title: Community Reinforcement Approach (CRA) for cocaine dependence in the Spanish public health system: 1 year outcome.
abstract: OBJECTIVE
  The development and dissemination of effective treatments for cocaine dependence is an important public health priority in Europe, and especially in Spain, given the increase in treatment demand over recent years. The aim of this study was to determine the effectiveness of the Community Reinforcement Approach (CRA) for cocaine dependents at an outpatient clinic within the Spanish public health system.
  
  
  METHODS
  A total of 82 cocaine-dependent patients were randomly assigned to one of two treatment conditions: Standard Treatment (n = 35) or CRA (n = 47). Dependent variables were treatment retention, cocaine abstinence and composite scores from the European version of the Addiction Severity Index at 12 month follow up.
  
  
  RESULTS
  Of the patients who received CRA, 55% completed 6 months of treatment, versus 40% who received Standard Treatment. At the 12 month follow up, patients assigned to the CRA condition achieved higher rates of abstinence (95.2%) by comparison with Standard Treatment (69.2%). In the CRA group, 27% of the patients achieved continuous cocaine abstinence, versus 21% in the Standard Treatment group. The CRA group also obtained lower scores than the Standard Treatment group in all Addiction Severity Index composite scores.
  
  
  CONCLUSIONS
  This study showed that CRA is a feasible treatment for cocaine addiction in a public community setting in Spain.
authors.affiliation: Department of Psychology, University of Oviedo, Oviedo, Spain. secades@uniovi.es
authors.forename: Roberto
authors.initials: R
authors.lastname: Secades-Villa
authors.forename: Emilio
authors.initials: E
authors.lastname: Sánchez-Hervás
authors.forename: Francisco
authors.initials: F
authors.lastname: Zacarés-Romaguera
authors.forename: Olaya
authors.initials: O
authors.lastname: García-Rodríguez
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Santonja-Gómez
authors.forename: Gloria
authors.initials: G
authors.lastname: García-Fernández
mesh_terms: D000328:Adult; D001521:Behavior Therapy / Q000379:methods*; D019970:Cocaine-Related Disorders / Q000628:therapy*; D003156:Community Mental Health Services; D005260:Female; D006801:Humans; D008297:Male; D011634:Public Health; D012054:Reinforcement, Psychology; D012111:Residence Characteristics; D055502:Secondary Prevention; D013030:Spain; D016896:Treatment Outcome