While there is as yet no consensus regarding effective treatment for cocaine abuse, psychotherapeutic approaches, particularly behavioral therapies, appear promising. No psychological treatment for cocaine abuse has yet been subjected to controlled, well-designed clinical trials. In this study, 120 cocaine abusers will be treated in a clinical trial with randomized treatment evaluation comparing four widely contrasting treatments: (a) Relapse Prevention, a cognitive-behavioral approach, (b) Interpersonal Psychotherapy, a short-term psychodynamic approach, (c) Desipramine plus Clinical Management, a pharmacological approach, and (d) Placebo plus Clinical Management as a control condition. Therapists will be experienced doctorate-level clinicians specifically trained to perform these therapies, which have been explicated in training manuals. Outcomes will be mulitdimensional and measured by raters blind to the treatment the subject is receiving. Three, six, and twelve month follow-up evaluations will be performed to evaluate the durability and/or delayed emergence of treatment effects. The following aims will be sought: (a) To evaluate the relative efficacy of these four treatments: (b) To seek specific, unique effects of the different approaches as related to (i) theoretically relevant types of changes noted, and (ii) subpopulations of clients for whom each treatment is particularly effective; (c) To discriminate these different treatment approaches based on therapy process variables; and (d) To identify effective elements in the treatment approaches by evaluating aspects of the therapeutic process as related to treatment outcome, with the eventual goal of scientifically derived treatment planning.
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