DIAGNOSIS: Substance and Alcohol Use Disorders
2015 EST Status: StrongResearch Support (SEE REPORT)Very strong: High-quality evidence that treatment improves symptoms and functional outcomes at post-treatment and follow-up; little risk of harm; requires reasonable amount of resources; effective in non-research settings
Strong: Moderate- to high-quality evidence that treatment improves symptoms OR functional outcomes; not a high risk of harm; reasonable use of resources
Weak: Low or very low-quality evidence that treatment produces clinically meaningful effects on symptoms or functional outcomes; Gains from the treatment may not warrant resources involved
Insufficient Evidence: No meta-analytic study could be identified
Insufficient Evidence: Existing meta-analyses are not of sufficient quality
Treatment pending re-evaluation
1998 EST Status: N/A Research Support
Strong: Support from two well-designed studies conducted by independent investigators.
Modest: Support from one well-designed study or several adequately designed studies.
Controversial: Conflicting results, or claims regarding mechanisms are unsupported.
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Brief Summary
Treatment Resources
Editors:David I.K. Moniz-Lewis, Cassandra L. Boness, Victoria R. Votaw, Frank J. Schwebel, R. Kathryn McHugh, Katie Witkiewitz
Note: The resources provided below are intended to supplement not replace foundational training in mental health treatment and evidence-based practice
Treatment Manuals / Outlines
Treatment Manuals
- A Cognitive-Behavioral Approach: Treating Cocaine Addiction (Carroll et al., 1998)
- Cognitive-Behavioral Coping Skills Therapy Manual: A Clinical Research Guide for Therapists Treating Individuals with Alcohol Abuse and Dependence (Kadden et al., 2003)
Books Available for Purchase Through External Sites
- A Cognitive-Behavioral Treatment Program for Overcoming Alcohol Problems: Therapist Guide (Epstein & McCrady, 2009)
- Relapse Prevention Counseling: Clinical Strategies to Guide Addiction Recovery and Reduce Relapse (Daley & Douaihy, 2015)
- Managing Your Substance Use Disorder (Treatments That Work), 3rd Edition (Daley & Douaihy, 2019)
Training Materials and Workshops
- Relapse Prevention: An Overview of Marlatt’s Cognitive-Behavioral Model (Larimer, Palmer, & Marlatt, 1999)
- Clinical Guidelines for Implementing Relapse Prevention Training (Marlatt, Parks, and Witkiewitz, 2002)
- What To Do If CBT Isn’t Working (Liese, 2020)
- Group Cognitive-Behavioral Therapy for Substance Use Disorders and Addictive Behaviors (Liese, 2017)
- CBT: It’s Not What You Think (Liese, 2016)
Measures, Handouts and Worksheets
- A Cognitive-Behavioral Approach: Treating Cocaine Addiction (Carroll et al., 1998)
- A Cognitive-Behavioral Treatment Program for Overcoming Alcohol Problems: Therapist Guide Forms and Worksheets (Epstein & McCrady, 2009)
- SMART Recovery Toolbox (SMART Recovery International, 2022)
Smartphone Apps
There are a plethora of smartphone applications, many of which have not been rigorously tested, as described by Tofighi and colleagues in this review: Smartphone Apps Targeting Alcohol and Illicit Substance Use: Systematic Search in in Commercial App Stores and Critical Content Analysis (Tofighi et al., 2019)
Those with the most empirical support and grounding in CBT principles include the following:
- Saying When Developed by the Centre for Addiction and Mental Health, Toronto, Canada
- Vorvida® Commercial app by Orexo
- A-CHESS Developed by CHESS Health
- Checkup and Choices web-based program with applications
- reSET (prescription digital therapeutic) by Pear Therapeutics
Video Demonstrations
- Cognitive-Behavioral Relapse Prevention for Addictions (Marlatt, n.d.)
Videos Available for Purchase Through External Sites
- Cognitive Behavioral Therapy to Address Substance Use Triggers (Addiction Technology Transfer Center Network, 2021)
Video Descriptions
Clinical Trials
- Computer-assisted delivery of cognitive-behavioral therapy for addiction: a randomized trial of CBT4CBT (Carroll et al., 2008)
- Network Support II: Randomized controlled trial of Network Support treatment and cognitive behavioral therapy for alcohol use disorder (Litt et al., 2016)
- Relative efficacy of mindfulness-based relapse prevention, standard relapse prevention, and treatment as usual for substance use disorders: A randomized clinical trial (Bowen et al., 2014)
- Acceptance and commitment therapy versus cognitive behavioral therapy in the treatment of substance use disorder with incarcerated women. (Lanza et al., 2014)
- Psychosocial treatment for methamphetamine use disorders: A preliminary randomized controlled trial of cognitive behavior therapy and acceptance and commitment therapy (Smout et al., 2010)
- Testing the effectiveness of cognitive-behavioral treatment for substance abuse in a community setting: within treatment and posttreatment findings (Morgenstern et al., 2001)
- Cognitive behavioral relapse prevention strategies and aftercare in alcoholism rehabilitation. (Donovan & Ito, 1988)
- Group counseling versus individualized relapse prevention aftercare following intensive outpatient treatment for cocaine dependence: Initial results (McKay et al., 1997)
- Matching Alcoholism Treatments to Client Heterogeneity: Project MATCH posttreatment drinking outcomes (Project MATCH Research Group, 1997)
Meta-analyses and Systematic Reviews
- Efficacy of Relapse Prevention: A Meta-Analytic Review (Irvin et al., 1999)
- Cognitive-Behavioral Treatment With Adult Alcohol and Illicit Drug Users: A Meta-Analysis of Randomized Controlled Trials (Magill & Ray, 2009)
- Cognitive Behavioral Therapy: A Meta-Analysis of Race and Substance Use Outcomes (Windsor et al., 2015)
- A Meta-Analysis of Cognitive-Behavioral Therapy for Alcohol or Other Drug Use Disorders: Treatment Efficacy by Contrast Condition (Magill et al., 2019)
Other Treatment Resources
- Cognitive-Behavioral Therapy for Substance Use Disorders (McHugh, Hearon, & Otto, 2010)