Randomized clinical trial evaluating the preliminary effectiveness of an integrated anxiety disorder treatment in substance use disorder specialty clinics

Abstract

Objective: Anxiety and substance use disorders are highly comorbid and mutually maintain each other. Treatments for anxiety disorders that are well integrated into substance use disorder treatment have the potential to improve both anxiety and substance use outcomes.

Method: Ninety-seven individuals seeking treatment at a community-based, evidence-based intensive outpatient program for substance use disorders who also had anxiety disorders were randomized to either (a) usual care (UC) at the intensive outpatient program; or (b) UC + coordinated anxiety learning and management for addiction recovery centers (CALM ARC), a 7-session, group-based, computer-assisted but therapist-directed treatment for anxiety disorders adapted for individuals with anxiety disorder and substance use disorder comorbidity.

Results: CALM ARC + UC outperformed UC on measures of anxiety and substance use at posttreatment and at a 6-month follow-up.

Conclusions: Adding CALM ARC to UC for patients with comorbid anxiety disorders and substance use disorders is superior to UC alone. Implications for future research and clinical practice are discussed. (PsycINFO Database Record

Trial registration: ClinicalTrials.gov NCT01764698.

Conflict of interest statement

The authors have no conflicts of interest to disclose.

(c) 2018 APA, all rights reserved).

Figures

Figure 1

Experimental Design and Flow of Participants through the Study (CONSORT Diagram). Note: aOf the 11 ineligible, 6 due to no anxiety disorder diagnosis, 3 due to uncontrolled psychotic features, 1 due to active suicidality, and 1 due to psychotic features and uncontrolled bipolar disorder. Randomization was conducted on a rolling basis during 6-week standardized periods of randomization into one cohort or another to more quickly enroll sufficient numbers of participants into a group (NIDA, 2003) bConducted one week prior to initiation of CALM ARC sessions or the matched weekly assessments in UC; attrition in both conditions between baseline eligibility/randomization and pre-treatment was due to treatment dropout from Matrix for a variety of reasons cImmediately following 7 weeks of CALM ARC or 7 weeks of matched weekly assessments in UC dConducted 6 months from the pre-treatment assessment