experimental: Psychoeducation; Intervention group	Behavioral: Psychoeducation; Psychoeducation group on stress and how it relates to alcohol use, 4 sessions a 45 minutes; Other Names: The manualized group intervention we developed for this study recently was named TARGET,; which reads as "Trauma- and Alcohol-Related Group Education and motivation Therapy"

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
University of Rhode Island Change Assessment (URICA)	Pre-assessment is at entry in in-patient alcohol detoxification treatment, post-assessment is at day of discharge. On average, the two measurements are 15 days apart.	Pre and Post (day 1, day 15 (average))
Detoxification treatment completion	It was evaluated how many subjects in both treatment arms and among traumatized and non-traumatized in each arm ended the detoxification treatment prematurely, i.e. discharge against medical advice or disciplinary discharge.	15 days (average treatment duration)
number of days in detoxification treatment	The number of days in detoxification treatment is a simple count of days of treatment between day of detoxification treatment entry and day of discharge	15 days (average treatment duration)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
adverse events	Adverse events were assessed during the detoxification treatment for patients taking part in the information group (TAU) or TARGET group (intervention), i.e. suicide attempts, psychiatric decompensation, aggressive behaviors, relapse of alcohol use. These events were recorded by the social worker who participated routinely in the three daily team meetings during which the situation of each patient was briefly discussed.	between admission and discharge

Collaborators and Investigators

• Sponsor: University of Konstanz

Study record dates

Study Major Dates

• Study Start: January 1, 2010
• Primary Completion (Actual): March 1, 2010
• Study Completion (Actual): March 1, 2010

Study Registration Dates

• First Submitted: December 22, 2009
• First Submitted That Met QC Criteria: March 25, 2011
• First Posted (Estimate): March 28, 2011

Study Record Updates

• Last Update Posted (Estimate): March 31, 2011
• Last Update Submitted That Met QC Criteria: March 30, 2011
• Last Verified: March 1, 2011

More Information

Terms related to this study

• Keywords: Psychoeducation; Group Control
• Additional Relevant MeSH Terms: Mental Disorders; Chemically-Induced Disorders; Alcohol-Related Disorders; Substance-Related Disorders; Alcoholism; Alcoholic Intoxication
• Other Study ID Numbers: UKonstanzMOdenwald2009-1