Sudden gains among women receiving treatment for alcohol use disorders

Abstract

Understanding the timing and types of change during treatment for mental health disorders is an important step toward elucidating possible mechanisms of behaviour change in response to therapeutic interventions, yet these issues have not been adequately addressed in the alcohol dependence treatment literature. The current study applied sudden gains (SGs) methodology, an approach originally developed in depression treatment studies, to a sample of women receiving treatment for alcohol use disorders. SGs are drastic improvements in symptoms that occur between two psychotherapy sessions and are hypothesised to be the result of what occurred in the first of those two sessions. SGs can happen at any time during the course of treatment, can happen more than once, and are individualised, as opposed to aggregated for a sample. For the current study, SGs were examined across three variables: percent drinking days (PDD), urge frequency (UF), and urge intensity (UI) in a sample of 102 women receiving either individual or couple cognitive-behavioural therapy for alcohol use disorders. Results indicated the presence of SGs; one-third of the sample experienced at least one SG in either alcohol use or urges to drink; the most common SGs were in frequency of urges to drink. SGs in urge frequency during treatment predicted better post-treatment drinking outcome.

• Alcohol
• mechanisms of change
• sudden gains
• treatment

Declaration of interest

This research was supported by NIAAA Grants R37 AA07070 and T32 AA07569. Parts of these findings were presented at the 2006 and 2007 Annual Meetings of the Research Society on Alcoholism as well as at the 13th world congress of the International Society for Biomedical Research on Alcoholism, Sydney, Australia.