We propose here treatment development work to create and test a """"""""community-friendly"""""""" manual-based individual plus group drug counseling package. The NIDA Collaborative Cocaine Treatment Study (Crits-Christoph et at., 1999) recently reported that manual-based individual drug counseling (IDC) plus group drug counseling (GDC) has superior drug use outcomes compared to cognitive-behavior therapy plus GDC, psychodynamic therapy plus GDC, and GDC alone. Proposed changes to IDC and GDC to make them more """"""""community-friendly"""""""" include changes to both the duration and content of the treatment models. The proposed treatment development work will include (1) obtaining feedback on the new treatment manuals by a sample of 15 community-based drug counselors, (2) evaluating whether a group of drug counselors can successfully learn to implement the new manuals, (3) evaluating counselors' experiences in learning and conducting the new treatments, (4) conducting a pilot randomized evaluation of the outcomes of the new package of individual plus group drug counseling compared to group drug counseling alone, (5) obtaining ratings of treatment fidelity to assess whether the new individual and group drug counseling approaches can be differentiated from the original therapies, (6) assessing patient reactions to the new treatment, and (7) conducting a preliminary investigation of potential mediators of change of the new treatments. The pilot randomized trial will involve assignment of 40 patients meeting DSM-IV criteria for cocaine dependence to either new versions of individual plus group drug counseling or group drug counseling alone. Assessments will be done at time of intake and weekly (for urines and self-report of cocaine use) or monthly (for other outcome measures) during a 3-month treatment phase. The primary efficacy measures will be the ASI Drug Use Composite scale and a composite cocaine use measure that incorporates urine data, Addiction Severity Index Interview data, and weekly self-report of cocaine use. Mediation of drug use change will be examined by assessing beliefs about substance use, endorsement of 12-step behaviors and beliefs, and attendance/ participation in 12-step meetings at baseline, weekly for the first month and monthly thereafter. The data gathered from this treatment development project will inform the design of a subsequent larger study.
| Crits-Christoph, Paul; Gibbons, Mary Beth Connolly; Ring-Kurtz, Sarah et al. (2009) A pilot study of community-friendly manual-guided drug counseling. J Subst Abuse Treat 37:8-16 |
| Crits-Christoph, Paul; Newberg, Andrew; Wintering, Nancy et al. (2008) Dopamine transporter levels in cocaine dependent subjects. Drug Alcohol Depend 98:70-6 |
