Motivational Therapy for Substance Users With Depression (Aftercare)

University of California, Los Angeles (UCLA)

Status: Completed

Conditions: Substance Dependence; Depression

Treatments: Behavioral: Dual Recovery Anonymous/Tx as usual; Behavioral: Motivational therapy

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT01189799

1K23DA020085

Details and patient eligibility

About

The primary objective of the study is to test the incremental efficacy and outcomes of an aftercare program of Cognitive Behavioral Therapy combined with motivational therapy (CBT-MT) relative to treatment as usual (TAU) in improving depression, substance use, and healthcare outcomes in a population with drug dependence and comorbid major depressive disorder (MDD). The investigators expect that among drug-dependent patients with comorbid MDD, CBT-MT will yield better clinical outcomes relative to TAU in reducing depressive symptoms and substance use and improving healthcare outcomes during treatment.

Secondary Objectives:

1. Test efficacy and outcomes of CBT-MT and TAU
2. Evaluate the differential effect of CBT-MT versus TAU on HIV-risk behavior of participants,
3. To evaluate the impact of cognitive functioning on treatment retention and outcomes, and
4. To explore additional psychosocial, demographic, and diagnostic factors (e.g., age, gender, education level, motivation for change, social support) that may be associated with treatment outcome and retention in this high need population.

Full description

This study will include approximately 80 participants randomized to either 12 weeks of motivational therapy or treatment as usual. Both treatments will meet once weekly for 60 minutes. Participants will be recruited from the Adult Partial Hospitalization program at University of California, Los Angeles. During the active treatment phase, participants will attend clinic weekly for collection of data and urine specimens.

1. For those randomly assigned to CBT-MT, they will meet with a therapist in a group format for 60-minute sessions once weekly.

   a. Each CBT-MT session will begin with 20 minutes of motivational therapy (MT), followed by 40 minutes of CBT content.

2. Those randomly assigned to TAU, they will attend a weekly 60-minute Dual Recovery Anonymous self-help group.

Enrollment: 36 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. Age 18 or over
2. DSM-IV diagnosis of Substance Dependence (cannabis, stimulant, opioid, or prescription drug) or DSM-IV diagnosis of Alcohol Dependence and abuse of cannabis, stimulant, opioid, or prescription drug
3. Diagnostic and Statistical Manual -IV diagnosis of lifetime Major Depressive Disorder (MDD)
4. BDI-II score of 13 or greater

Exclusion criteria

1. Presence of life threatening or unstable medical illness
2. Lack of proficiency in English
3. Current homelessness (unless residing in a recovery home for which contact information can be provided)
4. Psychiatric symptoms warranting safety concerns or inpatient treatment, including acute suicide risk
5. Present diagnosis of Bipolar Disorder, Schizophrenia, or Schizoaffective Disorder.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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36 participants in 2 patient groups

Motivational Therapy Aftercare

Experimental group

Description:

Twelve, 60 minute weekly structured manualized therapy sessions.

Treatment:

Behavioral: Motivational therapy

Dual Recovery Anonymous/Tx as usual

Active Comparator group

Description:

Aftercare Treatment as Usual,which is twelve 60 minute weekly sessions of peer led 12-step Dual Recovery Anonymous group.

Treatment:

Behavioral: Dual Recovery Anonymous/Tx as usual