Acute and extended exposure to episodic future thinking in a treatment seeking addiction sample: A pilot study

Individuals with addictive disorders commonly exhibit a shortened temporal window (shortened period of time an individual can imagine into their own future), which interferes with treatment focusing on long-term sobriety or reductions in use. Episodic future thinking (EFT) involves generating personalized cues related to anticipated, positive future events. EFT has been shown to reduce impulsive decision-making and the reinforcing value of addictive substances; however, this has only been shown in nontreatment samples. The current study examined the feasibility and impact of a 1-week EFT protocol on decision-making and alcohol motivation in a sample of individuals receiving treatment for alcohol use disorder. We randomly assigned twenty-eight individuals currently enrolled in community-based alcohol use disorder treatment to either an EFT protocol or a control episodic recent thinking (ERT) protocol. Participants completed assessments of delay discounting, alcohol demand, craving, self-efficacy, consideration of consequences, and mindfulness at baseline, after 1 week of EFT practice, and at 1-week follow-up. We observed patterns of reductions in alcohol demand indices, delay discounting rates, and an increase in mindfulness after both acute (1 session) and extended (4 sessions) exposure to EFT. These proof-of-concept findings lay the foundation for a randomized controlled trial of EFT as a supplement to addictions treatment.