Does the addition of integrated cognitive behaviour therapy and motivational interviewing improve the outcomes of standard care for young people with comorbid depression and substance misuse?

Abstract

Objective: To determine whether the addition of cognitive behaviour therapy and motivational interviewing (CBT/MI) to standard alcohol and other drug (AOD) care improves outcomes for young people with comorbid depression and substance misuse. Participants and setting: Participants were young people with comorbid depression (Kessler Psychological Distress Scale score ≥ 17) and substance misuse (mainly alcohol and/or cannabis) seeking treatment at two youth AOD services in Melbourne, Australia. The study was conducted between September 2006 and September 2008. Sixty young people received CBT/MI in addition to standard care (SC) (the SC+CBT/MI group) and 28 received SC only (the SC group). Main outcome measures: Depressive symptoms and AOD use in the previous 30 days, measured at baseline and at 3‐month and 6‐month follow‐up. Results: Compared with participants in the SC group, those in the SC+CBT/MI group showed significant reductions in depression and cannabis use and increased social contact and motivation to change substance use at 3‐month follow‐up. However, at 6‐month follow‐up, the SC group had achieved similar improvements to the CBT/MI group on these variables. All young people achieved significant improvements in functioning and quality of life variables over time, regardless of treatment group. No changes in AOD use were found in either group at 6‐month follow‐up. Conclusion: The delivery of CBT/MI in addition to SC may achieve accelerated treatment gains in the short term.

Treatment of comorbid alcohol use disorders and depression with cognitive‐behavioural therapy and motivational interviewing: a meta‐analysis

“…For seven studies (eight comparisons [24,[56][57][58][59][60][61]), we could assess the impact of CBT/MI on depressive symptoms at a follow-up measurement 6-12 months posttreatment. A similar small effect size (g = 0.26, 95% CI = −0.01 to 0.54; random-effects model) was found, but with only a trend towards significance and with a high level of heterogeneity (P = 0.063, I 2 = 65.433).…”

Eating Disorders, Addictions and Substance Use Disorders

“…While there are no studies that have specifically looked at the impact of phototherapy on SUD, high rates of comorbid depression and anxiety (Hides et al, 2011) and the negative impacts these disorders have on treatment outcomes suggest a possible role for phototherapy in this group of patients.…”

Interventions combining motivational interviewing and cognitive behaviour to promote medication adherence: a literature review

“…Several studies have combined MI and CBT interventions. The majority of MI-CBT studies focused on behavioural issues such as alcoholism or gambling, and are reported elsewhere (Greenwald 2002, Hides et al 2011). There are a few studies of MI-CBT in challenging clinical conditions.…”