Research and Moderation
Management (MM)
 
         
Frederick
Rotgers, Psy.D.
 
 
Jamieson,
Beals, Lalonde
and Associates
 
 
Presented at the 109th
Convention of the
American
Psychological
Association, August
25, 2001



Three Foci
 
  
Research directly supporting
moderation/reduced use
approaches
  
Research that supports the MM
approach
  
Research on MM itself



Research on Moderation
Approaches
 
Moderation approaches have
been studied extensively since the
early 1970s:
 
 – Miller at New Mexico
  
 – Sanchez-Craig at addiction
 Research Foundation
  
 – Sobells at ARF and Nova University
  
 – Heather in Australia and UK
 
 – Duckert in Norway



Evidence for Efficacy of
Moderation Approaches
 
Heather et al., 2000:
  
 “Behavioral Self-Control Training
(on form of moderation-focused
treatment) is probably the most
researched single treatment
modality in the alcohol problems
field with over 30 controlled trials
devoted to it…(and is) supported
by the second largest number of
positive studies of any treatment
modality in the literature.”



Who Benefits from
Moderation Approaches?
 
Less dependent problem drinkers,
(although Heather et al. (2000) found
evidence for greater efficacy of BSCT
with moderately to severely dependent
than less dependent problem drinkers).
 
Younger
 
Female
 
More psychologically/socially stable
 
Believe moderation is possible

Less prior contact with 12-step
approaches



Research Supporting the
MM Approach
 
 
MM’s approach emphasizes:

 
 – Personal choice and responsibility

 – Accurate information gathering and personal problem assessment
 

 – Behavioral change
 
 – Social support without
prescriptions/pressure to adopt a
particular drinking goal



Advantages of
Emphasizing Personal
Choice of Goals
   
Sobell, et al. (1992): Problem
drinkers overwhelmingly want to
choose their own goal.
 
Sanchez-Craig & Lei (1986):
Random assignment to drinking
goal produced poorer outcomes
than did allowing client to choose
treatment goal, regardless of
whether goal was abstinence or
moderation.



Decades of Research on Human Motivation Show

Enhancing intrinsic motivation
produces more persistent
behavior change
 
Intrinsic motivation best enhanced
by environment that provides:
 
 – Autonomy support
  
 – Relatedness
  
 – Competency enhancement
 
MM provides all of these



Research on MM Itself
 
Humphreys and Klaw: Can
targeting non-dependent problem
drinkers and providing internet-
based services expand access to
assistance for alcohol problems?:
A study of the Moderation
Management self-help/mutual aid
organization. Journal of Studies
on Alcohol, August 2001



Humphreys and Klaw Find
 
                
MMers are mostly:
 
 – White (95.5%)

 – Employed (81.4%)

 – Married (58.3%)

 – College educated (71.6%)
 
 – Early middle age (49.4%)

 – Less religious than the US population
as a whole
 
63% of online members are
women who would not have
sought help in any face to face
modality



Compared with AAs
MMers:
  
Are less dependent (4.3
dependence symptoms for MMers
vs 11.3 for AAs)
 
Have fewer intoxicated days per
month (MM=9.5, AA=12.8)
 
Report fewer alcohol-related
problems (MM=5.6, AA=10.4)



Conclusions
 
 
Decades of research on alcohol
treatment support the efficacy of
 
 – Moderation approaches
 
 – Fostering personal choice and   responsibility
  in an atmosphere of support and
  competency enhancement
 
 
While outcome research on MM
members remains to be done, the work
of Humphreys and Klaw suggests that
MM is reaching a largely unserved
population of problem drinkers precisely
because it does not emphasize
abstinence only, and provides a variety
of means of accessing support