Motivational Therapy for Substance Users With Depression (Aftercare)
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:
- Test efficacy and outcomes of CBT-MT and TAU
- Evaluate the differential effect of CBT-MT versus TAU on HIV-risk behavior of participants,
- To evaluate the impact of cognitive functioning on treatment retention and outcomes, and
- 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.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed 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.
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.
- Those randomly assigned to TAU, they will attend a weekly 60-minute Dual Recovery Anonymous self-help group.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Anne Bellows, MSW
- Phone Number: 310-267-5232
- Email: abellows@mednet.ucla.edu
Study Locations
-
-
California
-
Los Angeles, California, United States, 90025
- UCLA Integrated Substance Abuse Programs
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Age 18 or over
- 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
- Diagnostic and Statistical Manual -IV diagnosis of lifetime Major Depressive Disorder (MDD)
- BDI-II score of 13 or greater
Exclusion Criteria:
- Presence of life threatening or unstable medical illness
- Lack of proficiency in English
- Current homelessness (unless residing in a recovery home for which contact information can be provided)
- Psychiatric symptoms warranting safety concerns or inpatient treatment, including acute suicide risk
- Present diagnosis of Bipolar Disorder, Schizophrenia, or Schizoaffective Disorder.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Motivational Therapy Aftercare
Twelve, 60 minute weekly structured manualized therapy sessions.
|
Twelve, 60 minute weekly structured manualized therapy sessions.
|
|
Active Comparator: Dual Recovery Anonymous/Tx as usual
Aftercare Treatment as Usual,which is twelve 60 minute weekly sessions of peer led 12-step Dual Recovery Anonymous group.
|
Twelve 60 minute weekly sessions of peer led 12-step Dual Recovery Anonymous group.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change in Substance Use
Time Frame: weekly during active phase and through study completion, up to 6 months
|
|
weekly during active phase and through study completion, up to 6 months
|
|
Change in Depression symptoms
Time Frame: weekly during intervention and through study completion, up to 6 months
|
-Participants will complete the Beck's Depression Inventory (BDI) to measure changes in depression symptoms over time.
|
weekly during intervention and through study completion, up to 6 months
|
|
Change in Healthcare utilization
Time Frame: weekly and at follow up, up to 6 months
|
-Participants will self report use of ancillary treatment and healthcare services including ER visits and hospitalizations.
|
weekly and at follow up, up to 6 months
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Efficacy and outcomes of CBT-MT and TAU
Time Frame: Baseline, end of treatment, and at follow up, up to 6 months
|
- Participants will complete the Addiction Severity Index to assess change in psychosocial functioning between baseline, end of treatment and follow up.
|
Baseline, end of treatment, and at follow up, up to 6 months
|
|
HIV-risk behavior of participants
Time Frame: Baseline, end of treatment and follow up, up to 6 months
|
-Participants will complete the Risk Behavior Assessment (RBA) to measure effect of CBT-MT versus TAU on changes in HIV risk behaviors.
|
Baseline, end of treatment and follow up, up to 6 months
|
|
Cognitive functioning
Time Frame: Baseline and end of treatment at 3 months post treatment
|
-Participants will complete the MicroCog and Wisconsin Card Sort Test impact of cognitive functioning on treatment retention and outcomes.
|
Baseline and end of treatment at 3 months post treatment
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Suzette Glasner, PhD, University of California, Los Angeles
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimated)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 1K23DA020085 (U.S. NIH Grant/Contract)
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