The role of daily goal setting among individuals with alcohol use disorder

Introduction: Individuals with alcohol use disorder (AUD) who seek help to reduce their drinking are expected to vary with respect to drinking goal with some choosing abstinence and others moderation. The present research explored whether drinking goals vary day to day among individuals with AUD who plan to enter treatment and the relationship of specific daily goals to actual drinking behavior in daily life. Methods: Participants were 153 individuals with AUD who enrolled in a study of stepped care brief interventions and completed smartphone momentary assessments in daily life. Drinking goals and actual number of standard drinks consumed were reported daily for 21 consecutive days after receiving brief advice but prior to assignment to further treatment. Daily drinking goals were coded as (a) complete abstinence (b) moderation, i.e., 2 or fewer standard drinks, or (c) other. Mixed-effects models nested daily drinking goals within individuals to consider both individual and daily patterns in daily goal setting. Results: Complete abstinence was the most common daily drinking goal and showed greater day-to-day stability than setting a moderation goal. Setting an abstinence goal in the morning was also most successful in limiting alcohol consumption for the remainder of that day, relative to other goals. Those individuals who set abstinence goals more often, however, were also those who drank more per drinking occasion. Conclusions: Findings support the clinical benefit of mapping daily goal setting and strategizing for specific circumstances. Future research may track the relation of abstinence and moderation drinking goals to successful goal achievement during treatment and compare to overall treatment goals.