Stepping through treatment: Reflections on an adaptive treatment strategy among methamphetamine users with depression
- 1 September 2010
- journal article
- research article
- Published by Wiley in Drug and Alcohol Review
- Vol. 29 (5), 475-482
- https://doi.org/10.1111/j.1465-3362.2010.00203.x
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 requiredThis publication has 20 references indexed in Scilit:
- Adaptive Designs for Randomized Trials in Public HealthAnnual Review of Public Health, 2009
- Stepped-Care Prevention of Anxiety and Depression in Late LifeArchives of General Psychiatry, 2009
- Effectiveness of a stepped primary care smoking cessation intervention (ISTAPS study): design of a cluster randomised trialBMC Public Health, 2009
- Technology and innovation in the psychosocial treatment of methamphetamine use, risk and dependenceDrug and Alcohol Review, 2008
- How should the effectiveness of treatment for alcohol problems be evaluated?Drugs and Alcohol Today, 2007
- Stepped care in psychological therapies: access, effectiveness and efficiencyThe British Journal of Psychiatry, 2005
- Amphetamine use and co-occurring psychological problems: Review of the literature and implications for treatmentAustralian Psychologist, 2005
- The ‘co‐morbidity roundabout’: a framework to guide assessment and intervention strategies and engineer change among people with co‐morbid problemsDrug and Alcohol Review, 2004
- Strike while the iron is hot: Can stepped-care treatments resurrect relapsing smokers?Journal of Consulting and Clinical Psychology, 2001
- Stepped care as a heuristic approach to the treatment of alcohol problems.Journal of Consulting and Clinical Psychology, 2000