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A Broader View of Change in Drinking Behavior


  • The views expressed in this article are those of the author and do not reflect the position of the National Institute on Alcohol Abuse and Alcoholism, the National Institutes of Health, the Department of Health and Human Services, or any other government agency.

  • Conflict of Interest: The author states no conflict of interest.

Reprint requests: Mark L. Willenbring, MD, NIAAA/NIH, 5635 Fishers Lane Room 2047, Bethesda, MD 20892, Fax: 301-443-8774; E-mail:


Most research concerning change in drinking behavior has taken place within the context of specialized treatment for a help-seeking population. However, treatment approaches with different purported mechanisms of action yield very similar results, suggesting that common elements, rather than specific mechanisms, may be responsible for the bulk of the individual change process. Mechanisms of change have not been explicitly examined. Other factors such as social pressure may be more important mediators of change, which may occur prior to treatment entry. Also, most change occurs outside the context of specific treatment. A broader perspective focusing on mechanisms of change will need to account for change occurring both with and without professional treatment. Future research must be interdisciplinary in nature, seeking to relate social, behavioral, and neurophysiologic correlates of behavior change.