Program

Feb 24, 2012

OVERVIEW

Cognitive-behavioral therapy (CBT) is a type of psychotherapy based around the
concept that changing the way a person thinks also changes his/her behaviors and
the way that he/she feels. An experimental evaluation found that both CBT and

Multidimensional Family Therapy led to significant decreases in frequency of
cannabis use and substance abuse problem severity and marginally significant
decreases in alcohol use. However, CBT was inferior to MDFT in a number of ways.

DESCRIPTION OF PROGRAM

Target population:
Substance-abusing adolescents

Cognitive-behavioral therapy (CBT) for drug abuse is delivered in weekly session
lasting 60 to 90 minutes. CBT is an office-based treatment provided by a
therapist. Treatment occurs in three stages. Phase one is focused on identifying
and prioritizing adolescents’ problems through the creation of a treatment
contract. In this phase, parents attend treatment with the adolescent to help
identify the adolescent’s problems. Once identified, problems are ranked using a
five-level hierarchy system. After the problems are identified and prioritized,
the adolescents and their parents sign a treatment contract.

In the second phase
of treatment, therapists select treatment strategies from the CBT manual to
implement. The goal of this phase is to increase the adolescent’s coping
strategies and reduce problem behaviors. This phase of treatment may involve
providing information and education, contingency contracting, self-monitoring,
problem-solving training, communication skills training, identifying cognitive
distortions, increasing healthy recreational activities, and homework
assignments. This treatment phase focuses on reducing harm created by substance
abuse, rather than encouraging abstinence.

The final phase of
treatment focuses on relapse prevention. Therapeutic techniques such a
role-rehearsal and problem-solving are used to help adolescents resist peer
pressure.

EVALUATION(S) OF PROGRAM

Liddle, H. A.,
Dakof, G. A., Turner, R. M., Henderson, C. E., & Greenbaum, P. E. (2008).
Treating adolescent drug abuse: A randomized trial comparing multidimensional
therapy and cognitive behavioral therapy. Addiction, 103,1660-1670.

Evaluated population:
A total of
224 drug-using youth (12 to 17.5 years old)
were evaluated. The sample was 81 percent male, 72 percent African American, and
had an average age of 15 years. Seventy-five percent of the sample met DSM-IV
criteria for cannabis dependence.

Approach:
Eligible participants were referred to the study from the juvenile justice
system, child welfare service agencies, schools, and other sources. A 90-minute
baseline assessment was completed with parents and youth by trained staff at the
start of the study. Follow-up assessments were conducted at termination of
treatment and 6 and 12 months following treatment termination. Participants were
randomly assigned to either Cognitive Behavioral Therapy (CBT) or
Multidimensional Family Therapy (MDFT) treatment conditions. The study did not
include a no-treatment control group. Both treatments were delivered in 60-90
minute weekly, office-based sessions. Treatments were identical in duration,
dose, and delivery format. The study assessed frequency of drug use and
psychological involvement in drug use.

Results:
Both treatments led to significant decreases in frequency of cannabis use and
substance abuse problem severity and marginally significant decreases in alcohol
use. However, CBT was inferior to MDFT in a number of ways. Participants in the
MDFT condition retained treatment gains more effectively at the 6-and 12-month
follow-ups, used fewer drugs other than cannabis and alcohol, and were more
likely to report minimal substance use (zero or one occasion) at the 12-month
follow-up than participants in the CBT condition.

SOURCES FOR MORE INFORMATION

The manual used in
the evaluation can be purchased online at:

http://www.amazon.com/Cognitive-Therapy-Substance-Abuse-Aaron/dp/0898621151

References

Liddle, H. A.,
Dakof, G. A., Turner, R. M., Henderson, C. E., & Greenbaum, P. E. (2008).
Treating adolescent drug abuse: A randomized trial comparing multidimensional
therapy and cognitive behavioral therapy. Addiction, 103,1660-1670.

KEYWORDS:
Adolescents, Youth (16+), Males and Females (Co-ed), Black/African American,
Clinic/Provider-based, Manual Is Available, Counseling/Therapy, Parent or Family
Component, Skills Training, Marijuana/Illicit/ Prescription Drugs, Alcohol use

Program
information last updated 2/24/12.

Subscribe to Child Trends

Short weekly updates of recent research on children and youth.