Single-focussed versus integrated cognitive behaviour therapy for co-occurring depression and alcohol use problems

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This study is significant and timely in that it proposes a large-scale randomised controlled trial of cognitive behaviour therapy (CBT) for people with co-occurring depression and alcohol use problems. To date, very few researchers have conducted research within this population, whose complex presentation makes it difficult for treatment providers to select and deliver effective treatment programs. Thus, although rates of depressive disorders and alcohol use problems are on the increase in our community, it is still not clear how best to manage and treat this group of people. Typically, people will often receive treatment for one part of their presentation, for example their depression or alcohol use problem. However, it is uncommon for the two conditions to be treated in an integrated way. This is certainly true for psychological treatments. Research programs to date have explored effective treatments for depression and alcohol use in the absence of the co-occurring condition. Currently it is not known how well people with co-occurring alcohol use problems and depression respond to treatments with a singular focus. Furthermore, it is not known whether integrating both alcohol use and depressive treatment approaches provides any additional benefit. This study is therefore significant, as it is one of the first to explore effective treatment approaches among people with co-occurring depressive and alcohol use problems. Resolution of these issues will better inform the treatment choices of clinicians practicing in both mental health and alcohol-other drug settings. Importantly, this will potentially improve the match between treatment and people with depression and substance use problems, a clinically prevalent population encountered in community settings.