TY  - JOUR
T1  - AN effectiveness trial of group cognitive behavioral therapy for patients with persistent depressive symptoms in substance abuse treatment
AU  - Watkins KE, Hunter SB, Hepner KA, et al
Y1  - 2011/06/06
N1  - 10.1001/archgenpsychiatry.2011.53
JO  - Archives of General Psychiatry
SP  - 577
EP  - 584
VL  - 68
IS  - 6
N2  - Context 
    Although depression frequently co-occurs with substance abuse, few individuals entering substance abuse treatment have access to effective depression treatment.Objective 
    The Building Recovery by Improving Goals, Habits, and Thoughts (BRIGHT) study is a community-based effectiveness trial that compared residential substance abuse treatment with residential treatment plus group cognitive behavioral therapy for depression delivered by substance abuse treatment counselors. We hypothesized that intervention clients would have improved depression and substance use outcomes compared with those of clients receiving usual care.Design 
    A nonrandomized controlled trial using a quasi-experimental intent-to-treat design in which 4 sites were assigned to alternate between the intervention and usual care conditions every 4 months for 2½ years.Setting 
    Four treatment programs in Los Angeles County.Participants 
    We screened 1262 clients for persistent depressive symptoms (Beck Depression Inventory-II score >17). We assigned 299 clients to receive either usual care (n = 159) or usual care plus the intervention (n = 140). Follow-up rates at 3 and 6 months after the baseline interview were 88.1% and 86.2%, respectively, for usual care and 85.7% and 85.0%, respectively, for the intervention group.Intervention 
    Sixteen 2-hour group sessions of cognitive behavioral therapy for depression.Main Outcome Measures 
    Change in depression symptoms, mental health functioning, and days of alcohol and problem substance use.Results 
    Intervention clients reported significantly fewer depressive symptoms (P < .001 at 3 and 6 months) and had improved mental health functioning (P < .001 at 3 months and P < .01 at 6 months). At 6 months, intervention clients reported fewer drinking days (P < .05) and fewer days of problem substance use (P < .05) on days available.Conclusions 
    Providing group cognitive behavioral therapy for depression to clients with persistent depressive symptoms receiving residential substance abuse treatment is associated with improved depression and substance use outcomes. These results provide support for a new model of integrated care.Trial Registration 
    clinicaltrials.gov Identifier: NCT01191788
SN  - 0003-990X
M3  - doi: 10.1001/archgenpsychiatry.2011.53
UR  - http://dx.doi.org/10.1001/archgenpsychiatry.2011.53
ER  -