Cocaine Dependence

Untreated cocaine dependence can be a chronic disorder with potentially profound effects on medical, legal, employment, family and psychosocial functioning. To date, only limited empirical evidence exists documenting any particularly effective treatments.

The Center for Psychotherapy Research is now engaged in an on-going four-year study designed to improve treatments for cocaine dependence. By investigating what goes on during group drug counseling treatment sessions, researchers hope to determine the effective elements in group drug counseling for this disorder. These findings can then be disseminated to the therapist and mental health care communities to improve treatment. As part of the study, too, statistical approaches to group data will be developed, intended to advance methodological research on group counseling. The study uses the videotapes of sessions collected in the NIDA Collaborative Cocaine Study.

For Health Care Professionals

Group drug counseling is the primary treatment modality used in community settings for the treatment of cocaine dependence, as well as alcohol and most other substances of abuse. Despite the prevalence of this modality, and data on the efficacy of group approaches to the treatment of substance use disorders, little is known about how the treatment works to achieve positive outcomes. Thus, research is needed on the mechanism of action of group treatments for substance abuse.

Drawing upon research on individual drug counseling and on group therapy for non-substance abuse problems, the "Group Drug Counseling for Cocaine Dependence" study is examining several theoretically important therapy process variables as predictors of the outcome of group drug counseling for cocaine dependence. Specifically, the study is examining the predictive capacity on treatment outcome of the following factors, as assessed in group drug counseling sessions: the degree of patient participation, quality of participation, quality of the therapeutic alliance, and frequency of feedback (and positive feedback). Also being examined is the relation of these process variables to two potential mediators of changes in drug use - changes in beliefs about drug use and endorsement of 12-step philosophy. Group drug counseling sessions are drawn from an archival tape collection from the National Institute on Drug Abuse (NIDA) Cocaine Collaborative Treatment Study.

A second aim of the study is to develop a novel approach to the analysis of group therapy data. Research on the mechanism of group counseling has been hindered by a variety of difficulties in studying treatments delivered in group formats. In particular, statistical analyses of studies using group therapy/counseling needs to address the inherent clustering within the data (i.e., there is an issue of non-independence of observations within a group). While statistical techniques such as mixed-effects models and generalized estimating equations exist for handling clustered data arising in group therapy studies with traditional static group designs, in the real world drug counseling groups typically have a "rolling" or "dynamic" structure, meaning that new members are added on an ongoing basis and existing members drop out over time. Statistical solutions for addressing such "rolling" groups have yet to be developed. The second aim of the study is to develop a new statistical approach to the analysis of data from "rolling" groups.

Principal Investigator:  Paul Crits-Christoph, PhD (NIDA funded)

This study is CLOSED to recruitment.

 

 

 

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