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. 2011 Jan 1;7(4):207-227.
doi: 10.1080/15504263.2011.620425.

A Randomized Controlled Trial Comparing Integrated Cognitive Behavioral Therapy Versus Individual Addiction Counseling for Co-occurring Substance Use and Posttraumatic Stress Disorders

Mark P McGovern  1 , Chantal Lambert-Harris, Arthur I Alterman, Haiyi Xie, Andrea Meier
Affiliations

A Randomized Controlled Trial Comparing Integrated Cognitive Behavioral Therapy Versus Individual Addiction Counseling for Co-occurring Substance Use and Posttraumatic Stress Disorders

Mark P McGovern et al. J Dual Diagn. .

Abstract

OBJECTIVE: Co-occurring posttraumatic stress (PTSD) and substance use disorders provide clinical challenges to addiction treatment providers. Interventions are needed that are effective, well-tolerated by patients, and capable of being delivered by typical clinicians in community settings. This is a randomized controlled trial of integrated cognitive behavioral therapy for co-occurring PTSD and substance use disorders. METHODS: Fifty-three participants sampled from seven community addiction treatment programs were randomized to integrated cognitive behavioral therapy plus standard care or individual addiction counseling plus standard care. Fourteen community therapists employed by these programs delivered both manual-guided therapies. Primary outcomes were PTSD symptoms, substance use symptoms and therapy retention. Participants were assessed at baseline, 3- and 6-month follow-up. RESULTS: Integrated cognitive behavioral therapy was more effective than individual addiction counseling in reducing PTSD re-experiencing symptoms and PTSD diagnosis. Individual addiction counseling was comparably effective to integrated cognitive behavioral therapy in substance use outcomes and on other measures of psychiatric symptom severity. Participants assigned to individual addiction counseling with severe PTSD were less likely to initiate and engage in the therapy than those assigned to integrated cognitive behavioral therapy. In general, participants with severe PTSD were more likely to benefit from integrated cognitive behavioral therapy. CONCLUSIONS: The findings support the promise of efficacy of integrated cognitive behavioral therapy in improving outcomes for persons in addiction treatment with PTSD. Community counselors delivered both interventions with satisfactory adherence and competence. Despite several limitations to this research, a larger randomized controlled trial of integrated cognitive behavioral therapy appears warranted.

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Figures

FIGURE 1
FIGURE 1
ICBT and IAC retention: initiation, engagement, and completion.
See this image and copyright information in PMC

References

    1. Back S, Dansky BS, Coffey SF, Saladin ME, Sonne S, Brady KT. Cocaine dependence with and without post-traumatic stress disorder: A comparison of substance use, trauma history and psychiatric comorbidity. The American Journal on Addictions / American Academy of Psychiatrists in Alcoholism and Addictions. 2000;9(1):51–62. - PubMed
    1. Back SE, Brady KT, Sonne SC, Verduin ML. Symptom improvement in co-occurring PTSD and alcohol dependence. The Journal of Nervous and Mental Disease. 2006;194(9):690–696. [doi]; 00005053 200609000-00009 [pii] - PubMed
    1. Beck AT, Steer RA, Brown GK. Manual for the beck depression inventory-II. San Antonio Texas: Psychological Corporation; 1996.
    1. Blake DD, Weathers FW, Nagy LM, Kaloupek DG, Gusman FD, Charney DS, Keane TM. The development of a clinician-administered PTSD scale. Journal of Traumatic Stress. 1995;8(1):75–90. - PubMed
    1. Brady KT. Treatments for PTSD or combined PTSD and drug abuse; NIDA Conference on Addressing Substance Abuse Comorbidities among Military Personnel, Veterans, and their Families; Bethesda MD: 2009.

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