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Cue exposure in the treatment of alcohol dependence: Effects on drinking outcome, craving and self-efficacy


Correspondence should be addressed to Sabine Loeber, Department of Addictive Behaviour and Addiction Medicine at the University of Heidelberg, Central Institute of Mental Health, J5, 68159 Mannheim, Germany (e-mail:


Objectives The aim of the present study was to investigate beneficial effects of cue exposure treatment for alcohol dependence by contrasting it with a well-established treatment approach. We hypothesized that cue exposure treatment is associated with a stronger decline of craving, a stronger increase in self-efficacy and has beneficial effects on drinking behaviour after discharge.

Design and methods Sixty-three patients with a diagnosis of alcohol dependence were recruited from an in-patient alcohol-detoxification facility. Patients were sequentially assigned to either cue exposure or a standard cognitive-behavioural treatment. We assessed self-reports of craving and self-efficacy prior to treatment participation and at the end of treatment. Drinking behaviour was assessed in the 6-month period following discharge.

Results Both treatments were associated with a reduction of self-reported craving and an increase in self-reported measures of self-efficacy. A significant time x treatment interaction indicated a greater increase in self-reported measures of self-efficacy after cue exposure treatment. Measures of drinking behaviour showed clearly that both treatments were efficacious. Relapse rates and drinking-related variables were not significantly different for the two treatments at the 6-month follow-up. There was preliminary evidence that suggests that cue exposure therapy may be more effective for patients with severe alcohol dependence.

Conclusions With respect to drinking behaviour, cue exposure and standard cognitive-behavioural treatment seem to be equally effective for patients with a moderate severity of alcohol dependence. Further studies are necessary to specify criteria for differential treatment indication.