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Origins, Issues and Options in the Development of the Combined Behavioral Intervention

Richard Longabaugh, Allen Zweben, Joseph S. LoCastro, William R. Miller

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 wouldbe users in their own clinical and/or clinical research needs. (J. Stud. Alcohol, Supplement No. 15: 179-187, 2005)