The effect of a behavioral activation treatment for substance use on post-treatment abstinence: a randomized controlled trial.
The effect of a behavioral activation treatment for substance use on post-treatment abstinence: a randomized controlled trial.
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DOI：
10.1111/add.14049
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发表时间：
2018-03
期刊：
影响因子：
--
通讯作者：
Baker S
中科院分区：
文献类型：
--
作者：
Daughters SB;Magidson JF;Anand D;Seitz-Brown CJ;Chen Y;Baker S
比较使用物质的行为激活组治疗(LET ACT)的结果，与在住宅治疗环境中提供的时间和小组大小匹配的对照条件。单点双臂平行组随机临床试验，在治疗后3、6和12个月进行随访评估。美国住宅区物质使用处理设施。参与者是263名成年人[平均年龄42.7[11.8]；女性29.3%；非裔美国人94.7%；法院强制要求的72.6%]，他们的保险规定了30天(65.4%)或90天(34.6%)的治疗期限。LET ACT(n=142)是一种最初针对抑郁症开发的治疗方法，并经修改后用于物质使用。它教导参与者增加积极的、强化价值驱动的活动，以对抗抑郁和复发。对照组(SC；n=121)接受时间和团体规模相匹配的支持性咨询。根据患者的住院时间，治疗分五次或八次进行，每次一小时。随访时的戒断率、报告使用药物的药物使用天数的百分比、抑郁症状(BDI)和药物使用的不良后果(SIP-AD)。与SC相比，治疗后3个月(优势比=2.2，95%可信区间=1.3~3.7)、6个月(优势比=2.6，95%可信区间=1.3~5.0)和12个月(优势比=2.9，95%可信区间=1.3~6.1)的戒断率明显升高。让ACT参与者在治疗后12个月报告使用药物的不良后果显著减少(B=4.50，SE=2.17，95%可信区间=0.22-8.78)。治疗条件对恢复吸毒者的药物使用天数百分比或抑郁症状的改变没有影响；后者仅在住院治疗后继续戒断的患者中随着时间的推移而下降(B=0.43，SE=0.11，95%可信区间=0.22~0.65)。药物使用的行为激活组治疗(LET ACT)似乎增加了戒断的可能性，并减少了药物使用的不良后果，最长可达12个月。
to compare outcomes for a behavioral activation group treatment for substance use (LETS ACT), versus a time and group size matched control condition delivered in a residential treatment setting. single-site two-arm parallel-group randomized clinical trial with follow-up assessment at 3, 6 and 12 months post-treatment. residential substance use treatment facility in the USA. participants were 263 adults [mean age 42.7 [11.8]; 29.3% female; 94.7% African American; 72.6% court mandated] whose insurance dictated 30-day (65.4%) or 90-day (34.6%) treatment duration. LETS ACT (n=142) is a treatment originally developed for depression and modified for substance use. It teaches participants to increase positively reinforcing value-driven activities in order to counter depression and relapse. The control group (SC; n=121) received time and group-size matched supportive counseling. Treatment was delivered in five or eight one-hour sessions depending on patient length of stay. percent abstinent at follow-up, percent of substance use days among those reporting use, depressive symptoms (BDI), and adverse consequences of drug use (SIP-AD). LETS ACT had significantly higher abstinence rates at 3 months (odds ratio=2.2, 95% confidence interval=1.3–3.7), 6 months (odds ratio=2.6, 95% confidence interval=1.3–5.0), and 12 months (odds ratio=2.9, 95% confidence interval=1.3–6.1) post-treatment compared with SC. LETS ACT participants reported significantly fewer adverse consequences from substance use at 12 months post-treatment (B=4.50, SE=2.17, 95% confidence interval=0.22–8.78). Treatment condition had no effect on percent substance use days among those who resumed use or on change in depressive symptoms; the latter decreased over time only in those who remained abstinent after residential treatment irrespective of condition (B=0.43, SE=0.11, 95% confidence interval=0.22–0.65). a behavioral activation group treatment for substance use (LETS ACT) appears to increase the likelihood of abstinence and reduce adverse consequences from substance use up to 12 months post-treatment.
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