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Behavioral Therapies Trials: A Case Example

Marcus, Marianne T.; Liehr, Patricia R.; Schmitz, Joy; Moeller, F. Gerald; Swank, Paul; Fine, Micki; Cron, Stanley; Granmayeh, L. Kian; Carroll, Deidra D.

doi: 10.1097/01.NNR.0000270024.52242.39
Methods

Background: Behavior change is integral to the prevention and treatment of many disorders associated with deleterious lifestyles. Rigorous scientific testing of behavior change interventions is an important goal for nursing research.

Approach: The stage model for behavioral therapy development is recommended as a useful framework for evaluating behavior change strategies. The NIH model specifies three stages from initial testing of novel behavioral therapies to their dissemination in community settings. Definitions of each step in a Stage I trial and a case example of Mindfulness-Based Stress Reduction (MBSR) in therapeutic community treatment are provided.

Results: It is feasible to adapt a behavioral therapy such as MBSR using the stage model framework. Steps in the process include: (a) determining pilot study design and describing the population; (b) modifying the intervention and developing the manual; (c) training the teachers; (d) implementing a pilot study; and (e) monitoring treatment integrity.

Discussion: The development of behavior therapies requires the same scientific rigor used in pharmacotherapy research. Stage I of the model enables consideration of the "dose" of a behavioral intervention necessary to achieve behavior change in a defined population. The stage model offers an excellent approach to achieving rigor in a variety of potentially useful therapies of interest to nurse researchers.

Marianne T. Marcus, EdD, RN, FAAN, is Director, Center for Substance Abuse Education, Prevention and Research, The University of Texas at Houston Health Science Center School of Nursing.

Patricia R. Liehr, PhD, RN, is Associate Dean for Research and Scholarship, Florida Atlantic University Christine E. Lynn College of Nursing, Boca Raton.

Joy Schmitz, PhD, is Professor; F. Gerald Moeller, MD, is Professor; and Paul Swank, PhD, is Professor, The University of Texas Health Science Center at Houston Medical School.

Micki Fine, MEd, LPC, is Founder, Mindful Living, Houston, Texas.

Stanley Cron, MSPH, is Instructor; L. Kian Granmayeh, BA, is Research Coordinator; and Deidra D. Carroll, BS, is Research Assistant, The University of Texas Health Science Center at Houston School of Nursing.

Accepted for publication February 10, 2007.

This research was funded by NIH/NIDA R01 DA017719, awarded to Dr. Marianne T. Marcus.

Corresponding author: Marianne T. Marcus, EdD, RN, FAAN, Center for Substance Abuse Education, Prevention and Research, The University of Texas Health Science Center at Houston School of Nursing, 6901 Bertner Avenue, Suite 649, Houston, TX 77030 (e-mail: Marianne.T.Marcus@uth.tmc.edu).

© 2007 Lippincott Williams & Wilkins, Inc.