Abstract
BackgroundAlcohol use disorders and social anxiety disorder are common and disabling conditions that frequently co-exist. Although there are efficacious treatments for each disorder, only two randomized controlled trials of interventions for these combined problems have been published. We developed a new integrated treatment for comorbid Social Anxiety Disorder and Alcohol Use Disorder based on established Motivational Interviewing (MI) and Cognitive Behaviour Therapy (CBT) interventions for the separate disorders. Compared to established MI/CBT for alcohol use disorders this new intervention is hypothesised to lead to greater reductions in symptoms of social anxiety and alcohol use disorder and to produce greater improvements in quality of life. Higher levels of alcohol dependence will result in relatively poorer outcomes for the new integrated treatment.Methods/designA randomised controlled trial comparing 9 sessions of individual integrated treatment for alcohol and social phobia with 9 sessions of treatment for alcohol use problems alone is proposed. Randomisation will be stratified for stable antidepressant use. Post treatment clinical assessments of alcohol consumption and diagnostic status at 3 and 6 month follow-up will be blind to allocation.DiscussionThe proposed trial addresses a serious gap in treatment evidence and could potentially define the appropriate treatment for a large proportion of adults affected by these problems.Trial registrationAustralian New Zealand Clinical Trials Registry: ACTRN12608000228381.
Highlights
Alcohol use disorders and social anxiety disorder are common and disabling conditions that frequently co-exist
The proposed study will test a new integrated treatment for comorbid Social Anxiety and Alcohol Use Disorders based on established Motivational Interviewing (MI) and Cognitive Behaviour Therapy (CBT) interventions for the separate disorders in a randomized controlled trial
The proposed study aims to determine the relative efficacy of an integrated individual cognitive behaviour therapy (CBT) for alcohol use problems and social phobia compared with individual CBT targeting alcohol use problems alone for people with social phobia and alcohol problems
Summary
Alcohol use disorders and social phobia are commonly comorbid despite epidemiological and basic science findings that the two disorders interact to produce greater disability and poorer treatment outcomes. Existing clinical trials [4,5] indicate that alcohol focused treatment will give the best result These trials did not test integrated treatments based on research into the mechanisms that may underlie the comorbidity and probably treated samples with severe alcohol dependence. This trial will examine an integrated intervention based on basic cognitive and behavioural research in a sample with a range of severity of alcohol use disorders. It is hypothesised that this novel integrated package of motivational interviewing and cognitive behavioural therapy will lead to better overall outcomes across drinking, social anxiety and quality of life In addition those with more severe levels of alcohol dependence are hypothesised to achieve relatively less benefit from the novel intervention than intervention focused on alcohol alone.
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