Cue exposure in the treatment of alcohol dependence: effects on drinking outcome, craving and self-efficacy

Br J Clin Psychol. 2006 Nov;45(Pt 4):515-29. doi: 10.1348/014466505X82586.

Abstract

Objectives: The aim of the present study was to investigate beneficial effects of cue exposure treatment for alcohol dependence by contrasting it with a well-established treatment approach. We hypothesized that cue exposure treatment is associated with a stronger decline of craving, a stronger increase in self-efficacy and has beneficial effects on drinking behaviour after discharge.

Design and methods: Sixty-three patients with a diagnosis of alcohol dependence were recruited from an in-patient alcohol-detoxification facility. Patients were sequentially assigned to either cue exposure or a standard cognitive-behavioural treatment. We assessed self-reports of craving and self-efficacy prior to treatment participation and at the end of treatment. Drinking behaviour was assessed in the 6-month period following discharge.

Results: Both treatments were associated with a reduction of self-reported craving and an increase in self-reported measures of self-efficacy. A significant time x treatment interaction indicated a greater increase in self-reported measures of self-efficacy after cue exposure treatment. Measures of drinking behaviour showed clearly that both treatments were efficacious. Relapse rates and drinking-related variables were not significantly different for the two treatments at the 6-month follow-up. There was preliminary evidence that suggests that cue exposure therapy may be more effective for patients with severe alcohol dependence.

Conclusions: With respect to drinking behaviour, cue exposure and standard cognitive-behavioural treatment seem to be equally effective for patients with a moderate severity of alcohol dependence. Further studies are necessary to specify criteria for differential treatment indication.

MeSH terms

  • Alcoholism / diagnosis
  • Alcoholism / epidemiology*
  • Alcoholism / rehabilitation*
  • Cognitive Behavioral Therapy / methods*
  • Cues*
  • Culture
  • Disruptive, Impulse Control, and Conduct Disorders / diagnosis
  • Disruptive, Impulse Control, and Conduct Disorders / epidemiology*
  • Disruptive, Impulse Control, and Conduct Disorders / psychology
  • Female
  • Follow-Up Studies
  • Hospitalization
  • Humans
  • Male
  • Middle Aged
  • Recurrence
  • Reinforcement, Psychology
  • Self Efficacy*
  • Severity of Illness Index
  • Surveys and Questionnaires
  • Treatment Outcome