A functional imagery training-based intervention to support adherence to attentional bias modification for alcohol.

Objective: Adherence is a persistent challenge that influences the effectiveness of mental health treatments. The present study assessed whether Functional Imagery Training (FIT) enhanced adherence to a 4-week self-guided online alcohol-related attentional bias modification (ABM) program to reduce their drinking.

Method: Participants were 89 young adult drinkers aged 18-25 (68.5% female) seeking to reduce their alcohol consumption. Participants in the intervention condition (n = 45) received brief FIT-based content prior to each of the eight sessions of self-guided alcohol-related ABM training over 4 weeks, while participants in the control condition (n = 44) received breathing exercises. Outcomes relating to adherence (number of completed training trials), alcohol consumption and treatment satisfaction were assessed 35 days post baseline.

Results: All participants reported a significant reduction in their alcohol consumption at follow-up, however, FIT was not superior to breathing exercises in enhancing adherence to ABM training or reducing drinking. A supplementary "per protocol" analysis of participants who commenced the online training found that females in the FIT condition completed significantly more trials than females in the control condition. The sample size did not permit a similar analysis for male participants.

Conclusions: FIT-based content delivered at the commencement of each session was equivalent to breathing control exercises at influencing program adherence. The findings indicate a need for exploring a more intensive instructional protocol, especially in initial sessions. Additionally, future research should address the challenge of recruiting young male problem drinkers to enable better exploration of gender effects. (PsycInfo Database Record (c) 2025 APA, all rights reserved).