Implementation of two transdiagnostic psychological interventions for alcohol use: Study protocol, preliminary results

Alcohol use disorders are very prevalent in the Spanish Nacional Health System, have significant morbidity and mortality, and several associated comorbidities that limit the effectiveness of psychological treatments. The scientific literature suggests that emotional dysregulation is one of the most important determinants of craving and relapse. Therefore, emotional dysregulation could represent a promising target for improving psychological treatments for this problem. Recently, from a transdiagnostic perspective, different psychological treatments have been focused on the etiological and maintenance mechanisms underlying different disorders (e.g., anxiety and borderline personality disorders, addictions, among others) providing a comprehensive model to treat emotion dysregulation. From this perspective, alcohol use could be considered a maladaptive behavior to regulate aversive emotional states. Dialectical Behavior Therapy (DBT) and the Unified Protocol (PU) are two transdiagnostic treatments with good efficacy and effectiveness results to treat different psychological disorders.; Research studies on psychological treatments has traditionally focused on the efficacy and effectiveness of evidence-based interventions. However, there is a major problem in translating these interventions into clinical practice. Thus, implementation science (the scientific study of methods to promote the incorporation of research results into daily clinical practice, and to improve the health services) has emerged. Research on the dissemination and implementation of evidence-based interventions in addictions is recent and scarce. One of the main barriers encountered in the alcohol addiction interventions is the inadequate training of professionals in evidence-based treatment. In this project, two sequential studies are proposed. The first study aims to evaluate the effect of the dissemination of DBT and PU on attitudes, readiness to change, acceptability and intention to use these interventions in mental health professionals who treat people with alcohol use, as well as to explore information on the adaptation of both interventions to public addiction settings. The planned sample size is 160 mental health professionals, who will be randomized to receive DBT or PU training first and then the other. A series of quantitative and qualitative measures will be administered before and after each training. The second study aims to evaluate variables regarding implementation (e.g. barriers, adoption, fidelity) of the interventions by practitioners after the training. At least 20% of the trained professionals are expected to be evaluated. Quantitative and qualitative measures will be administered before, during and after the implementation process. The purpose of both studies is to promote an adequate implementation of transdiagnostic interventions in the reality of addiction resources. The protocol of the study as well as preliminary data on the study 1 will be presented.