Craving Management Program for Substance Use Disorders

A Preliminary Study on the Effectiveness of a Psychosocial Treatment Program (Craving Management and Alternative Behavior Enhancement Program) for Substance Use Disorders

This study examines whether a newly developed eight-session psychosocial treatment program, called the Craving Management and Alternative Behavior Enhancement Program, can be delivered in real-world hospital settings to people receiving inpatient care for substance use disorders in Korea, and whether it shows early signs of benefit. The program combines motivational interviewing, acceptance and commitment therapy, behavioral activation, and group activities, and is delivered twice a week over about four weeks (eight 50-minute sessions). About 20 adults will take part at two psychiatric hospitals.

Participants complete brief questionnaires and a short interview about their craving, motivation to change, behavioral activation, positive and negative affect, mindfulness, and drug use history before the program, immediately before and after each session, within one week after the program ends, and again at 1 month and 3 months after completion. After the program, some participants also join a small group discussion (focus group interview) to share their experience of the program.

Because this is a small, single-group preliminary (pilot) study without a comparison group, its primary purpose is to assess feasibility, that is, whether the program and the assessment approach work well enough, and to obtain preliminary effect and variability estimates to inform the design of a future large-scale randomized controlled trial.

Study Overview

• Status: Not yet recruiting
• Conditions: Substance Use Disorder (SUD)
• Intervention / Treatment: Behavioral: Craving Management and Alternative Behavior Enhancement Program

Detailed Description

Background: Substance use among the Korean population has increased rapidly, with spread into adolescents and people in their twenties. Yet standardized, evidence-based psychosocial treatment programs and a corresponding clinician training and certification system are not well established in Korea. Evidence-based psychosocial interventions such as cognitive behavioral therapy, motivational interviewing, community reinforcement approaches, and 12-step facilitation are widely used as standard care in other countries, but comparable, locally validated programs are scarce in Korea. To address this gap, a Korean psychosocial treatment program (the Craving Management and Alternative Behavior Enhancement Program) was developed, and this preliminary study evaluates its feasibility and preliminary effectiveness.

Objectives:

1. Primary objective: to evaluate the real-world feasibility of delivering the Craving Management and Alternative Behavior Enhancement Program to inpatients with substance use disorders.
2. Secondary objective: to examine preliminary changes in craving (VAS-C), motivation to change (URICA-DO), behavioral activation (K-BADS-SF), positive and negative affect (K-PANAS-SF), mindfulness (K-MMAS), and drug use history and treatment service utilization, and to assess whether these measures are suitable for a future comparative trial.
3. Tertiary objective: to explore participants' subjective experience and the acceptability of the program through a focus group interview, in order to refine the treatment manual and operational protocol for a future randomized controlled trial.

Design and setting: This is a single-arm, pre-post study with follow-up, without a control group. A total of 20 participants (10 per site) will be enrolled at two psychiatric hospitals that provide care to a large proportion of patients with drug use disorders in Korea (Incheon Chamsarang Hospital and Daegu Daedong Hospital). Study planning, rater training, informed consent storage, data management, and statistical analysis are coordinated centrally by the Catholic University of Korea. The two participating sites do not have their own IRB and are reviewed under the Uijeongbu St. Mary's Hospital IRB.

Intervention: The program consists of eight 50-minute group sessions delivered twice weekly over approximately four weeks. It integrates motivational interviewing, acceptance and commitment therapy, behavioral activation, and group therapy. Session themes are: (1) how craving arises; (2) craving regulation strategies I: the pause between impulse and action; (3) craving regulation strategies II: from automatic reactions to chosen responses; (4) anticipating high-risk situations and building a personal coping card; (5) identifying alternative behaviors that fit one's own life; (6) building small but reliable routines; (7) noticing positive moments and cultivating gratitude; and (8) creating a personal recovery practice manual.

Assessment schedule: Baseline assessment occurs within one week before the program. Craving is assessed immediately before and after each session, along with session satisfaction and a therapist treatment-fidelity self-assessment. Post-intervention assessment occurs within one week after the program, followed by a focus group interview. Follow-up assessments are conducted at 1 month and 3 months after program completion.

Statistical analysis: Feasibility will be summarized using recruitment, retention, session attendance, and assessment completion rates. Change in continuous outcomes over time (pre, post, follow-up) will be analyzed using repeated-measures analysis of variance and linear mixed models; where covariate adjustment for repeated measures is needed, generalized estimating equations will be used. Analyses adjust for sociodemographic covariates and indication variables, or use stratified comparison. Missing data judged to be MCAR/MAR will be handled via maximum likelihood estimation within linear mixed models or multiple imputation, with sensitivity analyses. The main analysis is based on the full analysis set, with the per-protocol set as a supportive analysis. Qualitative focus group data will be transcribed and analyzed using thematic analysis (Braun & Clarke, 2006) by at least two independent coders.

• Study Type: Interventional
• Enrollment (Estimated): 20
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Hae Kook Lee, MD, PhD; Phone Number: +82-31-820-3050; Email: policyhklee@gmail.com
• Study Contact Backup: Name: Hae-Ryoung Chun, PhD; Phone Number: +82-10-6567-7833; Email: mamimihae@catholic.ac.kr

Study Locations

• South Korea
  • Daegu, South Korea
    • Daegu Daedong Hospital
    • Contact: Do-Hoon Kwon, MD, PhD; Phone Number: +82-53-663-1634; Email: dohoonkwon@hotmail.com
  • Incheon, South Korea
    • Incheon Chamsarang Hospital
    • Contact: Younghoon Chon, MD, PhD; Phone Number: +82-32-571-9111; Email: 8542231@daum.net

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Adults aged 19 to 65 years who can understand the study purpose and procedures and provide written informed consent
• Currently hospitalized (inpatient)
• Able to communicate and complete questionnaires in Korean
• Physically able to participate in program activities
• Has completed detoxification treatment
• Meets indication thresholds: DAST-10 score >= 2, craving reported as present on the VAS-C craving screening (i.e., "yes"), and >= 2 DSM-5 criteria

Exclusion Criteria:

• Cognitive impairment that precludes communication
• Physical conditions that preclude program participation (e.g., musculoskeletal disorder, severe cardiopulmonary disease)
• Acute psychotic symptoms or risk of self-harm or harm to others
• At risk of disrupting group activities such that focus group participation is not feasible
• Individuals who are inmates or incarcerated at screening are not enrolled; participants who become incarcerated after enrollment are withdrawn

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm

Intervention / Treatment

Experimental: Craving Management and Alternative Behavior Enhancement Program; All participants receive the Craving Management and Alternative Behavior Enhancement Program, an eight-session group-based psychosocial treatment delivered twice weekly (50 minutes per session) over approximately four weeks. The program integrates motivational interviewing, acceptance and commitment therapy, behavioral activation, and group therapy, covering craving awareness, craving-regulation strategies, high-risk situation coping, alternative behaviors, routine building, gratitude, and a personalized recovery plan.

Behavioral: Craving Management and Alternative Behavior Enhancement Program; Eight 50-minute group sessions delivered twice weekly over approximately four weeks. Session 1: how craving arises. Session 2: craving regulation strategies I (the pause between impulse and action). Session 3: craving regulation strategies II (from automatic reactions to chosen responses). Session 4: anticipating high-risk situations and building a personal coping card. Session 5: identifying alternative behaviors that fit one's own life. Session 6: building small but reliable routines. Session 7: noticing positive moments and cultivating gratitude. Session 8: creating a personal recovery practice manual. Core techniques are motivational interviewing, acceptance and commitment therapy, behavioral activation, and group therapy.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Craving (VAS-C)	Craving measured by the Visual Analog Scale for Craving (VAS-C), ranging from 0 to 100 mm (0 = no craving, 100 = constant craving); higher scores indicate greater craving (worse outcome). Change from baseline is assessed at post-intervention and follow-up.	Immediately before and immediately after each of the 8 sessions (over approximately 4 weeks); baseline (within 1 week before the program); within 1 week post-intervention; 1 month and 3 months after completion
Feasibility: Program Completion (Retention) Rate	Proportion of enrolled participants who complete all eight sessions of the Craving Management and Alternative Behavior Enhancement Program. Feasibility is further characterized by recruitment rate, session attendance, and assessment completion rates.	From enrollment through the end of the 8-session intervention (approximately 4 weeks)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Drug Use and Treatment Service Utilization	Self-reported drug use history and treatment service utilization assessed via a structured 1:1 interview. Recall window is the past 30 days at most time points and the past 2 months at the 3-month follow-up.	Baseline, post-intervention (within 1 week), 1 month and 3 months after completion
Change in Motivation to Change (URICA-DO)	Motivation to change (readiness) measured by the Korean version of the University of Rhode Island Change Assessment for Drug Offenders (URICA-DO), a 24-item scale rated from 1 (strongly disagree) to 5 (strongly agree) with four subscales (Precontemplation, Contemplation, Action, Maintenance). A Readiness to Change score is computed as the sum of the mean Contemplation, Action, and Maintenance subscale scores minus the mean Precontemplation subscale score (range -2 to 14); higher scores indicate greater readiness to change (better outcome).	Baseline (within 1 week before program), post-intervention (within 1 week after program), 1 month and 3 months after completion
Program Acceptability (Focus Group Interview)	Acceptability and subjective experience of the program explored through a focus group interview using a semi-structured guide, analyzed by thematic analysis (Braun & Clarke, 2006).	Within 1 week after program completion
Change in Behavioral Activation (K-BADS-SF)	Behavioral activation measured by the Korean version of the Behavioral Activation for Depression Scale-Short Form (K-BADS-SF), a 9-item scale rated from 0 to 6, with avoidance/rumination items reverse-scored; higher total scores indicate greater behavioral activation (better outcome).	Baseline, post-intervention (within 1 week), 1 month and 3 months after completion
Change in Mindfulness (K-MMAS)	Mindful attention and awareness measured by the Korean version of the Mindful Attention Awareness Scale (K-MMAS), a 15-item scale rated from 1 to 7 (total range 15 to 105); higher scores indicate greater mindful attention and awareness (better outcome).	Baseline, post-intervention (within 1 week), 1 month and 3 months after completion

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Session Usefulness and Therapeutic Alliance	Participant-rated helpfulness of each session and therapeutic alliance on a visual analog scale from 0 to 10 (0 = not helpful at all, 10 = very helpful); higher scores indicate greater perceived usefulness and alliance (better outcome).	Immediately after each of the 8 sessions (over approximately 4 weeks)
Treatment Fidelity (Adherence Rate)	Therapist self-assessed treatment fidelity comprising common structural-fidelity items, session-specific core-practice items, and overall clinical-process fidelity items (yes/no), summarized as an adherence rate per session and per therapist.	Immediately after each of the 8 sessions

Collaborators and Investigators

• Sponsor: The Catholic University of Korea
• Investigators: Principal Investigator: Hae Kook Lee, MD, PhD, Study Principal Investigator

Study record dates

Study Major Dates

• Study Start (Estimated): August 1, 2026
• Primary Completion (Estimated): December 1, 2026
• Study Completion (Estimated): December 1, 2026

Study Registration Dates

• First Submitted: July 7, 2026
• First Submitted That Met QC Criteria: July 7, 2026
• First Posted (Actual): July 13, 2026

Study Record Updates

• Last Update Posted (Actual): July 13, 2026
• Last Update Submitted That Met QC Criteria: July 7, 2026
• Last Verified: July 1, 2026

More Information

Terms related to this study

• Keywords: Acceptance and Commitment Therapy; Mindfulness; Craving; Group therapy; Psychosocial intervention; Behavioral activation; Motivation to change
• Additional Relevant MeSH Terms: Mental Disorders; Chemically-Induced Disorders; Substance-Related Disorders
• Other Study ID Numbers: UC26FIDI0065

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: This is a small, single-group pilot study involving sensitive data from patients with substance use disorders. Given the limited sample size and re-identification risk, individual participant data will not be shared. Only de-identified, aggregated results will be reported.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No