Motivational enhancement and coping skills training for cocaine abusers: effects on substance use outcomes.
OBJECTIVE
This clinical trial investigated effects of motivational enhancement treatment (MET) and group coping-skills training (CST) tailored for cocaine dependence. Effects of MET were hypothesized to be greater with CST and for less motivated patients.


METHODS
A 2 x 2 design investigated two individual sessions of MET compared to meditation-relaxation (MRT), followed by four group sessions of CST versus drug education (ED), as daily adjuncts to intensive treatment.


METHODS
The substance abuse program provided full-day treatment with a learning-theory and 12-Step orientation.


METHODS
Cocaine-dependent patients were recruited.


METHODS
Assessment included treatment retention; change in cocaine-related urge, self-efficacy, pros and cons, and motivation; substance use and problems during 12-month follow-up. Findings Of 165 patients, follow-up status is known for 90% (n = 149). Patients in MET with low initial motivation to change reported less cocaine and alcohol relapse and use days and fewer alcohol problems than MET patients with higher initial motivation. MET produced more employment improvement than MRT, with no other significant benefit for MET. Patients with higher motivation had more cocaine use and alcohol problems after MET than MRT. Group CST reduced cocaine and alcohol use during follow-up for women only and reduced alcohol relapse for men and women.


CONCLUSIONS
MET is more beneficial for patients with lower initial motivation than for patients with high initial motivation. CST reduced cocaine and alcohol use for women only and reduced alcohol relapses, in contrast to results with lengthier individual CST.
Rohsenow
Damaris J
DJ
Providence VA Medical Center, Brown University, Providence, RI 02912, USA. Damaris_Rohsenow@brown.edu
Monti
Peter M
PM
Martin
Rosemarie A
RA
Colby
Suzanne M
SM
Myers
Mark G
MG
Gulliver
Suzy B
SB
Brown
Richard A
RA
Mueller
Timothy I
TI
Gordon
Alan
A
Abrams
David B
DB
D000223:Adaptation, Psychological; D000328:Adult; D001521:Behavior Therapy / Q000379:methods; D019970:Cocaine-Related Disorders / Q000523:psychology / Q000628:therapy*; D005260:Female; D006126:Group Processes; D006801:Humans; D008297:Male; D019122:Meditation / Q000379:methods; D009042:Motivation; D010353:Patient Education as Topic / Q000379:methods; D016896:Treatment Outcome