Efficacy of Cognitive Behavioral Therapy for Alcohol and Other Drug Use Disorders: Is a One-Size-Fits-All Approach Appropriate?
Efficacy of Cognitive Behavioral Therapy for Alcohol and Other Drug Use Disorders: Is a One-Size-Fits-All Approach Appropriate?
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DOI：
10.2147/sar.s362864
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发表时间：
2023
影响因子：
1.8
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中科院分区：
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我们概述了认知行为疗法（CBT）对成人酒精或其他药物使用障碍（AOD）的疗效，并考虑了应用中的一些关键变化以及与干预结果相关的上下文（即，主持人）或机械（即，调解人）因素。这项工作是一个叙述性的综述文献的CBT为AOD。强有力的证据表明，经典/传统CBT的疗效相比，最低限度和通常的护理控制条件。CBT与另一种循证治疗（如动机访谈，应急管理或药物治疗）相结合，与最小和常见的护理控制条件相比也是有效的，但与其他医疗支持方式相比，没有任何形式的CBT始终显示出疗效。CBT和CBT的综合形式具有灵活应用的潜力，例如以数字格式使用。然而，关于作用机制的数据非常有限，尽管有初步证据表明CBT对机械结果（即心理社会调整的次要指标）的影响大小是中等的，通常大于使用AOD的影响。针对AOD的CBT是一种行之有效的干预措施，具有已证实的疗效，效应量在小到中等范围内，并且鉴于干预措施的模块化形式，有可能进行定制。未来的工作应该考虑CBT的有效性机制和传播和实施的关键条件。
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. This work is a narrative overview of the review literature on CBT for AOD. 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. 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.