Origins, issues and options in the development of the combined behavioral intervention

OBJECTIVE: The aim of the investigators was to develop a moderate intensity comprehensive behavioral treatment based on the principles of motivational interviewing and Cognitive Behavioral Therapy that, within the confines of a standardized abstinence-oriented treatment, would provide a broad spectrum of modules to assist those seeking treatment to achieve reduction of problematic drinking. METHOD: The core issue of how to deliver a flexible therapy tailored to the needs of individual clients while at the same time providing a standardized treatment protocol for a randomized clinical trial provided the dilemma out of which this unique standardized protocol arose. By using a single decision tree, client choice, combined with limited options, we were able to reconcile these conflicting demands. RESULTS: Key decisions that were made in developing the treatment protocol and the thinking leading to these decisions are described. CONCLUSIONS: Understanding these key issues and the factors that led to the decisions made will assist would-be users in their own clinical and/or clinical research needs.