Diagnosis: Substance and Alcohol Use Disorders

2015 EST Status: Strong Research 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

Basic premise: As individuals understand the thoughts and behaviors associated with their substance use and gain skills to modify unwanted behaviors, they are better equipped to identify and cope with triggers for use, manage high risk situations, reinforce behaviors that align with their recovery goals, and challenge thoughts that precipitate substance use.
Essence of therapy: Cognitive-Behavioral Therapy (CBT) is a transdiagnostic psychosocial treatment that is premised on learning principles. CBT aims to treat substance use disorders (SUD) through targeting behavioral and cognitive processes that underlie one’s substance use. CBT for SUD focuses on intervening upon these processes through increasing awareness of antecedents and consequences of substance use and leveraging behavior change principles to reduce or eliminate substance use through environment and social reinforcement.
Length: Although the number of sessions and treatment length of CBT for substance use varies widely, standard approaches are delivered over approximately 6-14 sessions.

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
Books Available for Purchase Through External Sites

Training Materials and Workshops

Measures, Handouts and Worksheets

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

Videos Available for Purchase Through External Sites

Video Descriptions

Clinical Trials

Meta-analyses and Systematic Reviews

Other Treatment Resources