Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2023 Sep;41(3):377-388.
doi: 10.1037/fsh0000791. Epub 2023 May 25.

Adapting psychotherapy in collaborative care for treating opioid use disorder and co-occurring psychiatric conditions in primary care

Rachel French  1 , Julie Worley  1 , Margaret Lowenstein  2 , Hillary R Bogner  3 , Tara Calderbank  1 , Dominick DePhilippis  1 , Andrew Forrest  1 , Mary Beth Connolly Gibbons  1 , Rebecca Arden Harris  2 , Saida Heywood  1 , Kyle Kampman  1 , David S Mandell  1 , James R McKay  1 , Schyler Tristen Newman  1 , David W Oslin  1 , Steven Wadden  1 , Courtney Benjamin Wolk  1
Affiliations
Randomized Controlled Trial

Adapting psychotherapy in collaborative care for treating opioid use disorder and co-occurring psychiatric conditions in primary care

Rachel French et al. Fam Syst Health. 2023 Sep.

Abstract

Introduction: Opioid use disorder (OUD) and psychiatric conditions commonly co-occur yet are infrequently treated with evidence-based therapeutic approaches, resulting in poor outcomes. These conditions, separately, present challenges to treatment initiation, retention, and success. These challenges are compounded when individuals have OUD and psychiatric conditions.

Method: Recognizing the complex needs of these individuals, gaps in care, and the potential for primary care to bridge these gaps, we developed a psychotherapy program that integrates brief, evidence-based psychotherapies for substance use, depression, and anxiety, building on traditional elements of the Collaborative Care Model (CoCM). In this article, we describe this psychotherapy program in a primary care setting as part of a compendium of collaborative services.

Results: Patients receive up to 12 sessions of evidence-based psychotherapy and case management based on a structured treatment manual that guides treatment via Motivational Enhancement; Cognitive Behavioral Therapies for depression, anxiety, and/or substance use disorder; and/or Behavioral Activation components.

Discussion: Novel, integrated treatments are needed to advance service delivery for individuals with OUD and psychiatric conditions and these programs must be rigorously evaluated. We describe our team's efforts to test our psychotherapy program in a large primary care network as part of an ongoing three-arm randomized controlled trial. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

PubMed Disclaimer

Conflict of interest statement

Conflict of interest statement: None of the authors have any conflicts of interests to declare. The contents of this paper do not necessarily reflect the views of the Department of Veterans Affairs or the United State Government.

Figures

Figure 1.
Figure 1.
Algorithm Guiding Selection of Psychotherapy Approach Used in Collaborative Care Model+ (CoCM+) Integrated Treatment for Comorbid Opioid Use Disorder and Psychiatric Conditions Abbreviations: Patient Health Questionnaire (PHQ); Brief Addiction Monitor for Intensive Outpatient Programs (BAM-IOP); General Anxiety Disorder (GAD); Cognitive-Behavioral Therapy for Substance Use Disorders (CBT-SUD) Key: *BAM-IOP items 6-7 assess drug use in the past 30 days ±BAM-IOP items 4-5 assess alcohol use in the past 30 days
See this image and copyright information in PMC

Comment in

Similar articles

See all similar articles

Cited by

References

    1. American Psychiatric Association. (2020). Opioid Use Disorder. Retrieved from https://www.psychiatry.org/patients-families/addiction/opioid-use-disord....
    1. Anxiety & Depression Association of America. (2020). Anxiety and Depression.
    1. Barry DT, Cutter CJ, Beitel M, Kerns RD, Liong C, & Schottenfeld RS (2016). Psychiatric disorders among patients seeking treatment for co-occurring chronic pain and opioid use disorder. The Journal of clinical psychiatry, 77(10), 13715. - PMC - PubMed
    1. Bartels SJ, Coakley EH, Zubritsky C, Ware JH, Miles KM, Areán PA, … Costantino G (2004). Improving access to geriatric mental health services: a randomized trial comparing treatment engagement with integrated versus enhanced referral care for depression, anxiety, and at-risk alcohol use. American Journal of Psychiatry, 161(8), 1455–1462. - PubMed
    1. Bastien G, Del Grande C, Dyachenko A, Kaczorowski J, Pagé MG, Brissette S, … Jutras-Aswad D (2021). Preferences for research design and treatment of comorbid depression among patients with an opioid use disorder: A cross-sectional discrete choice experiment. Drug and Alcohol Dependence, 226, 108857. - PubMed

Publication types