Network intervention analysis of ACT processes in cocaine use disorder

Cocaine Use Disorder (CUD) remains a difficult condition to treat, with high rates of relapse and limited long-term success across current treatment options. This study aims to identify modifiable cognitive-affective processes that may facilitate recovery, with a particular focus on mechanisms targeted by Acceptance and Commitment Therapy (ACT).

This study is a secondary analysis of data from the original RCT. A total of 110 participants meeting DSM-5 criteria for moderate to severe CUD were included in the study. Participants were demographically and clinically comparable across two intervention groups: ACT combined with Contingency Management (n = 53) and Drug Counseling combined with Contingency Management (n = 57). Network intervention analysis was conducted to examine changes in dynamic interactions before and after treatment.

Experiential avoidance emerged as a key treatment target, showing the highest strength centrality index. Additionally, progress aligned with personal values was directly associated with successful cocaine abstinence.

These findings help identify the pathways through which ACT influences cocaine cessation, ultimately contributing personalized treatment strategies for CUD, particularly in the context of ACT-based interventions.