EFFICACY OF PSYCHOSOCIAL THERAPIES FOR DRUG ABUSE

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The primary aim of this K02 application is to further the applicant's career in improving the efficacy of psychosocial treatments for patients with substance use disorder, comprising three subsidiary aims: (1) an emphasis on psychosocial treatments for "poor prognosis" substance use disorder (SUD) populations (e.g., patients who have co-occurring posttraumatic stress disorder or bipolar disorder, low motivation for treatment, or HIV; are poor and/or homeless; and inner-city women); (2) improving the quality of treatment of treatment delivery by psychosocial clinicians; and (3) developing new assessment measures to assist the above goals, for both research and clinical use. The K02 award would be useful to strengthen the applicant's involvement in the following eight studies, six of which are NIDA-funded: (1) Group Cognitive-Behavioral Therapy for Dual Diagnosis Women (and HIV supplement), a controlled randomized trial comparing a new cognitive-behavioral group psychotherapy developed by the applicant for women with posttraumatic stress disorder (PTSD) and SUD versus a "treatment-as-usual" control; a supplement to the grant focuses on reducing HIV risk behaviors in the sample; (2) A Relapse Prevention Group for Bipolar Substance Abusers to develop and pilot-test an integrated group therapy manual for patients with bipolar disorder and SUD; (3) Collaborative Cocaine Treatment Study, a multi-site randomized controlled trial comparing four psychosocial treatments for cocaine-dependent outpatients; (4) PTSD treatment outcomes for cocaine dependent women, a controlled randomized trial comparing the new cognitive-behavioral psychotherapy developed by the applicant versus standard relapse prevention for inner-city cocaine- dependent women with PTSD; (5) Validity of the ASAM Criteria for Drug Abuse Treatment, to test the validity of a widely used treatment- matching protocol and its applicability to a publicly funded population; (6) Research Diagnostic Project, to analyze the relationship between PTSD and SUD among 375 adult treatment-seeking patients; (7) Behavioral and Pharmacologic Treatment of Alcoholism, a multi-site controlled randomized trial comparing two psychosocial and two pharmacologic interventions for 720 outpatients with alcohol dependence; (8) PTSD and substance abuse among poor and homeless women (Smith-Richardson Foundation), a controlled randomized trial comparing the new cognitive- behavioral psychotherapy developed by the applicant versus "treatment- as-usual" for poor and/or homeless women with PTSD and SUD. The award would also enhance the applicant's potential to expand into related areas of research and to mentor new researchers.