Telephone-based self-change modules help stabilize early natural recovery in problem drinkers

Abstract

Objective: Self-guided attempts to resolve drinking problems are common, but little is known about the processes by which supportive interventions of lower intensity might promote resolution. This study investigated how brief supportive educational modules delivered as part of an interactive voice response self-monitoring (IVR SM) system helped stabilize initial resolution among otherwise untreated problem drinkers.

Method: Recently resolved problem drinkers allocated to the intervention group of a randomized controlled trial were offered IVR access for 24 weeks to report daily drinking and hear weekly educational modules designed to support resolution. Using data from the 70 active IVR callers, hierarchical linear models evaluated whether module retrieval reduced subsequent alcohol consumption, including high-risk drinking, and whether module retrieval attenuated the effects on drinking of established proximal risk factors for relapse (e.g., urges, drug use, and weekends). The analyses controlled for initial resolution status (abstinence or low-risk drinking).

Results: Urges, drug use, and weekends were associated with increased drinking reports on the next IVR call (all ps < .01), whereas retrieving a module was associated with decreases in next-call drinking reports, including high-risk drinking episodes (p < .05). Module retrieval, however, did not reduce or buffer the effects of urges on drinking. Findings were similar across initially abstinent and low-risk drinkers.

Conclusions: IVR-delivered supportive educational modules may help stabilize initial problem-drinking resolutions, but mechanisms of change deserve more study. The study adds to evidence of the co-occurring negative effects of multiple behavioral and environmental risk factors on the temporal patterning of post-recovery alcohol use.