Behavior therapy for depression in drug dependence (BTDD): results of a stage Ia therapy development pilot.
Limited access to positive reinforcers is a central feature in behavioral formulations of substance use and depression, and evidence suggests both disorders share similar environmental contexts. The Behavioral Therapy for Depression in Drug Dependence (BTDD) was developed to target the density of potential reinforcers in a patient's environment to reduce both depression and illicit substance use using therapeutic techniques from three operant based treatment programs, Community Reinforcement Approach, Changing Reinforcement Events, and Treatment-plan Contingency Management. Results of an uncontrolled Stage Ia trial (n = 29), indicated 48% of the participants demonstrated at least a 50% reduction in baseline depression scores during the 16-session treatment program. Those designated as treatment responders completed more out-of-session behavioral activities, attended more treatment sessions, and demonstrated less benzodiazepine use during the program than non-responders. There were no changes in opiate and cocaine use. BTDD may be a useful adjunct to methadone maintenance for treating comorbid depressive disorders.
Carpenter
Kenneth M
KM
Division on Substance Abuse, New York State Psychiatric Institute and Columbia University College of Physicians and Surgeons, New York, New York 10032, USA. carpent@pi.cpmc.columbia.edu
Aharonovich
Efrat
E
Smith
Jennifer L
JL
Iguchi
Martin Y
MY
Nunes
Edward V
EV
D001521:Behavior Therapy; D003131:Combined Modality Therapy; D003866:Depressive Disorder / Q000523:psychology*; D019263:Dysthymic Disorder / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008691:Methadone / Q000627:therapeutic use; D010865:Pilot Projects; D019966:Substance-Related Disorders / Q000534:rehabilitation*
D008691:Methadone