A values-based intervention for alcohol abuse

The mechanism of action for the highly efficacious alcohol treatment programs such as Motivational Enhancement Therapy (MET) and Brief Motivational Interviewing (BMI) is not well understood. One hypothesized mechanism is that attitudes and behaviors will undergo long-term change if they are experienced as inconsistent with deeply held values. In this conceptualization, stress and damage to self-esteem are related to a contradiction between what one values and how one behaves in relation to those values. Therapy involves the conscious identification of the components of the conflict, values versus behavior. Treatment-induced changes are predicted to occur in the direction of increasing consistency with self-conceptions and toward maintenance or enhancement of self-esteem. The present study examined the treatment effectiveness of a brief values-based therapy session for adults in treatment for alcohol abuse problems. Study participants were assigned to receive either a one-hour session of values-behavior consistency/clarification therapy or to watch substance abuse videos approximately one hour in length. For both groups, this was in addition to the normal treatment they received. Follow-up assessments were scheduled at 3 and 6 months after the treatment session. Results indicate significantly greater improvement in drinking measures for the values-based intervention group compared with the control group. Variables consistent with a values model (self-esteem, depression, purpose in life and private self-awareness) were not significant in predicting drinking differences between the groups. However, for the values group, self-esteem increase in the interim between the values treatment and the first follow-up was significantly correlated with drinking reduction at the second follow-up. This is consistent with the idea that values-related awareness may be a key component in effectiveness of brief motivational interventions. Effect sizes of the values-based intervention were comparable to those found in other studies using motivational interviewing. Incorporation of a values-based component may be useful for therapists less skilled with motivational interviewing techniques without compromising the effectiveness of the approach. (PsycINFO Database Record (c) 2010 APA, all rights reserved)