Stacey B Daughters1, Jessica F Magidson2, Deepika Anand1, C J Seitz-Brown3, Yun Chen1, Sydney Baker1. 1. Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. 2. Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA. 3. Department of Psychology, University of Maryland, College Park, MD, USA.
Abstract
AIMS: To compare outcomes for a behavioral activation group treatment for substance use [life enhancement treatment for substance use (LETS ACT)] versus a time and group size-matched control condition delivered in a residential treatment setting. DESIGN: Single-site two-arm parallel-group randomized clinical trial with follow-up assessment at 3, 6 and 12 months post-treatment. SETTING: Residential substance use treatment facility in the United States. PARTICIPANTS: Participants were 263 adults [mean age 42.7 (11.8); 29.5% female; 95.4% African American; 73.2% court mandated] whose insurance dictated 30-day (65.9%) or 90-day (34.1%) treatment duration. INTERVENTION AND COMPARATOR: LETS ACT (n = 142) is a treatment developed originally for depression and modified for substance use. It teaches participants to increase positively reinforcing value-driven activities in order to counter depression and relapse. The control group [supportive counseling (SC); n = 121] received time and group size-matched supportive counseling. Treatment was delivered in five or eight 1-hour sessions depending on patient length of stay. MEASUREMENTS: Percentage abstinent at follow-up, percentage of substance use days among those reporting use, depressive symptoms [Beck Depression Inventory (BDI)] and adverse consequences of drug use [Short Inventory of Problems-Alcohol and Drug (SIP-AD)]. FINDINGS:LETS ACT had significantly higher abstinence rates at 3 months [odds ratio (OR) = 2.2, 95% confidence interval (CI) = 1.3-3.7], 6 months (OR = 2.6, 95% CI= 1.3-5.0) and 12 months (OR = 2.9, 95% CI = 1.3-6.1) post-treatment compared with SC. LETS ACT participants reported significantly fewer adverse consequences from substance use at 12 months post-treatment [B = 4.50, standard error (SE) = 2.17, 95% CI = 0.22-8.78]. Treatment condition had no effect on percentage substance use days among those who resumed use or on change in depressive symptoms; the latter decreased over time only in those who remained abstinent after residential treatment irrespective of condition (B = 0.43, SE = 0.11, 95% confidence interval = 0.22-0.65). CONCLUSIONS: A behavioral activation group treatment for substance use (LETS ACT) appears to increase the likelihood of abstinence and reduce adverse consequences from substance use up to 12 months post-treatment.
RCT Entities:
AIMS: To compare outcomes for a behavioral activation group treatment for substance use [life enhancement treatment for substance use (LETS ACT)] versus a time and group size-matched control condition delivered in a residential treatment setting. DESIGN: Single-site two-arm parallel-group randomized clinical trial with follow-up assessment at 3, 6 and 12 months post-treatment. SETTING: Residential substance use treatment facility in the United States. PARTICIPANTS: Participants were 263 adults [mean age 42.7 (11.8); 29.5% female; 95.4% African American; 73.2% court mandated] whose insurance dictated 30-day (65.9%) or 90-day (34.1%) treatment duration. INTERVENTION AND COMPARATOR: LETS ACT (n = 142) is a treatment developed originally for depression and modified for substance use. It teaches participants to increase positively reinforcing value-driven activities in order to counter depression and relapse. The control group [supportive counseling (SC); n = 121] received time and group size-matched supportive counseling. Treatment was delivered in five or eight 1-hour sessions depending on patient length of stay. MEASUREMENTS: Percentage abstinent at follow-up, percentage of substance use days among those reporting use, depressive symptoms [Beck Depression Inventory (BDI)] and adverse consequences of drug use [Short Inventory of Problems-Alcohol and Drug (SIP-AD)]. FINDINGS:LETS ACT had significantly higher abstinence rates at 3 months [odds ratio (OR) = 2.2, 95% confidence interval (CI) = 1.3-3.7], 6 months (OR = 2.6, 95% CI= 1.3-5.0) and 12 months (OR = 2.9, 95% CI = 1.3-6.1) post-treatment compared with SC. LETS ACT participants reported significantly fewer adverse consequences from substance use at 12 months post-treatment [B = 4.50, standard error (SE) = 2.17, 95% CI = 0.22-8.78]. Treatment condition had no effect on percentage substance use days among those who resumed use or on change in depressive symptoms; the latter decreased over time only in those who remained abstinent after residential treatment irrespective of condition (B = 0.43, SE = 0.11, 95% confidence interval = 0.22-0.65). CONCLUSIONS: A behavioral activation group treatment for substance use (LETS ACT) appears to increase the likelihood of abstinence and reduce adverse consequences from substance use up to 12 months post-treatment.
Authors: Scott A Baldwin; David M Murray; William R Shadish; Sherri L Pals; Jason M Holland; Jonathan S Abramowitz; Gerhard Andersson; David C Atkins; Per Carlbring; Kathleen M Carroll; Andrew Christensen; Kari M Eddington; Anke Ehlers; Daniel J Feaster; Ger P J Keijsers; Ellen Koch; Willem Kuyken; Alfred Lange; Tania Lincoln; Robert S Stephens; Steven Taylor; Chris Trepka; Jeanne Watson Journal: Cogn Behav Ther Date: 2011
Authors: Bridget F Grant; Tulshi D Saha; W June Ruan; Risë B Goldstein; S Patricia Chou; Jeesun Jung; Haitao Zhang; Sharon M Smith; Roger P Pickering; Boji Huang; Deborah S Hasin Journal: JAMA Psychiatry Date: 2016-01 Impact factor: 21.596
Authors: Lidia Z Meshesha; Kathryn E Soltis; Edward A Wise; Damaris J Rohsenow; Katie Witkiewitz; James G Murphy Journal: J Subst Abuse Treat Date: 2020-03-19
Authors: James G Murphy; Ashley A Dennhardt; Matthew P Martens; Brian Borsari; Katie Witkiewitz; Lidia Z Meshesha Journal: J Consult Clin Psychol Date: 2019-05-09
Authors: Jessica F Magidson; Lena S Andersen; Emily N Satinsky; Bronwyn Myers; Ashraf Kagee; Morgan Anvari; John A Joska Journal: Psychotherapy (Chic) Date: 2019-10-31