title: Group counseling versus individualized relapse prevention aftercare following intensive outpatient treatment for cocaine dependence: initial results.
abstract: Ninety-eight male cocaine-dependent patients who completed an intensive outpatient program (IOP) were randomly assigned to either standard group counseling (STND) or individualized relapse prevention (RP) aftercare. Heavier cocaine and alcohol use during IOP and low self-efficacy predicted more cocaine use during the treatment phase of the study, whereas lifetime diagnoses of alcohol dependence, major depression, and any anxiety disorder predicted less cocaine use. Rates of complete abstinence during the 6-month study period were higher in STND than RP, whereas RP was more effective in limiting the extent of cocaine use in those who used during Months 1-3. Matching analyses indicated patients who failed to achieve remission from cocaine dependence during IOP and those with a commitment to absolute abstinence did better in RP than in STND, whereas patients with other abstinence goals did better in STND than RP. Several differences in experiences before cocaine use and "near-miss" episodes were also identified.
authors.affiliation: Treatment Research Center, University of Pennsylvania, Philadelphia 19104, USA.
authors.forename: J R
authors.initials: JR
authors.lastname: McKay
authors.forename: A I
authors.initials: AI
authors.lastname: Alterman
authors.forename: J S
authors.initials: JS
authors.lastname: Cacciola
authors.forename: M J
authors.initials: MJ
authors.lastname: Rutherford
authors.forename: C P
authors.initials: CP
authors.lastname: O'Brien
authors.forename: J
authors.initials: J
authors.lastname: Koppenhaver
mesh_terms: D000328:Adult; D000359:Aftercare / Q000523:psychology*; D000553:Ambulatory Care / Q000523:psychology; D003042:Cocaine; D015928:Cognitive Behavioral Therapy; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011615:Psychotherapy, Group; D012008:Recurrence; D019966:Substance-Related Disorders / Q000523:psychology / Q000534:rehabilitation*; D016896:Treatment Outcome; D014728:Veterans / Q000523:psychology
chemical_list: D003042:Cocaine