BACKGROUND: No studies have examined long-term changes in substance-related coping skills as a statistical mediator of cognitive-behavioral therapy (CBT) for substance use disorders (SUD). METHODS: We tested both short- and long-term changes in coping as mediators of treatment effects in two trials of in-person and/or computerized CBT for SUD. The first trial included 137 individuals (75 % male; 65.7 % non-White; mean age = 35.9) with drug and/or alcohol use disorders randomized to one of the following: in-person CBT, computer-delivered CBT (CBT4CBT) plus brief monitoring, or treatment-as-usual (TAU). The second trial included 68 individuals (65 % male; 66.2 % non-white; mean age = 42.7) with an alcohol use disorder randomized to one of the following: CBT4CBT plus brief monitoring, CBT4CBT plus TAU, or TAU only. Coping was assessed with the Coping Strategies Scale. Latent growth curve mediational models were conducted, with both short-term (baseline through end-of-treatment) and long-term (baseline through 3-month post-treatment follow-up) changes in coping. RESULTS: There were no mediation effects for short-term changes in coping. However, in both trials, there were significant mediation effects for long-term changes in coping: In trial 1, the effect of CBT4CBT vs. TAU on substance use at the 6-month follow-up was mediated by long-term increases in coping. This same mediation effect was not found for in-person CBT vs. TAU. In trial 2, the effect of CBT4CBT vs. not receiving CBT4CBT on heavy drinking at the 6-month follow-up was mediated by long-term increases in coping. CONCLUSIONS: Long-term increases in coping may be a mechanism of change in computerized CBT for SUD.
RCT Entities:
BACKGROUND: No studies have examined long-term changes in substance-related coping skills as a statistical mediator of cognitive-behavioral therapy (CBT) for substance use disorders (SUD). METHODS: We tested both short- and long-term changes in coping as mediators of treatment effects in two trials of in-person and/or computerized CBT for SUD. The first trial included 137 individuals (75 % male; 65.7 % non-White; mean age = 35.9) with drug and/or alcohol use disorders randomized to one of the following: in-person CBT, computer-delivered CBT (CBT4CBT) plus brief monitoring, or treatment-as-usual (TAU). The second trial included 68 individuals (65 % male; 66.2 % non-white; mean age = 42.7) with an alcohol use disorder randomized to one of the following: CBT4CBT plus brief monitoring, CBT4CBT plus TAU, or TAU only. Coping was assessed with the Coping Strategies Scale. Latent growth curve mediational models were conducted, with both short-term (baseline through end-of-treatment) and long-term (baseline through 3-month post-treatment follow-up) changes in coping. RESULTS: There were no mediation effects for short-term changes in coping. However, in both trials, there were significant mediation effects for long-term changes in coping: In trial 1, the effect of CBT4CBT vs. TAU on substance use at the 6-month follow-up was mediated by long-term increases in coping. This same mediation effect was not found for in-person CBT vs. TAU. In trial 2, the effect of CBT4CBT vs. not receiving CBT4CBT on heavy drinking at the 6-month follow-up was mediated by long-term increases in coping. CONCLUSIONS: Long-term increases in coping may be a mechanism of change in computerized CBT for SUD.
Authors: Brian D Kiluk; Charla Nich; Matthew B Buck; Kathleen A Devore; Tami L Frankforter; Donna M LaPaglia; Srinivas B Muvvala; Kathleen M Carroll Journal: Am J Psychiatry Date: 2018-05-24 Impact factor: 18.112
Authors: Michelle C Acosta; Kyle Possemato; Stephen A Maisto; Lisa A Marsch; Kimberly Barrie; Larry Lantinga; Chunki Fong; Haiyi Xie; Michael Grabinski; Andrew Rosenblum Journal: Behav Ther Date: 2016-09-20
Authors: Kathleen M Carroll; Samuel A Ball; Steve Martino; Charla Nich; Theresa A Babuscio; Kathryn F Nuro; Melissa A Gordon; Galina A Portnoy; Bruce J Rounsaville Journal: Am J Psychiatry Date: 2008-05-01 Impact factor: 18.112
Authors: Richard A Rawson; Alice Huber; Michael McCann; Steven Shoptaw; David Farabee; Chris Reiber; Walter Ling Journal: Arch Gen Psychiatry Date: 2002-09