Narrative Writing for Alcohol Use Disorder

Overseen By Mai Pham

Age: < 65

Sex: Any

Trial Phase: Academic

Sponsor: University of Washington

Compensation: Varies

Number of Visits: 4

528 Participants Needed

Trial Summary

What is the purpose of this trial?

The purpose of the proposed research is to evaluate (1) whether a future possible self task (FPST) can lead to changes drinking identity (DI; how much one associates one's self with drinking) and (2) whether the FPST and changes in drinking identity also change indicators of alcohol misuse . This study focuses on individuals who are graduating from highly school, which is a time of transition and identity change. If such changes can be demonstrated, DI may be a mechanism for alcohol misuse and the FPST may be an additional, novel intervention strategy to reduce alcohol misuse during the post-high school transition. The goal of this clinical trial is to test the future possible self task (FPST) in individuals who are about to graduate from high school. The main questions it aims to answer are: * Can the FPST change drinking identity (a risk factor for alcohol misuse)? * Can the FPST reduce risks for alcohol misuse? Participants will complete the FPST, a task that involves writing for 20 minutes, and will answer a series of questionnaires and computer-based word categorization tasks. Participants will be followed for a year after completing the FPST. Researchers will compare different versions of the FPST and different doses (one writing sessions vs. 3 writing sessions) to see which are more effective for changing drinking identity and reducing risks for alcohol misuse.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the treatment Narrative Writing for Alcohol Use Disorder?

The case study on the narrative approach suggests that storytelling can be useful in treating alcohol problems, indicating that narrative writing might help individuals with Alcohol Use Disorder by allowing them to process and reframe their experiences. ^{1 2 3 4 5}

Is narrative writing generally safe for humans?

In studies of psychosocial treatments, which include therapies like narrative writing, no serious adverse events were found to be related to the treatment itself, suggesting it is generally safe for humans. ^{6 7 8 9 10}

How does narrative writing treatment differ from other treatments for alcohol use disorder?

Narrative writing treatment for alcohol use disorder is unique because it involves using storytelling to help individuals understand and change their relationship with alcohol, which is different from traditional treatments that might focus on medication or behavioral therapy. This approach leverages personal stories to explore and address the psychological and social aspects of alcohol use, offering a more personalized and reflective method of treatment. ^{1 11 12 13 14}

Research Team

Kristen P Lindgren, PhD

Principal Investigator

University of Washington

Eligibility Criteria

This trial is for high school seniors aged 17-19 in Seattle or Houston who have drunk alcohol at least once last year. They should be interested in not increasing their drinking or reducing it, fluent in English, and willing to attend three virtual sessions on Zoom.

Inclusion Criteria

I am a high school senior and will graduate this year.

Reports at least some interest in NOT increasing one's drinking or at least some interest in reducing drinking

Currently reside in greater Seattle (UW Site) or Houston (UH Site)

Exclusion Criteria

N/A

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Participants complete the Future Possible Self Task (FPST) involving writing tasks about future selves related to drinking

3 weeks

3 virtual sessions

Follow-up

Participants are monitored for changes in drinking identity and alcohol misuse indicators

12 months

Online surveys at 1, 3, 6, and 12 months

Treatment Details

Interventions

• Narrative Writing

Trial Overview The study tests a writing task called the future possible self task (FPST) to see if it can change how much participants identify with drinking and reduce risks of alcohol misuse. It compares different versions of FPST and frequency (one vs. three sessions).

Participant Groups

Group I: Most hoped future self, 1 dose Experimental Treatment 1 Intervention

Participants complete a writing task in which they think and write about their most hoped for future self one time (on the third session).

Group II: Most hoped for future self, 3 dose Experimental Treatment 1 Intervention

Participants complete a writing task in which they think and write about their most hoped for future self, weekly for 3 weeks (i.e., at each session).

Group III: Most feared future self, 3 dose Experimental Treatment 1 Intervention

Participants complete a writing task in which they think and write about their most feared future self, weekly for 3 weeks (i.e., at each session).

Group IV: Most feared future self, 1 dose Experimental Treatment 1 Intervention

Participants complete a writing task in which they think and write about their most feared future self one time (on the third session).

Group V: Balanced self (hoped and feared self), 3 dose Experimental Treatment 1 Intervention

Participants complete a writing task in which they think and write about their most hoped for and feared future self, weekly for 3 weeks (i.e., at each session).

Group VI: Balanced self (hoped and feared self), 1 dose Experimental Treatment 1 Intervention

Participants complete a writing task in which they think and write about their most hoped for and feared future self one time (on the third session).

Group VII: Control, 1 dose Placebo Group 1 Intervention

Participants in this condition complete a task in which they think and write about a trip to the zoo one time (on the third session).

Group VIII: Control, 3 dose Placebo Group 1 Intervention

Participants in this condition complete a task in which they think and write about a trip to the zoo weekly for 3 weeks (i.e., at each session).

Who Is Running the Clinical Trial?

University of Washington

Lead Sponsor

Trials

1,858

Recruited

2,023,000+

National Institute on Alcohol Abuse and Alcoholism (NIAAA)

Collaborator

Trials

865

Recruited

1,091,000+

Findings from Research

The narrative or story-telling approach to treating alcoholism can be an effective method, as it allows individuals to express their experiences and emotions related to alcohol use.

This approach can be particularly useful in family practice settings, providing a personalized and relatable way to address alcohol problems and engage patients in their treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Treating alcoholism through a narrative approach. Case study and rationale. Kaminsky, D., Rabinowitz, S., Kasan, R.[2019]

A study involving 78 alcohol-dependent inpatients showed that a self-administered care assessment tool effectively measures treatment outcomes, demonstrating strong agreement with standard clinical assessments.

The tool, which takes about 20 minutes for patients to complete, can help clinicians understand how routine inpatient care impacts alcohol consumption and recovery, with baseline severity being a key predictor of outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Does this treatment work? Validation of an outcomes module for alcohol dependence. Rost, KM., Ross, RL., Humphrey, J., et al.[2019]

In a study of 50 alcoholics who underwent a 2-year outpatient treatment program, long-term outcomes (3-6 years post-treatment) were significantly influenced by drinking outcomes during the later phases of treatment, particularly in the 2nd and 4th half-year periods.

Patients who had a favorable drinking outcome in the first 2 years after treatment were likely to maintain that positive outcome in the following years, with 80% of those showing initial success continuing to do well, highlighting the importance of early recovery phases in predicting long-term success.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A 6-year follow-up of alcoholics after long-term outpatient treatment. Ojehagen, A., Berglund, M., Moberg, AL.[2019]

Outpatient Long-term Intensive Therapy for Alcoholics (OLITA) has shown promising results, with over 50% of participants maintaining abstinence from alcohol after 9 years and a 60% re-employment rate.

This therapy not only helps with alcohol dependence but also significantly improves comorbid conditions like depression and anxiety, highlighting its effectiveness as a comprehensive treatment approach.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Outpatient Long-term Intensive Therapy for Alcoholics (OLITA): a successful biopsychosocial approach to the treatment of alcoholism. Krampe, H., Stawicki, S., Hoehe, MR., et al.[2021]

Only 16% of the 351 patients treated for alcoholism and substance use disorders remained abstinent after 28 months, highlighting the challenges in achieving long-term recovery.

Younger, married, and fully employed patients had the best outcomes, with 23-28% remaining abstinent, while those with multiple prior treatments and divorced individuals had the poorest outcomes, indicating the importance of personal circumstances in treatment success.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Results of alcoholism treatment 28 months after admission.]. Tomasson, K.[2009]

A new standardized strategy for reporting adverse events (AEs) and serious adverse events (SAEs) in substance use disorder (SUD) clinical trials was developed, which aims to reduce the reporting burden while maintaining safety monitoring.

In a review of 17 SUD trials involving 6737 participants, the new strategy showed a significant reduction in irrelevant safety event reporting, leading to a more consistent safety assessment system tailored to the risks associated with specific trial interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Strategies for safety reporting in substance abuse trials. Lindblad, R., Campanella, M., Styers, D., et al.[2013]

Pharmacological treatments for alcohol use disorders (AUD), such as acamprosate, naltrexone, nalmefene, and disulfiram, are effective but underused, highlighting the need for better implementation despite their proven efficacy.

Each medication has a distinct safety profile that must be carefully considered alongside individual patient circumstances, including their drinking patterns and any comorbid conditions, to optimize treatment outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Safety and Tolerability of Pharmacological Treatment of Alcohol Dependence: Comprehensive Review of Evidence. Sinclair, JM., Chambers, SE., Shiles, CJ., et al.[2018]

In a study involving 1,687 substance-abusing participants over 27,198 person-weeks, 12% experienced serious adverse events (SAEs), but none were deemed related to the psychosocial interventions being tested.

There were no significant differences in the incidence rates of SAEs between those receiving standard care and those receiving additional interventions like contingency management or motivational enhancement, suggesting that these psychosocial treatments are safe in terms of serious adverse events.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Serious adverse events in randomized psychosocial treatment studies: safety or arbitrary edicts? Petry, NM., Roll, JM., Rounsaville, BJ., et al.[2021]

A review of 19 randomized controlled trials (RCTs) on alcohol use disorder (AUD) found that the completeness of patient-reported outcome (PRO) reporting was only 40.8%, indicating a significant deficiency in how these outcomes are documented.

Trials published after 2014 showed a 15% improvement in PRO reporting completeness, suggesting that adherence to the CONSORT-PRO guidelines is gradually improving, but overall reporting remains inadequate for effective treatment evaluation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Reporting of patient-reported outcomes in trials on alcohol use disorder: a meta-epidemiological study. Douglas, A., Garrett, E., Staggs, J., et al.[2023]

Visualizing adverse events in clinical trials using methods like dot plots and volcano plots can enhance communication about the severity, timing, and recurrence of harms, rather than just counting occurrences.

The study analyzed individual participant data from a randomized trial of gabapentin for neuropathic pain, demonstrating that effective visualizations can help stakeholders better understand the multidimensional nature of harms in clinical research.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Comparing the Value of Data Visualization Methods for Communicating Harms in Clinical Trials. Qureshi, R., Chen, X., Goerg, C., et al.[2022]

Narrative methods can be a valuable research strategy for exploring the complexities of alcohol and drug use, providing insights into personal experiences and societal influences.

The article highlights both the effectiveness of narrative strategies in treatment approaches and their limitations, particularly in the context of psychology, sociology, and social work research.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Chapter 14. Discussion about narrative methods as a strategy for investigating and understanding the use and misuse of alcohol and drugs. Lilja, J., Larsson, S., von Braun, T., et al.[2013]

Narrative analysis can be a valuable tool for understanding the complexities of alcohol and drug use, including both their use and misuse.

The chapter discusses theoretical and methodological aspects of narrative research, highlighting its potential benefits and limitations in studying substance use dependency issues.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Chapter 2. General theoretical perspectives of narrative analysis of substance use-related dependency. Larsson, S., Lilja, J., von Braun, T., et al.[2013]

A qualitative study involving six individuals with alcohol use disorders (AUD) revealed that they often view heavy drinking as a normal part of their lives, which contributes positively to their quality of life.

Participants expressed a reluctance to seek treatment, perceiving it as either irrelevant to their situation or a threat to their personal autonomy, indicating that addressing these perceptions is crucial for encouraging more individuals with AUD to seek help.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Why treatment is not an option: Treatment naïve individuals, suffering from alcohol use disorders' narratives about alcohol use and treatment seeking. Tarp, K., Sari, S., Nielsen, AS.[2022]

The systematic review analyzed 32 studies involving 1055 participants, revealing eight key dimensions of alcohol recovery narratives, such as identity, recovery setting, and spirituality, which can inform research and healthcare practices.

The review highlighted significant themes in recovery narratives, including shame for female narrators and feelings of alienation for indigenous narrators, while also identifying a lack of studies focusing on recovery experiences in lower-income countries.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Characteristics of alcohol recovery narratives: Systematic review and narrative synthesis. Subhani, M., Talat, U., Knight, H., et al.[2023]

References

1. Canada pubmed.ncbi.nlm.nih.gov

Treating alcoholism through a narrative approach. Case study and rationale. [2019]

2. United States pubmed.ncbi.nlm.nih.gov

Does this treatment work? Validation of an outcomes module for alcohol dependence. [2019]

3. England pubmed.ncbi.nlm.nih.gov

A 6-year follow-up of alcoholics after long-term outpatient treatment. [2019]

4. England pubmed.ncbi.nlm.nih.gov

Outpatient Long-term Intensive Therapy for Alcoholics (OLITA): a successful biopsychosocial approach to the treatment of alcoholism. [2021]

5. Iceland pubmed.ncbi.nlm.nih.gov

[Results of alcoholism treatment 28 months after admission.]. [2009]

6. England pubmed.ncbi.nlm.nih.gov

Strategies for safety reporting in substance abuse trials. [2013]

7. New Zealand pubmed.ncbi.nlm.nih.gov

Safety and Tolerability of Pharmacological Treatment of Alcohol Dependence: Comprehensive Review of Evidence. [2018]

8. United States pubmed.ncbi.nlm.nih.gov

Serious adverse events in randomized psychosocial treatment studies: safety or arbitrary edicts? [2021]

9. England pubmed.ncbi.nlm.nih.gov

Reporting of patient-reported outcomes in trials on alcohol use disorder: a meta-epidemiological study. [2023]

10. United States pubmed.ncbi.nlm.nih.gov

Comparing the Value of Data Visualization Methods for Communicating Harms in Clinical Trials. [2022]

11. England pubmed.ncbi.nlm.nih.gov

Chapter 14. Discussion about narrative methods as a strategy for investigating and understanding the use and misuse of alcohol and drugs. [2013]

12. England pubmed.ncbi.nlm.nih.gov

Chapter 2. General theoretical perspectives of narrative analysis of substance use-related dependency. [2013]

13. United States pubmed.ncbi.nlm.nih.gov

Why treatment is not an option: Treatment naïve individuals, suffering from alcohol use disorders' narratives about alcohol use and treatment seeking. [2022]

14. United States pubmed.ncbi.nlm.nih.gov

Characteristics of alcohol recovery narratives: Systematic review and narrative synthesis. [2023]