A meta-analysis of cognitive-behavioral therapy for alcohol or other drug use disorders: Treatment efficacy by contrast condition.

Abstract

Objective: This meta-analysis examined 30 randomized controlled trials (32 study sites; 35 study arms) that tested the efficacy of cognitive-behavioral therapy (CBT) for alcohol or other drug use disorders. The study aim was to provide estimates of efficacy against three levels of experimental contrast (i.e., minimal [k = 5]; nonspecific therapy [k = 11]; specific therapy [k = 19]) for consumption frequency and quantity outcomes at early (1 to 6 months [kes = 41]) and late (8+ months [kes = 26]) follow-up time points. When pooled effect sizes were statistically heterogeneous, study-level moderators were examined. Method: The inverse-variance weighted effect size was calculated for each study and pooled under random effects assumptions. Sensitivity analyses included tests of heterogeneity, study influence, and publication bias. Results: CBT in contrast to minimal treatment showed a moderate and significant effect size that was consistent across outcome type and follow-up. When CBT was contrasted with a nonspecific therapy or treatment as usual, treatment effect was statistically significant for consumption frequency and quantity at early, but not late, follow-up. CBT effects in contrast to a specific therapy were consistently nonsignificant across outcomes and follow-up time points. Of 10 pooled effect sizes examined, two showed moderate heterogeneity, but multivariate analyses revealed few systematic predictors of between-study variance. Conclusions: The current meta-analysis shows that CBT is more effective than a no treatment, minimal treatment, or nonspecific control. Consistent with findings on other evidence-based therapies, CBT did not show superior efficacy in contrast to another specific modality.

<p>Cognitive Impairments in Early-Detoxified Alcohol-Dependent Inpatients and Their Associations with Socio-Demographic, Clinical and Psychological Factors: An Exploratory Study</p>

“…8 For example, it is well known that cognitive behavioral therapy (CBT) is an effective treatment, but only a few studies have paid attention to patients' neuropsychological functioning; this approach could be inappropriate or insufficient for patients with cognitive impairments since it requires preserved cognitive capacities such as episodic and procedural memories and executive functions. 8,44,45 Furthermore, cognitive impairment can also influence readiness to change, active participation in group therapy, treatment compliance and outcomes. 9 Unfortunately, cognitive assessment is often missed in AUD treatment since neuropsychological test batteries are costly and time-consuming.…”

Randomised controlled trial of integrated cognitive behavioural treatment and motivational enhancement for comorbid social anxiety and alcohol use disorders

“…A large body of evidence supports the effectiveness of cognitive behavioural therapy (CBT) for treating SAD (Olatunji et al, 2010). CBT is also a widespread treatment for AUD, yielding moderate effects compared to no/minimal treatment, although a recent systematic review concluded it was no more effective than other established AUD therapies, such as motivational interviewing (Magill et al, 2019). Effective approaches for managing SAD or AUD cannot be assumed to generalise to individuals with comorbid anxiety and AUDs, who are typically excluded from treatment trials (Smith and Randall, 2012).…”

Technological Interventions for the Treatment of Substance Use Disorders

“…CBT is one of the most commonly used psychotherapeutic interventions for the treatment of SUDs ( Substance Abuse and Mental Health Services Administration, 2014 ). CBT is a multisession intervention targeting cognitive, affective, behavioral and environmental risks in substance users that has shown its effectiveness in alcohol use reduction and other primary substances ( Magill et al., 2019 ). However, less is known about the effectiveness of CBT in amphetamine-type stimulant reduction.…”

“…On the other hand, interventions containing multiple sessions often apply cognitive behavioral therapy (CBT), motivational interviewing (MI), community reinforcement approach (CRA), ecological momentary assessment (EMA), or a combination of several principles in “integrated therapeutic principles”, and are more commonly applied in more severe cases of substance use, including illicit substances. Several reviews and meta-analyses have indicated the effectiveness of different therapeutic principles in the reduction of substance use, including CBT (e.g., Magill et al., 2019 ), MI (e.g., DiClemente et al., 2017 ), CRA (e.g., Roozen et al., 2004 ), and EMA ( Clifford and Davis, 2012 ).…”