Preliminary Outcomes of a Computerized CBT/MET Intervention for Depressed Cannabis Users in Psychiatry Care

Although depression is common among cannabis users, there is a paucity of targeted interventions addressing depression and cannabis use disorders concurrently. In the present pilot study, we examine the feasibility, acceptability, and preliminary outcomes of a computer-assisted intervention combining cognitive behavioral therapy (CBT) and motivational enhancement therapy (MET) techniques for adults with comorbid major depressive disorder (MDD) and cannabis use disorder (CUD) presenting for care in a psychiatric setting. Adults with MDD and CUD (N=26) recruited from mental health care settings were enrolled in a 10-week, computer-assisted psychosocial intervention: Self-Help for Alcohol and other Drug Use and Depression (SHADE). Feasibility, acceptability, perceived helpfulness, treatment retention, completion, and clinical outcomes including cannabis use and depression were assessed. Participants found the SHADE intervention to be acceptable and helpful in facilitating action towards their therapeutic goals concerning depression and cannabis use. Treatment completion, achieved by the majority (85%) of participants, was excellent. On average, participants reduced their past 30 day cannabis use from baseline (mean percentage of days using = 69%) to follow-up (M=44%) (t(22)= 2.3, p<0.05; Effect Size= 0.79). Concurrently, they evidenced reductions in depressive symptom severity, from the moderately severe range at baseline to the mild range at follow-up (t(24)=7.3, p<0.001; Effect Size=1.52). Addressing comorbid CUD and MDD using a computer-assisted, evidence-based treatment strategy is feasible in a psychiatric care setting, and may produce improvements in both depressive symptoms and cannabis use.