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Randomized Controlled Trial
. 2013 Mar;38(3):1764-75.
doi: 10.1016/j.addbeh.2012.08.011. Epub 2012 Aug 31.

Behavioral treatment for marijuana dependence: randomized trial of contingency management and self-efficacy enhancement

Mark D Litt  1 , Ronald M Kadden, Nancy M Petry
Affiliations
Randomized Controlled Trial

Behavioral treatment for marijuana dependence: randomized trial of contingency management and self-efficacy enhancement

Mark D Litt et al. Addict Behav. 2013 Mar.

Abstract

Objective: The purpose of the present study was to develop a treatment for marijuana dependence specifically designed to enhance self-efficacy.

Method: The participants were 215 marijuana-dependent men and women randomized to one of three 9-week outpatient treatments: a condition intended to enhance self-efficacy through successful completion of treatment-related tasks (motivational enhancement plus cognitive-behavioral treatment plus contingency management reinforcing completion of treatment homework; MET+CBT+CM(Homework)); a condition that controlled for all elements except for reinforcement of homework (MET+CBT+contingency management reinforcing drug abstinence; MET+CBT+CM(Abstinence)); or a case management control condition (CaseM). Participants in the two MET+CBT conditions were also asked to complete interactive voice recordings three times per week during treatment to confirm homework completion.

Results: All patients showed modest improvements over time through 14months, with few between-treatment effects on outcomes. Latent Class Growth Models, however, indicated that a subsample of patients did extremely well over time. This subsample was more likely to have been treated in the CM(Abstinence) condition. In turn, this treatment effect appears to have been accounted for by days of continuous abstinence accrued during treatment, and by pre-post increases in self-efficacy.

Conclusions: The most effective treatments may be those that elicit abstinence while increasing self-efficacy.

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Conflict of interest statement

Conflict of Interest

None of the authors have any financial or other relationships that might lead to a conflict of interest.

Figures

Figure 1
Figure 1
Main outcome measures over time by treatment condition. MET+CB+CM-Homework = Motivational Enhancement plus cognitive-behavioral treatment plus contingency management of homework completion. MET+CB+CM-Abst = Motivational Enhancement plus cognitive-behavioral treatment plus contingency management of abstinence. CaseM=Case Management.
Figure 2
Figure 2
Cognitive and behavioral mechanism variables over time by treatment condition. MET+CB+CM-Homework = Motivational Enhancement plus cognitive-behavioral treatment plus contingency management of homework completion. MET+CB+CM-Abst = Motivational Enhancement plus cognitive-behavioral treatment plus contingency management of abstinence. CaseM=Case Management.
Figure 3
Figure 3
Four-trajectory model extracted using Latent Class Growth modeling. Dotted lines indicated 95% confidence intervals around the estimated trajectories.
Figure 4
Figure 4
Four-trajectory Latent Class Growth model results by treatment condition. MET+CB+CM-Homework = Motivational Enhancement plus cognitive-behavioral treatment plus contingency management of homework completion. MET+CB+CM-Abst = Motivational Enhancement plus cognitive-behavioral treatment plus contingency management of abstinence. CaseM=Case Management.
See this image and copyright information in PMC

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