Substance abuse and personality disorders frequently co-occur in clinical populations. The presence of a personality disorder may lead to higher relapse rates, noncompliance, and poor outcome in substance abuse treatment programs. Although treatments for antisocial and borderline personality disordered drug abusers are being developed, there have been no systematic evaluations of integrated treatments of a more diverse range of disorders. We propose to modify and develop a 24-week individual cognitive-behavioral therapy which integrates relapse prevention with a schema-focused approach to treat the interrelated symptoms of substance abuse and personality disorders. We propose that developing a theoretically and technically integrated psychotherapy which is systematically linked to assessment results may improve drug abuse treatment retention and efficacy for this difficult to treat population. The goals of this Stage I behavioral therapy development study are to: l) pre-pilot (n=l0) and develop a manual for schema-focused cognitive- behavioral therapy for substance abusers with any Axis II personality disorder (SCT-II); 2) develop an SCT-II training manual, train therapists, and develop and implement competence and adherence rating scales; (3) conduct a pilot study of the SCT-II manual, which will evaluate the effectiveness, feasibility, and acceptability of SCT-II in comparison with drug counseling with 30 opioid dependent patients in methadone maintenance. Primary outcomes of the pilot study will be: l) treatment retention; 2) substance use; 3) psychological symptoms.
| Samuel, Douglas B; Carroll, Kathleen M; Rounsaville, Bruce J et al. (2013) Personality disorders as maladaptive, extreme variants of normal personality: borderline personality disorder and neuroticism in a substance using sample. J Pers Disord 27:625-35 |
| Ball, Samuel A (2007) Comparing individual therapies for personality disordered opioid dependent patients. J Pers Disord 21:305-21 |
| Ball, S A; Cecero, J J (2001) Addicted patients with personality disorders: traits, schemas, and presenting problems. J Pers Disord 15:72-83 |
| Ball, S A (1998) Manualized treatment for substance abusers with personality disorders: dual focus schema therapy. Addict Behav 23:883-91 |
