User:Scarpy/Project MATCH

Project MATCH began in 1989 and was sponsored by the National Institute on Alcohol Abuse and Alcoholism (NIAAA). The project was an 8-year, multi site, $27-million investigation that studied which types of alcoholics respond best to which forms of treatment. MATCH studied whether treatment should be uniform or assigned to patients based on specific needs and characteristics. The programs were administered by psychotherapists and, although twelve-step methods were incorporated into the therapy, actual AA meetings were not included. Three types of treatment were investigated:
 * Cognitive Behavioral Coping Skills Therapy, focusing on correcting poor self-esteem and distorted, negative, and self-defeating thinking.
 * Motivational Enhancement Therapy, which helps clients to become aware of and build on personal strengths that can help improve readiness to quit.
 * Twelve-Step Facilitation Therapy administered as an independent treatment designed to familiarize patients with the AA philosophy and to encourage participation.

The study concluded that patient-treatment matching is not necessary in alcoholism treatment because the three techniques are equal in effectiveness. Tonigan and colleagues stated that "AA has rarely been investigated with the kind of rigorous methological attention it received in Project MATCH."

Criticism
Project MATCH participants who volunteered for treatment but dropped out after the initial visit, the "zero treatment group" showed improvement in proportion to full treatment groups

and second, that improvement in all groups occurred immediately after enrollment in the study.

A median of only 3% of the drinking outcome at follow-up could be attributed to treatment. However this effect appeared to be present at week one before most of the treatment had been delivered. The zero treatment dropout group showed great improvement, achieving a mean of 72 percent days abstinent at follow-up... two-thirds to three-fourths of the improvement in the full treatment group was duplicated in the zero treatment group." They concluded that the success rate shown in project MATCH, had more to do with the population of people who volunteered for the study than with the treatments that were administered. Those who received zero treatment {people who dropped out of the study immediately} had better outcomes than those who received one session of treatment. Evidence is showing that extensive therapy may be no more effective than that of brief intervention, there is also literature that shows many of those with serious alcohol consumption problems are able to recover without any treatment.

Dr. Stanton Peele criticized MATCH on the basis that there was no control group { a group selected specifically for non treatment}, to determine whether the treatments were more effective than the natural recovery process. Therapists in MATCH were more highly trained and monitored than addiction counselors usually available to the public. Effectiveness for all treatments was measured by reduction in frequency and intensity of drinking, whereas twelve-step and abstention-based programs, he argued, should claim no improvement without full abstention. Peele states the Project Match failure to confirm a matching  hypothesis revealed more its oversights  in their  methods,  as well as  shows that American conceptions of alcoholism and treatment policy are fundamentally wrong. Non American research has shown that subjective matching does work and and other research shows that many with alcohol abuse problems heal on their own without treatment.