title: Examining the effect of the Life Enhancement Treatment for Substance Use (LETS ACT) on residential substance abuse treatment retention.
abstract: Effective, parsimonious behavioral interventions that target reinforcement are needed for substance users with depression to improve mood as well as treatment retention. The Life Enhancement Treatment for Substance Use (LETS ACT; Daughters et al., 2008) is a behavioral activation-based approach tailored to increase levels of positive reinforcement among depressed substance users while in substance abuse treatment. The current study tested the efficacy of LETS ACT compared to a contact-time matched control condition, supportive counseling (SC), examining effects on depressed mood, substance abuse treatment retention, and behavioral activation outcomes. Fifty-eight adult substance users in residential substance abuse treatment presenting with depressive symptoms (BDI≥12) were randomly assigned to LETS ACT or SC. Assessments were administered at pre- and post-treatment and included assessment of DSM-IV psychiatric diagnoses, depression severity, treatment motivation, overall activation, environmental reward, and substance abuse treatment retention. Patients in LETS ACT had significantly higher rates of substance abuse treatment retention and significantly greater increases in activation on the Behavioral Activation for Depression Scale (BADS) compared to those in SC. Both groups had decreased depression severity at post-treatment, although the group by time interaction was not significant. This study was the first to compare LETS ACT to a contact-time matched control treatment to evaluate effects on substance abuse treatment retention and two distinct measures of behavioral activation: overall activation and environmental reward. Findings suggest preliminary support for the feasibility, tolerability, and efficacy of a brief behavioral activation-based protocol that may be particularly useful to improve substance abuse treatment retention.
authors.affiliation: Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, College Park, MD 20742, United States; Center for Addictions, Personality, and Emotion Research (CAPER), Psychology Department, University of Maryland, College Park, College Park, MD 20742, United States. Electronic address: jmagidson@psyc.umd.edu.
authors.forename: Jessica F
authors.initials: JF
authors.lastname: Magidson
authors.affiliation: Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, College Park, MD 20742, United States. Electronic address: sgorka@umd.edu.
authors.forename: Stephanie M
authors.initials: SM
authors.lastname: Gorka
authors.affiliation: Center for Addictions, Personality, and Emotion Research (CAPER), Psychology Department, University of Maryland, College Park, College Park, MD 20742, United States. Electronic address: lmacpherson@psyc.umd.edu.
authors.forename: Laura
authors.initials: L
authors.lastname: MacPherson
authors.affiliation: University of Tennessee, Department of Psychology, Room 301D, Austin Peay Building, Knoxville, TN 37996, United States. Electronic address: dhopko@utk.edu.
authors.forename: Derek R
authors.initials: DR
authors.lastname: Hopko
authors.affiliation: Department of Psychiatry, Columbia University, 1051 Riverside Drive, New York, NY 10032, United States. Electronic address: cb255@columbia.edu.
authors.forename: Carlos
authors.initials: C
authors.lastname: Blanco
authors.affiliation: Center for Addictions, Personality, and Emotion Research (CAPER), Psychology Department, University of Maryland, College Park, College Park, MD 20742, United States. Electronic address: clejuez@psyc.umd.edu.
authors.forename: C W
authors.initials: CW
authors.lastname: Lejuez
authors.affiliation: Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, College Park, MD 20742, United States. Electronic address: daughter@umd.edu.
authors.forename: Stacey B
authors.initials: SB
authors.lastname: Daughters
mesh_terms: D000328:Adult; D003376:Counseling; D003866:Depressive Disorder / Q000523:psychology / Q000628:therapy*; D017831:Diagnosis, Dual (Psychiatry); D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012114:Residential Treatment / Q000379:methods*; D019966:Substance-Related Disorders / Q000523:psychology / Q000628:therapy*; D016896:Treatment Outcome; D014861:Washington