Cognitive behavioral therapy (CBT) is a commonly used treatment for substance use disorders (SUDs) but has not been evaluated using the American Psychological Association’s “Tolin Criteria” for determining the empirical basis of psychological treatments. The current systematic review evaluated five meta-analyses of CBT for SUD. One meta-analysis had sufficient quality to be considered in the evaluation of effect sizes. CBT produced small to moderate effects on substance use when compared with inactive treatment and was most effective at early follow-up (1–6 months posttreatment) compared with late follow-up (8+ months posttreatment). Sensitivity analyses including all five meta-analyses found similar results. A “strong recommendation” was provided for CBT as an empirically supported treatment for SUD, based on effects on substance use, quality of the evidence, and consideration of contextual factors (e.g., efficacy in diverse populations).

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This document includes a formal evaluation of cognitive behavioral therapy for substance use disorder per the Tolin et al., (2015) criteria.

Shame is one of the leading barriers to successful recovery in substance use treatment settings. This secondary analysis study examined measurement invariance of the Internalized Shame Scale (ISS) and explored changes in shame during treatment. Participants (N = 105) in the parent study were recruited from a nonprofit residential treatment center for justice-involved women and were randomized to receive mindfulness-based relapse prevention or relapse prevention treatment. A series of confirmatory factor analyses were used to assess measurement invariance in a one-factor measurement model of the ISS. Latent growth curve modeling was used to examine change in shame over time. Our findings support the assumption of measurement invariance across multiple time points and across treatment conditions, supporting comparisons of stigma scores across groups and over time. Although we observed significant reductions in shame from pre-to posttreatment, there were no differences across treatment conditions. Additional research is needed to determine how distinct treatment components relate to reductions in shame among individuals receiving treatment for a substance use disorder.

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