Network Support II: Randomized controlled trial of Network Support treatment and cognitive behavioral therapy for alcohol use disorder

Abstract

Background: The social network of those treated for alcohol use disorder can play a significant role in subsequent drinking behavior, both for better and worse. Network Support treatment was devised to teach ways to reconstruct social networks so that they are more supportive of abstinence and less supportive of drinking. For many patients this may involve engagement with AA, but other strategies are also used.

Purpose: The current trial of Network Support treatment, building on our previous work, was intended to further enhance the ability of patients to construct abstinence-supportive social networks, and to test this approach against a strong control treatment.

Methods: Patients were 193 men and women with alcohol use disorder recruited from the community and assigned to either 12 weeks of Network Support (NS) or Packaged Cognitive-Behavioral Treatment (PCBT), and followed for 27 months.

Results: Results of multilevel analyses indicated that NS yielded better posttreatment results in terms of both proportion of days abstinent and drinking consequences, and equivalent improvements in 90-day abstinence, heavy drinking days and drinks per drinking day. Mediation analyses revealed that NS treatment effects were mediated by pre-post changes in abstinence self-efficacy and in social network variables, especially proportion of non-drinkers in the social network and attendance at Alcoholics Anonymous.

Conclusion: It was concluded that helping patients enhance their abstinent social network can be effective, and may provide a useful alternative or adjunctive approach to treatment.

Trial registration: ClinicalTrials.gov NCT01129804.

Keywords: Alcohol treatment; Alcoholics Anonymous; Network Support; Self-efficacy; Treatment mechanisms.

Conflict of interest statement

Conflict of interest

None of the authors has any financial conflict of interest to report.

Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Figures

Figure 1

Flow of patients in the Network Support II project. Only in-person follow-ups are shown here.

Figure 2

Means of continuous drinking-related outcome variables by treatment condition and by time.

Figure 3

Proportion of patients abstinent in each 90-day period by treatment condition.

Figure 4

Means of selected social network variables by treatment condition and by time.