Proposed Model of the Neurobiological Mechanisms Underlying Psychosocial Alcohol Interventions: The Example of Motivational Interviewing

Despite the prevalence and profound consequences of alcohol use disorders, psychosocial alcohol interventions have widely varying outcomes. The range of behavior following psychosocial alcohol treatment indicates the need to gain a better understanding of active ingredients and how they may operate. Although this is an area of great interest, at this time there is a limited understanding of how in-session behaviors may catalyze changes in the brain and subsequent alcohol use behavior. Thus, in this review, we aim to identify the neurobiological routes through which psychosocial alcohol interventions may lead to post-session behavior change as well as offer an approach to conceptualize and evaluate these translational relationships. PubMed and PsycINFO searches identified studies that successfully integrated functional magnetic resonance imaging and psychosocial interventions. Based on this research, we identified potential neurobiological substrates through which behavioral alcohol interventions may initiate and sustain behavior change. In addition, we proposed a testable model linking within-session active ingredients to outside-of-session behavior change. Through this review, we present a testable translational model. Additionally, we illustrate how the proposed model can help facilitate empirical evaluations of psychotherapeutic factors and their underlying neural mechanisms, both in the context of motivational interviewing and in the treatment of alcohol use disorders.