Stepping through treatment: reflections on an adaptive treatment strategy among methamphetamine users with depression.

Abstract:

INTRODUCTION AND AIMS:Stepped-care has been recommended in the alcohol and other drug field and adopted in a number of service settings, but few research projects have examined this approach. This article aims to describe a pilot trial of stepped-care methods in the treatment of methamphetamine use and depression comorbidity. DESIGN AND METHODS:An adaptive treatment strategy was developed based on recommendations for stepped-care among methamphetamine users, and incorporating cognitive behaviour therapy/motivational intervention for methamphetamine use and depression. The adaptive treatment strategy was compared with a fixed treatment, comprising an extended integrated cognitive behaviour therapy/motivational intervention treatment. Eighteen participants across two study sites were involved in the trial, and were current users of methamphetamines (at least once weekly) exhibiting at least moderate symptoms of depression (score of 17 or greater on the Beck Depression Inventory II). RESULTS:Treatment delivered via the adaptive treatment (stepped-care) model was associated with improvement in depression and methamphetamine use, however, was not associated with more efficient delivery of psychological treatment to this population relative to the comparison treatment. DISCUSSION AND CONCLUSIONS:This pilot trial attests to the potential for adaptive treatment strategies to increase the evidence base for stepped-care approaches within the alcohol and other drug field. However, in order for stepped-care treatment in this trial to be delivered efficiently, specific training in the delivery and philosophy of the model is required.

journal_name

Drug Alcohol Rev

journal_title

Drug and alcohol review

authors

Kay-Lambkin FJ,Baker AL,McKetin R,Lee N

doi

10.1111/j.1465-3362.2010.00203.x

subject

Has Abstract

pub_date

2010-09-01 00:00:00

pages

475-82

issue

5

eissn

0959-5236

issn

1465-3362

pii

DAR203

journal_volume

29

pub_type

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