Substance Abuse and Rehabilitation (Feb 2023)

Efficacy of Cognitive Behavioral Therapy for Alcohol and Other Drug Use Disorders: Is a One-Size-Fits-All Approach Appropriate?

  • Magill M,
  • Kiluk BD,
  • Ray LA

Journal volume & issue
Vol. Volume 14
pp. 1 – 11

Abstract

Read online

Molly Magill,1 Brian D Kiluk,2 Lara A Ray3 1Brown University Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, USA; 2Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; 3Department of Psychology, University of California at Los Angeles, Los Angeles, CA, USACorrespondence: Molly Magill, Brown University Center for Alcohol and Addiction Studies, Brown University School of Public Health, Box-G-S121-5, Providence, RI, 02913, USA, Email [email protected]: We provide an overview of Cognitive Behavioral Therapy (CBT) efficacy for adult alcohol or other drug use disorders (AOD) and consider some key variations in application as well as contextual (ie, moderators) or mechanistic (ie, mediators) factors related to intervention outcomes.Methods: This work is a narrative overview of the review literature on CBT for AOD.Results: Robust evidence suggests the efficacy of classical/traditional CBT compared to minimal and usual care control conditions. CBT combined with another evidence-based treatment such as Motivational Interviewing, Contingency Management, or pharmacotherapy is also efficacious compared to minimal and usual care control conditions, but no form of CBT consistently demonstrates efficacy compared to other empirically-supported modalities. CBT and integrative forms of CBT have potential for flexible application such as use in a digital format. Data on mechanisms of action, however, are quite limited and this is despite preliminary evidence that shows that CBT effect sizes on mechanistic outcomes (ie, secondary measures of psychosocial adjustment) are moderate and typically larger than those for AOD use.Conclusion: CBT for AOD is a well-established intervention with demonstrated efficacy, effect sizes are in the small-to-moderate range, and there is potential for tailoring given the modular format of the intervention. Future work should consider mechanisms of CBT efficacy and key conditions for dissemination and implementation with fidelity.Keywords: behavioral treatment, clinical trials, mechanisms of behavior change, substance use disorder

Keywords