A "community-friendly" version of integrated group therapy for patients with bipolar disorder and substance dependence: a randomized controlled trial.
BACKGROUND
Integrated group therapy, a new treatment for patients with bipolar disorder and substance use disorder, has previously been found to be efficacious in reducing substance use, but its length (20 sessions) and need for highly trained therapists may limit its adoption in substance use disorder community treatment programs. This paper compares a briefer (12 session) version of integrated group therapy, led by substance use disorder counselors without previous cognitive-behavioral training or bipolar disorder experience, to group drug counseling.


METHODS
Sixty-one patients with bipolar disorder and substance dependence, taking mood stabilizers, were randomized to 12 sessions of integrated group therapy (n=31) or group drug counseling (n=30).


RESULTS
Analyses of primary outcomes showed trends favoring integrated group therapy, with greater reduction in substance use during follow-up and a greater decline in risk of mood episodes during treatment. Secondary analyses favored integrated group therapy, with a significantly greater likelihood of achieving total abstinence, a significantly shorter time to the first abstinent month, and a significantly greater likelihood of achieving a "good clinical outcome" (a composite measure encompassing both substance use and mood simultaneously).


CONCLUSIONS
A shortened version of integrated group therapy can be delivered successfully by substance use disorder counselors, with better overall outcomes than those achieved with group drug counseling.
Weiss
Roger D
RD
Department of Psychiatry, Harvard Medical School, Boston, MA 02115, USA. rweiss@mclean.harvard.edu
Griffin
Margaret L
ML
Jaffee
William B
WB
Bender
Rachel E
RE
Graff
Fiona S
FS
Gallop
Robert J
RJ
Fitzmaurice
Garrett M
GM
D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use; D018692:Antimanic Agents / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000150:complications / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003156:Community Mental Health Services / Q000379:methods*; D003376:Counseling; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D006801:Humans; D008297:Male; D011615:Psychotherapy, Group / Q000379:methods*; D019966:Substance-Related Disorders / Q000150:complications / Q000628:therapy*; D013997:Time Factors; D016903:Drug Monitoring
D000928:Antidepressive Agents; D018692:Antimanic Agents