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Evaluation of Cognitive-Behavioral Therapy for Drinking. Outcome of Japanese Alcoholic Patients.

New Study (1)Abstract

This study examined the efficacy of a group-based cognitive-behavioral treatment (CBT) for Japanese alcoholic outpatients. Participants (N = 169) were assigned either to a CBT-based relapse prevention group or a TAU (treatment as usual) group. The CBT group received 12-session CBT treatment with a structured treatment workbook once a week. The TAU group received usual daycare treatment including 12-step meeting, vocational training and leisure activities. Participants in the CBT group demonstrated a significantly low relapse rate at the end of treatment. Moreover, coping skills of the CBT group participants were significantly improved than those of the TAU group at the 6-month follow-up period. However, at the 6-month follow-up, the difference in relapse rates diminished. The effectiveness of CBT for alcoholics was well documented in Western countries but few studies were conducted outside of the West. The results provide support for the use of CBT for Japanese alcoholics.

 

Harada, T., Yamamura, K., Koshiba, A., Ohishi, H., & Ohishi, M. (2014). Evaluation of

cognitive-behavioral therapy for drinking.  Outcome of Japanese alcoholic patients.

Nihon Arukoru Yakubutsu Igakkai Zasshi. 49(5), 249-258

Computer-Assisted CBT (CBT4CBT) is Effective for Cocaine-Dependent Individuals on Methadone

OBJECTIVE: A previous pilot trial evaluating computer-based training for cognitive-behavioral therapy (CBT4CBT) in 77 heterogeneous substance users (alcohol, marijuana, cocaine, and opioids) demonstrated preliminary support for its efficacy in the context of a community-based outpatient clinic. The authors conducted a more definitive trial in a larger, more homogeneous sample.

METHOD: In this randomized clinical trial, 101 cocaine-dependent individuals maintained on methadone were randomly assigned to standard methadone maintenance or methadone maintenance with weekly access to CBT4CBT, with seven modules delivered within an 8-week trial.

RESULTS: Treatment retention and data availability were high and comparable across the treatment conditions. Participants assigned to the CBT4CBT condition were significantly more likely to attain 3 or more consecutive weeks of abstinence from cocaine (36% compared with 17%; p<0.05, odds ratio=0.36). The group assigned to CBT4CBT also had better outcomes on most dimensions, including urine specimens negative for all drugs, but these reached statistical significance only for individuals completing the 8-week trial (N=69). Follow-up data collected 6 months after treatment termination were available for 93% of the randomized sample; these data indicate continued improvement for those assigned to the CBT4CBT group, replicating previous findings regarding its durability.

CONCLUSIONS: This trial replicates earlier findings indicating that CBT4CBT is an effective adjunct to addiction treatment with durable effects. CBT4CBT is an easily disseminable strategy for broadening the availability of CBT, even in challenging populations such as cocaine-dependent individuals enrolled in methadone maintenance programs.

Carroll, K. M., Kiluk, B. D., Nich, C., Gordon, M. A., Portnoy, G. A., Marino, D. R., & Ball, S. A. (April 01, 2014). Computer-assisted delivery of cognitive-behavioral therapy: Efficacy and durability of cbt4cbt among cocaine-dependent individuals maintained on methadone. American Journal of Psychiatry, 171, 4, 436-444.

Changes in Early Maladaptive Schemas After Residential Treatment for Substance Use

Early maladaptive schemas are cognitive and behavioral patterns that cause considerable distress and are theorized to underlie mental health problems. Research suggests that early maladaptive schemas may underlie substance abuse and that the intensity of early maladaptive schemas may decrease after brief periods of abstinence. The current study examined changes in early maladaptive schemas after a 4-week residential substance use treatment program. Preexisting records of a sample of male alcohol- and opioid-dependent treatment seeking adults (N = 97; mean age = 42.55) were reviewed for the current study. Pre-post analyses demonstrated that 8 of the early maladaptive schemas significantly decreased by the end of the 4-week treatment. Findings indicate that early maladaptive schemas can be modified during brief substance use treatment and may be an important component of substance use intervention programs. Implications of these findings for substance use treatment are discussed.

Shorey, R. C., Stuart, G. L., Anderson, S., & Strong, D. R. (September 01, 2013). Changes in Early Maladaptive Schemas After Residential Treatment for Substance Use. Journal of Clinical Psychology, 69(9), 912-922.

 

CBT is Effective for Adherence and Depression in HIV-Infected Injection Drug Users

A recent study in the Journal of Consulting and Clinical Psychology suggests that cognitive behavioral therapy for adherence and depression (CBT-AD) can be an effective treatment for decreasing depression and increasing adherence to medication in HIV-infected injection drug users. The present study examined the effects of time-limited CBT-AD on participants with HIV and depression, and currently receiving treatment for their injection drug use.  Participants (n=89) ranged from age 18 to 65 and were randomly assigned to receive either CBT-AD (n=44) or enhanced treatment as usual (ETAU) (n=45). Participants in the intervention group received 9 treatment sessions over a period of 3 months, involving 11 informational, problem-solving, and cognitive behavioral steps. At each step, the participants and the therapist collaboratively defined the problem, generated alternative solutions, made decisions about the solutions, and developed a plan for implementing them.

At post-treatment, the intervention group showed significant improvements.  The Beck Depression Inventory showed a significant reduction in symptoms of depression in the CBT-AD group (M=5.1 points) compared to the ETAU group (M= <1 point). A 40% decrease in symptoms of depression was shown from baseline to post treatment with CBT-AD. These clinically significant improvements were maintained at the 12 month follow up. The Medication Event Monitoring System (MEMS) showed that during the CBT-AD intervention, adherence improved 11.8% from baseline and 11.3% more than the ETAU condition. However adherence gains were not maintained at follow-up. It is proposed that continued adherence counseling may be necessary to maintain adherence gains, even when depression symptoms improve.

Depression and substance abuse are the most comorbid disorders associated with HIV-infection, and it is suggested that even a small change in adherence can result in improved outcomes for HIV patients. The results of this study suggest that the integration of CBT-AD into substance abuse counseling may be useful for decreasing depression and improving adherence to medication (with continued sessions) in HIV-infected patients with a history of injection drug use.

Safren, S.A., O’Cleirigh, C.M., Bullis, J.R., Otto, M.W., Stein, M.D., & Pollack, M.H. (2012) Cognitive Behavioral Therapy for Adherence and Depression (CBT-AD) in HIV-Infected Injection Drug Users: A Randomized Controlled Trial. Journal of Consulting and Clinical Psychology, 80(3), 404-415.

CBT for Substance Abuse

In this video from a recent CBT workshop at the Beck Institute, Dr. Aaron Beck discusses his academic and clinical history in the treatment of substance abuse. He speaks of his early clinical trials involving cognitive therapy for substance abuse. Dr. Beck also references a recent book, Group Cognitive Therapy for Addictions, which he co-authored with Amy Wenzel, Ph.D., Bruce Liese, Ph.D., and Dara Friedman-Wheeler, Ph.D.

For CBT resources, visit Beck Institute’s CBT Store.

Beck Institute’s next CBT for Substance Abuse Workshop will take place April 15-17, 2013. For more information, or to sign-up, visit our website.

CBT for Substance Abuse

In this video from a recent CBT workshop at the Beck Institute, Dr. Aaron Beck discusses cognitive behavior therapy for addictions and explains the methodology and effectiveness of in-office desensitization with substance use disorder patients. Dr. Beck also references a recent book, Group Cognitive Therapy for Addictions, which he co-authored with Amy Wenzel, Ph.D., Bruce Liese, Ph.D., and Dara Friedman-Wheeler, Ph.D.

For CBT resources, visit Beck Institute’s CBT Store:

Beck Institute’s next CBT for Substance Abuse Workshop will take place April 15-17, 2013. For more information, or to sign-up, visit our website.

Cognitive Behavior Therapy for Substance Abuse

In this clip from a recent 3-day workshop at the Beck Institute for Cognitive Behavior Therapy, Dr. Aaron Beck discusses how CBT can be used to treat substance use disorders. Dr. Beck explains how the generic cognitive model can be applied to specific situations, such as when a patient is faced with a craving. He also describes the process of coping with cravings via experiential CBT treatment.  Beck Institute will be hosting its first ever CBT for Substance Abuse workshop this year.  For more information visit our website.

Seeking Safety Treatment Improves Outcomes in Patient with Substance Use Disorders and Co-Occurring PTSD

According to a recent study published in Addiction, seeking safety treatment (SS), a manualized, present-focused, cognitive behavior therapy (CBT) treatment program for substance use disorders and PTSD, is associated with better drug use outcomes than treatment as usual. The current study compared treatment as usual to a combination of SS and treatment as usual. Results indicate that SS may reduce drug use in veterans with substance use disorders and PTSD better than treatment as usual, and works as well as treatment as usual in reducing alcohol use and PTSD symptoms. SS is also associated with greater treatment attendance, treatment satisfaction, and improvements in active coping. Requirements for training, supervision and consultation in SS is less costly than other evidence-based treatments for PTSD, which may increase its feasibility of use. Seeking safety treatment was developed by Lisa Najavits, Ph.D.

Boden, M. T., Kimerling, R., Jacobs-Lentz, J., Bowman, D., Weaver, C., Carney, D., Trafton, J. A.,& Walser, R. (2012). Seeking Safety treatment for male veterans with a substance use disorder and post-traumatic stress disorder symptomatology. Addiction, 107(3), 578-586.