Superior efficacy of cognitive-behavioral therapy for urban crack cocaine abusers: Main and matching effects.

Maude-Griffin, Peg M.; Hohenstein, Jill; Humfleet, Gary L.; Reilly, Patrick; Tusel, Donald J.; Hall, Sharon M.

doi:10.1037/0022-006x.66.5.832

Cited by 143 publications

(115 citation statements)

References 31 publications

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“…Meta-analyses and extensive reviews of the literature have established that cognitive behavior approaches have strong empirical support for use in treatment of alcohol use disorders (44,45) and several non-substance-related psychiatric disorders (46) and that these approaches have been demonstrated to be effective in drug-using populations as well (47). Several research groups have demonstrated the efficacy of cognitive behavior therapy in the treatment of cocaine-dependent outpatients, particularly depressed and more severely dependent cocaine users (48)(49)(50)(51)(52)(53)(54), and have shown that cognitive behavior therapy is compatible and possibly has additive effects when combined with pharmacotherapies such as disulfiram (55,56). Furthermore, cognitive behavior therapy is characterized by an emphasis on the development of skills that can be used initially to foster abstinence but can also be applied to a range of co-occurring problems.…”

Section: Cognitive Behavior and Skills Training Therapiesmentioning

confidence: 99%

Behavioral Therapies for Drug Abuse

Carroll

Onken

2005

AJP

397

232

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The past three decades have been marked by tremendous progress in behavioral therapies for drug abuse and dependence, as well as advances in the conceptualization of approaches to development of behavioral therapies. Cognitive behavior therapy, contingency management, couples and family therapy, and a variety of other types of behavioral treatment have been shown to be potent interventions for several forms of drug addiction, and scientific progress has also been greatly facilitated by the articulation of a systematic approach to the development, evaluation, and dissemination of behavioral therapies. The authors review recent progress in strategies for the development of behavioral therapies for drug and alcohol abuse and dependence and discuss the range of effective behavioral therapies that are currently available.Before the advent of research on treatments derived from operant and classic behaviorism, there was little indication that any form of psychosocial treatment was effective for any type of mental disorder (1-3). Research on behavioral therapies flourished with the adoption of the technology model (4, 5), which sought to systematize these therapies and the experimental methods through which they could be evaluated to achieve a level of methodological rigor on a par with the standards for pharmacological research (6,7). By the mid to late 1980s, there were a number of behavioral treatments that had been shown to be efficacious in the treatment of a variety of mental disorders, including depressive, panic, and obsessive-compulsive disorders. However, the methodological rigor and specificity that were characteristic of these studies were not yet apparent in drug abuse treatment studies, with a few exceptions (8). Although behavioral approaches were universally available in drug abuse treatment programs by the late 1980s (9), there was continued pessimism in the field regarding the efficacy of behavioral therapies for drug use disorders (10, 11).In the early 1990s, studies in which behavioral therapies, therapist training, study populations, and objective outcome measures were carefully specified and in which participants were randomly assigned to experimental and control or comparison conditions began to appear more frequently in the drug abuse treatment literature. The technology model facilitated the identification of effective behavioral treatments for substance use disorders as it enhanced the internal validity and replicability of research on behavioral therapies. However, the technology model also had the unanticipated effect of restricting the development of novel therapies. The stringent methodological requirements associated with the technology model (e.g., requiring investigators to have fully developed treatment manuals, therapist training protocols, and fidelity rating procedures) limited the therapies eligible for efficacy evaluation to those already developed for drug abuse and to those which could easily be adapted from other areas (e.g., alcohol and depression treatments). This res...

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Section: Cognitive Behavior and Skills Training Therapiesmentioning

confidence: 99%

Behavioral Therapies for Drug Abuse

Carroll

Onken

2005

AJP

397

232

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“…Support for CBT in the treatment of cocaine dependence has been demonstrated (Carroll et al, 1991(Carroll et al, , 1994Maude-Griffin et al, 1998;McKay et al, 1997;Rohsenow et al, 2000;Schmitz et al, 1997), with recent evidence suggesting additive effects when combining CBT with pharmacotherapy (Carroll et al, 2004a;Carroll et al, 1998;Schmitz et al, 2001). CBT is considered to be more powerful than ClinMan, but not sufficiently potent to override medication effects (Carroll et al, 2004b).…”

Section: Behavioral Platformsmentioning

confidence: 99%

Levodopa pharmacotherapy for cocaine dependence: Choosing the optimal behavioral therapy platform

Schmitz

Mooney

Moeller

et al. 2008

Drug and Alcohol Dependence

113

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Background: The dopamine precursor levodopa has shown some, albeit relatively weak, promise in treating cocaine dependence. This study sought to identify the most appropriate behavioral therapy platform for levodopa pharmacotherapy by evaluating its effect when administered in combination with behavioral platforms of varying intensities. Method:A total of 161 treatment-seeking cocaine dependent subjects received sustained release levodopa/carbidopa (400/100 mg bid, Sinemet) or placebo delivered in combination with Clinical Management (ClinMan); ClinMan+Cognitive Behavioral Therapy (CBT); or ClinMan+CBT +Voucher-Based Reinforcement Therapy (VBRT) in a 12-week randomized, placebo-controlled, double-blind (for medication condition) trial. Medication compliance was monitored with riboflavin (100 mg/capsule) and the Medication Event Monitoring System. Protocol compliance was addressed in weekly, 10-minute nurse-delivered ClinMan sessions. Weekly, 1-hour CBT sessions focused on coping skills training. VBRT (with escalating reinforcer value) provided cash-valued vouchers contingent on cocaine-negative urine toxicology results. Urine benzoylecgonine assays collected thrice-weekly were analyzed by intention-to-treat criteria using generalized linear mixed models.Results: Levodopa main effects were found on all outcome measures of cocaine use. Contrasts testing the levodopa-placebo difference within each behavioral platform found reliable effects, favoring levodopa, only in the VBRT platform. Levodopa treatment with vouchers produced higher proportions of cocaine-negative urines and longer periods of consecutive abstinence compared to other treatment combinations.Conclusion: This is the first study to find a significant treatment effect for levodopa and, in doing so, to demonstrate that the magnitude of this effect is dependent upon conditions of the behavioral therapy platform. The data support use of levodopa with abstinence-based reinforcement therapy as one efficacious combination in cocaine dependence disorder treatment.

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“…Relapseprevention cognitive behavioural therapy (RP-CBT) is derived from a cognitive model of drug misuse. The emphasis is on identifying and modifying irrational thoughts, managing negative mood and intervening after a lapse to prevent a full-blown relapse [26]. The emphasis is on development of skills to (a) recognize High Risk Situations (HRS) or states where clients are most vulnerable to drug use, (b) avoidance of HRS, and (C) to use a variety of cognitive and behavioural strategies to cope effectively with these situations.…”

Section: Course Of Treatment and Assessment Of Progressmentioning

confidence: 99%

“…The emphasis is on development of skills to (a) recognize High Risk Situations (HRS) or states where clients are most vulnerable to drug use, (b) avoidance of HRS, and (C) to use a variety of cognitive and behavioural strategies to cope effectively with these situations. RP-CBT differs from typical CBT in that the accent is on training people who misuse drugs to develop skills to identify and anticipate situations or states where they are most vulnerable to drug use and to use a range of cognitive and behavioural strategies to cope effectively with these situations [26].…”

Section: Course Of Treatment and Assessment Of Progressmentioning

confidence: 99%