Narrative Writing for Alcohol Use Disorder

Overseen By Mai Pham

Age: < 65

Sex: Any

Trial Phase: Academic

Sponsor: University of Washington

Disqualifiers: None

Compensation: Varies

Number of Visits: 4

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine if writing about one's future self can alter perceptions of drinking and reduce alcohol misuse among those finishing high school. Participants will explore their future selves through writing tasks and examine the impact on drinking habits. Various writing tasks and frequencies will be tested to identify the most effective approach. The trial seeks high school seniors or recent graduates who have consumed alcohol at least once in the past year and are interested in not increasing their drinking. As an unphased trial, this study offers a unique opportunity to explore personal growth and potentially improve one's relationship with alcohol.

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 prior data suggests that the future possible self task (FPST) is safe for individuals transitioning from high school?

Research has shown that narrative writing, a form of expressive writing, is generally safe for participants. Studies on treatments like narrative writing have found no serious side effects, indicating it is well-tolerated by participants. Typically, participants engage in simple, non-invasive writing exercises. The aim is to explore thoughts and feelings, often leading to positive outcomes without major risks. Overall, current evidence supports the safety of narrative writing as a treatment. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the narrative writing approach for Alcohol Use Disorder because it offers a unique, non-pharmacological method that could complement or even substitute traditional treatments like medication and therapy. This technique involves participants reflecting on their most hoped for and feared future selves, aiming to boost motivation and self-awareness, which are crucial for recovery. Unlike standard treatments that often involve medication or structured therapy sessions, this method empowers individuals to explore personal narratives, potentially leading to deeper personal insights and behavioral change. By focusing on personal storytelling, this approach may provide a more personalized and engaging path to recovery, which is why researchers are eager to see its impact on alcohol use.

What evidence suggests that this trial's treatments could be effective for reducing alcohol misuse?

Research has shown that writing can help people reduce alcohol consumption. In one study, participants who wrote about their thoughts and feelings planned to drink fewer drinks each week. Another study found that writing about negative experiences with drinking decreased the desire to drink. Creative writing can also help individuals look beyond their current problems, including addiction. This trial will explore various writing exercises, such as imagining one's most hoped-for or feared future self, to see how they might change perceptions of alcohol use and lower the risk of excessive drinking. ^{4 6 7 8 9}

Who Is on the Research Team?

Kristen P Lindgren, PhD

Principal Investigator

University of Washington

Are You a Good Fit for This Trial?

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

Willing to provide contact information, including phone number (for text messages and reminders), email (reminders), and mailing address (payment)

I am willing to join three weekly online sessions.

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

Exclusion Criteria

N/A

Timeline for a Trial Participant

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

What Are the Treatments Tested in This Trial?

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).

How Is the Trial Designed?

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+

Published Research Related to This Trial

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]

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]

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]

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]

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]

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]

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]

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]

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]

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]

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]

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]

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