Feasibility and acceptability of contingency management and problem-solving therapy intervention for enhancing alcohol abstinence: a single-arm, mixed methods pilot clinical trial.

OBJECTIVE

To assess the feasibility and acceptability of a new integrated behaviour therapy of contingency management and problem-solving therapy (CM-PST) in a fully remote format for young adults with alcohol use disorder (AUD).

DESIGN

A single-arm clinical trial using mixed methods.

SETTING

Both online and in-person recruitment in Chicagoland, USA.

PARTICIPANTS

20 young adults aged 18-24 with mild, moderate or severe AUD participated in the study.

INTERVENTION: The CM-PST intervention included 8 sessions over 12 weeks, focusing on problem-solving skills, goal setting, stress management and behaviour change to support alcohol abstinence. Participants used digital materials, tracked weekly goals, submitted two times per day breathalyser tests for incentives and completed homework assignments.

PRIMARY AND SECONDARY OUTCOME MEASURES: In this study, participants were assessed before and after the intervention using mixed methods to evaluate feasibility based on recruitment rates, retention rates of 85% and high adherence to the PST sessions defined as attendance and remaining for the full duration of each session, and acceptability based on participant feedback of ≥3 on Client Counselling Satisfaction Scale.

RESULTS

A total of 20 participants completed the study. The mean age of the study participants was 21.35 (SD=2.18), ranging from 18 to 24 and 55% of participants were women. Adherence to the PST sessions, which include attending all eight PST sessions and remaining for the full duration of each session, was 100.0%, indicating strong engagement. Participant feedback highlighted the influence of CM on behaviour and decision-making and the effectiveness of PST in addressing life challenges.

CONCLUSION

This study's results indicate that the CM-PST intervention is feasible and acceptable among participants, although the benchmark of 85% expected retention rate was unmet. Future studies could explore strategies to improve retention rates.

TRIAL REGISTRATION NUMBER: NCT05778734.