TY - JOUR
T1 - Modified cognitive behavioral therapy (M-CBT) for cocaine dependence
T2 - Development of treatment for cognitively impaired users and results from a Stage 1 trial.
AU - Aharonovich, Efrat
AU - Hasin, Deborah S.
AU - Nunes, Edward V.
AU - Stohl, Malka
AU - Cannizzaro, Daniela
AU - Sarvet, Aaron
AU - Bolla, Karen
AU - Carroll, Kathleen M.
AU - Genece, Kamala Greene
N1 - Funding Information:
This research was funded by grant R01DA020647 from the National Institute on Drug Abuse (PI: Efrat Aharonovich). Interpretations of the data discussed in this article were presented in posters at the 2013 Research Society on Alcoholism Annual Conference and the 2013 College for Problems on Drug Dependence Annual Conference, and as a Grand Rounds presentation at Jacobi Medical Center in 2014. The abstracts for the posters are shared on ResearchGate.
Publisher Copyright:
© 2018 APA, all rights reserved.
PY - 2018/11
Y1 - 2018/11
N2 - Cognitive impairments are associated with poor outcomes when treating cocaine dependent patients, but behavioral interventions to mitigate this impact have not been developed. In this Stage 1A/1B treatment development study, several compensatory strategies (e.g., content repetition, daily logs, diaries, visual presentation) were combined to create a modified cognitive behavioral therapy (M-CBT) for treating cocaine dependence. Initially, a select group of therapists, neuropsychology experts, and patients were asked to provide input on early drafts of the treatment manual and companion patient workbook. After an uncontrolled small trial (N = 15) and two rounds of manual development (Stage 1A), a pilot randomized clinical trial (N = 102) of cocaine dependent outpatients with and without cognitive impairments was conducted (Stage 1B). Participants were randomized to M-CBT (N = 52) or CBT (N = 50). Both treatments were individually delivered over 12 weeks with assessments conducted at baseline, end-of-treatment, and 3-month follow-up. The primary outcome was frequency of cocaine use, measured by number of days used in the prior 7 days. Participants in the two treatment groups did not differ significantly on drug use reduction or retention in treatment. However, among participants who completed at least 9 weeks of treatment, those in M-CBT showed a trend toward greater reduction in cocaine use compared to those in the CBT group. M-CBT is feasible for impaired and nonimpaired cocaine dependent participants. However, M-CBT treatment did not show significant superiority over standard CBT in the present sample.
AB - Cognitive impairments are associated with poor outcomes when treating cocaine dependent patients, but behavioral interventions to mitigate this impact have not been developed. In this Stage 1A/1B treatment development study, several compensatory strategies (e.g., content repetition, daily logs, diaries, visual presentation) were combined to create a modified cognitive behavioral therapy (M-CBT) for treating cocaine dependence. Initially, a select group of therapists, neuropsychology experts, and patients were asked to provide input on early drafts of the treatment manual and companion patient workbook. After an uncontrolled small trial (N = 15) and two rounds of manual development (Stage 1A), a pilot randomized clinical trial (N = 102) of cocaine dependent outpatients with and without cognitive impairments was conducted (Stage 1B). Participants were randomized to M-CBT (N = 52) or CBT (N = 50). Both treatments were individually delivered over 12 weeks with assessments conducted at baseline, end-of-treatment, and 3-month follow-up. The primary outcome was frequency of cocaine use, measured by number of days used in the prior 7 days. Participants in the two treatment groups did not differ significantly on drug use reduction or retention in treatment. However, among participants who completed at least 9 weeks of treatment, those in M-CBT showed a trend toward greater reduction in cocaine use compared to those in the CBT group. M-CBT is feasible for impaired and nonimpaired cocaine dependent participants. However, M-CBT treatment did not show significant superiority over standard CBT in the present sample.
KW - cognition
KW - cognitive- behavioral therapy
KW - stage model
KW - substance use disorders
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U2 - 10.1037/adb0000398
DO - 10.1037/adb0000398
M3 - Article
C2 - 30346186
AN - SCOPUS:85055128864
SN - 0893-164X
VL - 32
SP - 800
EP - 811
JO - Psychology of Addictive Behaviors
JF - Psychology of Addictive Behaviors
IS - 7
ER -