Computer-Assisted Motivational Enhancement Therapy, Cognitive-Behavioral Therapy and Abstinence-Based Contingency-Management (cMET/CBT/CM)

Evaluations

• An initial trial of a computerized behavioral intervention for cannabis use disorder.

  Budney AJ, Fearer S, Walker DD, Stanger C, Thostenson J, Grabinski M, Bickel WK. Drug and Alcohol Dependence. 2011. 115(1-2):74-79. PMCID: PMC3071451.

  Summary: In this comparative study, two computer modules of MET therapy followed by seven modules of CBT were delivered either via a computer program or individual sessions with a therapist. Participants in the computer-based intervention also received 45-90 minutes of individual therapy. Abstinence-based incentives were provided upon receipt of negative urine samples.

  19 participants (50%) completed treatment. No difference between treatments was observed for cannabis use. Attendance and retention did not differ significantly between groups, nor did changes in coping skills. Participants provided positive ratings of the computer delivered sessions.

  Take Away: Computer-assisted MET/CBT/CM treatment for cannabis use disorders did not adversely affect compliance or outcomes. Participants who received the internet-based program achieved comparable results to in-person therapy. There was high attrition over the 12 week period for both groups.

• Computer-assisted behavioral therapy and contingency management for cannabis use disorder.

  Budney AJ, Stanger C, Tilford JM, Scherer EB, Brown PC, Li Z, Li Z, Walker DD. Psychology of Addictive Behaviors. 2015. Advance online publication. PMID: 25938629.

  Summary: In this randomized controlled trial, the effectiveness of cMET/ICBT/CM was compared to two therapist delivered treatments for cannabis use disorders. Adults with cannabis use disorders were recruited (n=75) and randomly assigned to: 1)cMET/ICBT/CM; 2) Nine sessions of a therapy incorporating MET, CBT, and CM delivered in-person with a therapist (THERAPIST); or 3) Two motivational interviewing sessions, in-person with a therapist (BRIEF). Cannabis use was assessed pre-treatment, post-treatment, and at 3- and 9-month post-treatment follow-ups. Post-treatment, participants in the cMET/ICBT/CM and THERAPIST conditions had significantly longer durations of continuous abstinence from cannabis than the BRIEF group. Participants in the THERAPIST and cMET/ICBT/CM conditions were also significantly more likely to be abstinent from cannabis at the end of treatment. While 47% and 45% of the cMET/ICBT/CM and THERAPIST groups, respectively, were abstinent, only 13% of the BRIEF group was abstinent from cannabis post-treatment. There were no post-treatment differences in cannabis use between the cMET/ICBT/CM and THERAPIST conditions. At the 3- and 9-month follow-ups, the rates of participants abstaining from cannabis use were similar across all three treatment conditions. Participants in the THERAPIST group, however, used cannabis on a greater percentage of days at 9-months, compared to the cMET/ICBT/CM group.

  Take Away: cMET/ICBT/CM demonstrated greater short-term effectiveness than a brief therapist-delivered motivational intervention. More research is needed to examine how to sustain program effectiveness over time.

• Litt MD, Kadden RM, Tennen H, Petry NM. (2020). Individualized assessment and treatment program (IATP) for cannabis use disorder: Randomized controlled trial with and without contingency management. Psychol Addict Behav,34(1):40-51. doi:10.1037/adb0000491

  Study Design: RCT
  Study Type: Efficacy
  Sample Size: N = 198
  Demographics:
  Age
  Adult: 35.6 years (SD = 21.0)
  Gender
  Female: 42%
  Male: 58%
  Transgender: Not reported
  Non-Binary+: Not reported

  Race
  Black: 28%
  White: 51%
  Other: 7%

  Ethnicity
  Hispanic: 14%