Author: John Carter

Technology-Delivered Cognitive-Behavioral Interventions for Alcohol Use: A Meta-Analysis PMC

Furthermore, meta-regression analyses were unable to determine systematic sources of this variability. Due to the nature of our research aims, which considered integrated CBI for co-occurring disorders, there may be concern about comparing ‘apples to oranges’ and underpowered moderator analysis even in the context of high statistical heterogeneity (Wilson, 2000). As a result, we consider our results as preliminary and adding to the emerging review literature on this important topic. We also believe that the subgroup analyses allowed us to inspect some of the systematic differences between primary studies.

Furthermore, evaluation of its mechanisms has revealed that individuals appear to increase the quality of their coping skills acquired during treatment, and this in part contributes to their abstinence from drugs and alcohol. There is also some indication that individuals gain greater knowledge of cognitive and behavioral concepts from CBT4CBT than from standard addiction treatment, or even therapist-delivered CBT, which may play a role in its efficacy. Studies meeting inclusion criteria were English language, peer-reviewed articles published between 1990 and 2019.

Using CBT for Alcohol Treatment

Here, the substantive question was about the efficacy of integrated CBI over single-disorder or other usual care interventions. Aim two examined these effect sizes in subgroups by follow-up time point, type of contrast condition and targeted disorder. Given the clinical heterogeneity of our sample (i.e. a range of substance use and mental health conditions), potential clinical and methodological moderators of effect size variability were explored. The pooled effect estimates were additionally examined in sensitivity analyses (i.e. publication bias).

Primary Study Descriptive Characteristics

For example, a particular benefit was observed for alcohol studies and for studies with those affected by PTSD. We also excluded roughly 10 trials on the PTSD treatment Seeking Safety from our review, and this could be viewed as a limitation. However, this evidence-based CBI treatment has been the subject of two prior meta-analyses (Torchalla et al., 2012; Roberts et al., 2015) and is the subject of an ongoing, large-scale meta-analytic project on integrated treatments for alcohol use disorders and PTSD (R01AA02583). An additional caveat is the absence of empirical benchmarks for interpreting the magnitude of the effect observed and instead relying on Cohen’s (1988) guidelines, which are generic to any form of effect estimation, meta-analytic or otherwise. Finally, 50% of our MHD outcome studies and 44% of our AOD outcomes studies received a ‘High Risk’ designation for risk of bias. This suggests that study quality could have an effect on our findings, although meta-regression suggested this was only marginally the case (and the direction was the opposite of what is typically the concern i.e. low-quality studies have higher effect sizes).

These were outcome reports of randomized controlled trials that included both substance use and mental health outcomes. The targeted population was adults (age ≥ 18) meeting criteria for an AOD and at least one co-occurring MHD (DSM III-R through V; American Psychiatric Association, 1987, 1994, 2000, 2013). The treatment must have been identified as cognitive-behavioral or based on a cognitive-behavioral approach. Commonly reported intervention components were functional analysis, relapse prevention, affect management, and social and life skills training. These cognitive-behavioral therapies must have been integrated and thus also included components targeting mental health symptoms, such as exposure-based interventions, medication management or an exploration of the relationship between mental health symptoms and substance use (see Supplemental Table 1 for details).

Data availability statement

  1. For face-to-face CBT trials for alcohol use from the Magill and Ray (2009) meta-analysis, the average sample size was 198, but after excluding two outliers (Project MATCH Research Group, 1997), the average sample size was 90.
  2. These were outcome reports of randomized controlled trials that included both substance use and mental health outcomes.
  3. Outcomes were alcohol or other drug use and mental health symptoms at post-treatment through follow-up.
  4. Additional sensitivity analyses were conducted for heterogeneity and publication bias, including a visual inspection of funnel plots and a test for funnel plot asymmetry using Egger’s regression test of the relationship between study effect size and precision (Egger et al., 1997).
  5. Multiple clinical trials in different treatment settings have indicated CBT4CBT’s efficacy at reducing rates of alcohol and drug use when provided as an add-on to standard addiction treatment, as well as when provided with minimal clinical monitoring (i.e., virtual stand-alone).

Posttreatment results of combining naltrexone with cognitive- behavioral therapy for the treatment of alcoholism. Our writers and reviewers are experienced professionals in medicine, addiction treatment, and healthcare. AddictionResource fact-checks all the information before publishing and uses only credible and trusted sources when citing any medical data. The Verified badge on our articles is a trusted sign of the most comprehensive scientifically-based medical content.If you have any concern that our content is inaccurate or it should be updated, please let our team know at email protected. We may be paid a fee for marketing or advertising by organizations that can assist with treating people with substance use disorders.

CBT Sessions Explained

A literature search was conducted through December of 2019 to identify eligible studies for a large-scale, meta-analytic project on cognitive-behavioral therapy in addictions care (R21AA026006). Then, a search of the Cochrane Register and EBSCO database (i.e. Medline, PsycARTICLES) was performed, removing duplicates from the results of the PubMed search. A bibliographic search of topically related systematic reviews and meta-analyses was also performed to identify any candidate studies not identified by the original search methods (e.g. Hobbs et al., 2011; Torchalla et al., 2012; Riper et al., 2014). Figure 1 provides a visual representation of study inclusion for the present report, following PRISMA guidelines (Moher et al., 2009). Cognitive behavioral therapy (CBT) is one of the most-studied approaches for the treatment of alcohol use disorder (AUD), with considerable empirical support establishing its efficacy.

No one should assume the information provided on Addiction Resource as authoritative and should always defer to the advice and care provided by a medical doctor. There are some specific cognitive behavioral therapy techniques that are effective at all stages of change in recovery. CBT for substance abuse helps overcome alcoholism and drug addiction by dismissing false beliefs, developing mood-improving skills, and teaching the client effective communication.

Data Availability Statement

In CBT, the B, or your beliefs, is considered the most important, as it helps you change your beliefs to have better consequences, or outcomes. Instead of looking backward, which is a very important thing to do in other kinds of therapy, it works well for people to gain insight as to why these things occurred,” explains Dr. Robin Hornstein, a Philadelphia-based psychologist who works with a variety of populations using CBT as well as many other therapies. There can be a wide range of thoughts like these, but all of them point to a smattering of automatic thoughts that may come up when faced with stressors, triggers, or cravings to use. This section collects any data citations, data availability statements, or supplementary materials included in this article. AddictionResource aims to present the most accurate, trustworthy, and up-to-date medical content to our readers.