title: Brief cognitive behavioural interventions for regular amphetamine users: a step in the right direction.
abstract: OBJECTIVE
  The present study sought to replicate and extend a small pilot study conducted by Baker, Boggs & Lewin (2001) which demonstrated that brief interventions consisting of motivational interviewing and cognitive-behaviour therapy (CBT) were feasible and associated with better outcomes compared with a control condition.
  
  
  METHODS
  Randomized controlled trial (RCT).
  
  
  METHODS
  Greater Brisbane Region of Queensland and Newcastle, NSW, Australia.
  
  
  METHODS
  The study was conducted among 214 regular amphetamine users.
  
  
  METHODS
  Demographic characteristics, past and present alcohol and other drug use and mental health, treatment, amphetamine-related harms and severity of dependence.
  
  
  RESULTS
  The main finding of this study was that there was a significant increase in the likelihood of abstinence from amphetamines among those receiving two or more treatment sessions. In addition, the number of treatment sessions attended had a significant short-term beneficial effect on level of depression. There were no intervention effects on any other variables (HIV risk-taking, crime, social functioning and health). Overall, there was a marked reduction in amphetamine use among this sample over time and, apart from abstinence rates and short-term effects on depression level, this was not differential by treatment group. Reduction in amphetamine use was accompanied by significant improvements in stage of change, benzodiazepine use, tobacco smoking, polydrug use, injecting risk-taking behaviour, criminal activity level, and psychiatric distress and depression level.
  
  
  CONCLUSIONS
  A stepped-care approach is recommended. The first step in providing an effective intervention among many regular amphetamine users, particularly those attending non-treatment settings, may include provision of: a structured assessment of amphetamine use and related problems; self-help material; and regular monitoring of amphetamine use and related harms. Regular amphetamine users who present to treatment settings could be offered two sessions of CBT, while people with moderate to severe levels of depression may best be offered four sessions of CBT for amphetamine use from the outset, with further treatment for amphetamine use and/or depression depending on response. Pharmacotherapy and/or longer-term psychotherapy may be suitable for non-responders. An RCT of a stepped-care approach among regular amphetamine users is suggested.
authors.affiliation: Centre for Mental Health Studies, University of Newcastle, University Drive, Callaghan, New South Wales, Australia.
authors.forename: Amanda
authors.initials: A
authors.lastname: Baker
authors.forename: Nicole K
authors.initials: NK
authors.lastname: Lee
authors.forename: Melissa
authors.initials: M
authors.lastname: Claire
authors.forename: Terry J
authors.initials: TJ
authors.lastname: Lewin
authors.forename: Tanya
authors.initials: T
authors.lastname: Grant
authors.forename: Sonja
authors.initials: S
authors.lastname: Pohlman
authors.forename: John B
authors.initials: JB
authors.lastname: Saunders
authors.forename: Frances
authors.initials: F
authors.lastname: Kay-Lambkin
authors.forename: Paul
authors.initials: P
authors.lastname: Constable
authors.forename: Linda
authors.initials: L
authors.lastname: Jenner
authors.forename: Vaughan J
authors.initials: VJ
authors.lastname: Carr
mesh_terms: D000328:Adult; D019969:Amphetamine-Related Disorders / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011614:Psychotherapy, Brief / Q000379:methods*; D016896:Treatment Outcome