Mediators of drug treatment outcomes.

Treatment for drug use, like the process by which a person comes to use illicit drugs, may be seen to be at least in part a psychosocial process involving emotional, cognitive, and relationship domains. Treatment programs attempt to improve the psychosocial functioning of clients with the ultimate goal of effecting change in drug-use behaviors. In a longitudinal study of clients in an intensive outpatient treatment program using a cognitive behavioral model to treat crack cocaine use, it was found that length of treatment was directly associated with improvement in emotional well-being, cognitive functioning, and relationships. Of the three psychosocial domains, improvement in relationships had the strongest effect on self-reported decreases in cocaine usage, verified by urinalysis. Improvement in cognitive functioning had a small impact on cocaine use, whereas improvement in emotional well-being had almost no independent effect in this cognitive behavioral treatment program.