Table 1.
Patient-Treatment Matching Findings From the Literature
| Reference | Patient Variable | Treatments | Match1 |
|---|---|---|---|
| Demographics | |||
|
| |||
| Cronkite and Moos (1984) | Gender | In-depth therapy (IT—group therapy) vs. Education sessions (ES—films and lectures) | Males: IT>ES Females: ES>IT |
| Babor and Grant (1992) | Gender | Simple advice (SA—20-minute health interview plus 5 minutes of advice about abstinence or sensible drinking) vs. Brief counseling (BC—20-minute health interview plus 15 minutes of counseling, a self-help manual, and followup sessions) vs. Control (C—20-minute health interview) | Males: SA=BC>C Females: SA=BC=C |
| Scott and Anderson (1990) | Gender | 10-minute Physician advice (PA—health survey given plus a 10-minute feedback-and-advice session about drinking less and a self-help booklet) vs. Usual care (UC—health survey given. No advice unless requested) | Males: PA>UC Females: PA=UC |
|
| |||
| Drinking-Related Characteristics | |||
|
| |||
| Annis and Davis (1989) | “Differentiated” drinker (able to recognize situations prompting drinking) | Relapse prevention therapy (RP—focuses on identifying patients’ high-risk drinking situations and how to handle them) vs. Traditional counseling (TC) | Differentiated: RP>TC Undifferentiated: RP=TC |
| Miller et al. (1993) | Clients view of alcoholism (bad habit vs. disease) | Confrontive therapist (CT—therapists confront patients’ minimization of problem with evidence of alcohol problems) vs. Nonconfrontive therapist (NCT—therapists respond in an empathetic manner and make no direct attempts to prove points about alcohol problems) | Bad habit view: NCT>CT Disease view: NCT=CT |
| Gerra et al. (1992) | Family history with respect to alcoholism | Fluoxetine (F) vs. Ca-acetyl-homotaurinate (H) (each medication acts through a different mechanism to reduce drinking) vs. Placebo (C) | +Family hx: F>H=C −Family hx: H>F=C |
|
| |||
| Intrapersonal Characteristics | |||
|
| |||
| Kadden et al. (1989); Cooney et al. (1991) | Sociopathy (being aggressively antisocial) | Interactional skills (IS—group therapy that explores participants’ interpersonal relationships) vs. Coping skills (CS—highly structured group therapy focusing on learning problem-solving and interpersonal skills) | Hi socio: CS>IS Lo socio: IS>CS |
| Hartman et al. (1988) | Locus of control (internal vs. external) | Brief nondirective treatment (BND—three individual counseling sessions given at 1-month intervals. Focus on identifying treatment goals and giving pragmatic advice) vs. Intensive structured treatment (INS—eight group sessions over 4 weeks with followup. Focus on coping skills training2) | Internal: BND>INS External: INS>BND |
| Annis and Chan (1983) | Self-image (SI) | Intensive group confrontive (IGC—centered on highly confrontational, 2-hour group therapy sessions) vs. Standard institutional program (SIP) | +SI: IGC>SIP −SI: SIP>IGC |
| Welte et al. (1981) | Social stability (SS) | Longer inpatient (L—more than 60 days) vs. Shorter inpatient (S—less than 60 days) | Lo SS: L>S Hi SS: L=S |
| Longabaugh et al. (1993) | Social investment (SI) (person’s dependence on others for differential reinforcement) | Relationship enhancement cognitive behavioral (RE—involves significant others in learning how a relationship can reinforce abstinence and deal with slips) vs. Individual focus cognitive behavioral2 (IF—teaching problem-solving techniques and how to deal with slips) | Lo SI: IF>RE Hi SI: RE=IF |
A shorthand notation has been devised to summarize patient-treatment matching results. It presents outcomes for the treatments being compared as they relate to the level of the client characteristic of interest using standard equality and inequality symbols to denote better, worse, or equal outcomes. For the Annis and Davis study, for example, the notation means that alcoholics identified as “differentiated” (i.e., they are able to identify stimuli to drink) had better outcomes from the relapse prevention therapy than from traditional counseling. Conversely, among those classified as “undifferentiated,” no difference was seen in treatment effects: differentiated: RP>TC undifferentiated: RP=TC
For a more detailed discussion of this and other cognitive-behavioral techniques, see the article by Kadden, p. 279–286.