Feasibility of a simple and scalable cognitive-behavioral intervention to treat problem substance use

Our proof-of-concept study tested a simple cognitive-behavioral strategy based on experimental psychology research that draws on the concept of self-distancing and is consistent with mindfulness principles - using non-first person self-talk when facing substance use cues or cravings -- to help people achieve substance use goals. We evaluated participants' understanding, use, and utility of the intervention at follow-up.

We recruited 17 New York City residents who used drugs. At baseline, we collected demographic and substance use data and conducted the intervention. At one-week follow-up, participants were asked about their understanding, use, and perceived utility of the intervention, and asked to complete an anonymous five-item assessment of the intervention.

Sixteen participants completed follow-up. Understanding was judged "acceptable" or better for 15; 11 used their scripts during follow-up; four described their scripts as very useful, one as moderately, five as a little, and one as not useful. Nine returned assessments; ratings were strongly favorable.

Results from our pilot are encouraging and point to further research on this intervention. The intervention is suitable for integration into longer-term therapy and we envision non-first person self-talk as one strategy alongside others individuals can employ to moderate their substance use.