An Evaluation of Cognitive Behavioral Therapy for Substance Use Disorder: A Systematic Review and Application of the Society of Clinical Psychology Criteria for Empirically Supported Treatments - PubMed (original) (raw)

An Evaluation of Cognitive Behavioral Therapy for Substance Use Disorder: A Systematic Review and Application of the Society of Clinical Psychology Criteria for Empirically Supported Treatments

Cassandra L Boness et al. Clin Psychol (New York). 2023 Jun.

Abstract

Cognitive behavioral therapy (CBT) is a commonly used treatment for substance use disorders (SUDs) but has not been evaluated using the American Psychological Association's "Tolin Criteria" for determining the empirical basis of psychological treatments. The current systematic review evaluated five meta-analyses of CBT for SUD. One meta-analysis had sufficient quality to be considered in the evaluation of effect sizes. CBT produced small to moderate effects on substance use when compared to inactive treatment and was most effective at early follow-up (1-6 months post-treatment) compared to late follow-up (8+ months post-treatment). Sensitivity analyses including all five meta-analyses found similar results. A "strong recommendation" was provided for CBT as an empirically supported treatment for SUD, based on effects on substance use, quality of evidence, and consideration of contextual factors (e.g., efficacy in diverse populations).

Keywords: cognitive behavioral therapy; empirically supported treatment; research-supported treatment; substance use; substance use disorder.

PubMed Disclaimer

Conflict of interest statement

Dr. Boness is a member of the Division 12 Committee on Science and Practice and played a key role in the development of the “Tolin Criteria” manual. To mitigate this conflict, Dr. Boness was not involved in the evaluation or discussion of this evaluation report by the Division 12 Committee on Science and Practice. Dr. Witkiewitz was the primary author of a randomized controlled trial of relapse prevention, a form of CBT for substance use, which is a treatment included in our evaluation: Witkiewitz, K., Warner, K., Sully, B., Barricks, A., Stauffer, C., Steckler, G., Thompson, B., & Luoma, J. (2014). Randomized trial comparing mindfulness-based relapse prevention with relapse prevention for women offenders at a residential addiction treatment center. Substance Use and Misuse, 49, 536–546. doi: 10.3109/10826084.2013.856922. To mitigate any potential impacts of Dr. Witkiewitz’s conflict of interest, she has not contributed to any coding of the included quantitative reviews. All other authors declare no conflicts.

Figures

Figure 1.

Figure 1.

Flow Chart for Cognitive Behavioral Therapy for Substance Use Search Process. This figure illustrates the search process for locating reviews eligible for inclusion in the treatment evaluation.

Figure 2.

Figure 2.

Effect size estimates (Hedge’s g) with 95% confidence intervals for Magill et al., 2019 for each comparator group type.

Figure 3.

Figure 3.

Effect size estimates (Hedge’s g) with 95% confidence intervals for Magill et al., 2019 for minimal versus active treatment comparator groups. Treatment (Active) represents an aggregate of effect sizes for the original non-specific and specific treatment comparator groups. “Use” is the average of quantity and frequency, where available.

References

    1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Association.
    1. Atkins D, Eccles M, Flottorp S, Guyatt GH, Henry D, Hill S, Liberati A, O’Connell D, Oxman AD, Phillips B, Schünemann H, Edejer TT-T, Vist GE, Williams JW, & The GRADE Working Group. (2004). Systems for grading the quality of evidence and the strength of recommendations I: Critical appraisal of existing approaches The GRADE Working Group. BMC Health Services Research, 4(1), 38. 10.1186/1472-6963-4-38 -DOI -PMC -PubMed
    1. Boness CL, Votaw V, Schwebel FJ, Moniz-Lewis DI, McHugh R. K., PhD, & Witkiewitz K (2022, January 13). An Evaluation of Cognitive Behavioral Therapy for Substance Use: An Application of Tolin’s Criteria for Empirically Supported Treatments. https://osf.io/rbx8s/ -PMC -PubMed
    1. Benishek LA, Dugosh KL, Kirby KC, Matejkowski J, Clements NT, Seymour BL, & Festinger DS (2014). Prize-based contingency management for the treatment of substance abusers: A meta-analysis: Prize-based contingency management meta-analysis. Addiction, 109(9), 1426–1436. 10.1111/add.12589 -DOI -PMC -PubMed
    1. Boness CL, Hershenberg R, Grasso D, Kaye J, Mackintosh M-A, Nason E, Shah A, & Raffa S (2021). The Society of Clinical Psychology’s Manual for the Evaluation of Psychological Treatments Using the Tolin Criteria [Preprint]. Open Science Framework. 10.31219/osf.io/8hcsz -DOI

Grants and funding

LinkOut - more resources