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Developing an integrated treatment for substance use and depression using cognitive-behavioral therapy.
Karen Chan Osilla1, Kimberly A Hepner, Ricardo F Muñoz
1RAND Corporation, Santa Monica, CA 90407-2138, USA. karenc@rand.org
Journal of Substance Abuse Treatment
|June 23, 2009
Summary
Integrated cognitive-behavioral therapy (CBT) for depression and substance use disorders (SUD) shows promise. Clients found the group treatment applicable and recognized improvements, though counselors noted feasibility challenges.
Area of Science:
- Mental Health
- Addiction Medicine
- Psychology
Background:
- Co-occurring disorders require integrated treatment approaches for substance abuse and mental health.
- Group-based cognitive-behavioral therapy (CBT) is a potential model for integrated care.
- Implementing integrated treatment in substance use disorder (SUD) settings presents unique challenges.
Purpose of the Study:
- To develop and evaluate the feasibility and acceptability of a group-based CBT integrated treatment for depression and SUD.
- To assess client, counselor, and administrator perspectives on the integrated treatment.
- To identify key decisions and recommendations for implementing integrated care in SUD settings.
Main Methods:
- An in-depth case study methodology was employed.
- Data were collected through 15 focus groups with clients (n=7) and semistructured interviews with counselors (n=2) and administrators (n=3).
- Qualitative analysis explored treatment acceptance, perceived benefits, and implementation challenges.
Main Results:
- Cognitive-behavioral therapy (CBT) as an integrated treatment approach was widely accepted by clients, counselors, and administrators.
- Clients reported the treatment was applicable to various life aspects and facilitated recognition of clinical improvements.
- Counselors and administrators identified challenges related to long-term treatment feasibility.
Conclusions:
- Integrated group-based CBT is a feasible and acceptable treatment for co-occurring depression and SUD.
- Client engagement and perceived benefits support the use of CBT in SUD settings.
- Addressing counselor and administrator concerns is crucial for successful long-term implementation of integrated care.
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