Cognitive-behavioral interventions for co-occurring substance use and mental health disorders

The current meta-analysis provides an overview of cognitive-behaviorally-based interventions (CBI) that treat co-occurring alcohol and other drug use (AOD) and one or more mental health disorders. A literature search was conducted through October of 2024. All published outcome data were extracted and categorized into one of thirteen different outcome types (e.g., abstinence, quantity, mental health symptoms, quality of life) and two broader outcome classes (i.e., consumption; psychosocial). The study sample included 47 randomized trials (K = 101 publications; 912 effect sizes). The studies were primarily polydrug-focused and targeted samples where diagnostic criteria for a use disorder were met. CBIs targeting co-occurring disorders provided benefit over usual care and control comparators for consumption, but not psychosocial outcomes. The opposite pattern of effects was observed when CBI was added to usual care and compared to usual care alone. When a CBI treatment was compared to a CBI treatment targeting AOD or mental health only, significant effects were not observed. These results suggest modest efficacy of CBI interventions in this sample of studies targeting a range of substances and co-occurring mental health conditions.