Psychosocial Treatment for Methamphetamine Use Disorders: A Preliminary Randomized Controlled Trial of Cognitive Behavior Therapy and Acceptance and Commitment Therapy
Abstract
Acceptance and Commitment Therapy (ACT) incorporates developments in behavior therapy, holds promise but has not been evaluated for methamphetamine use disorders. The objective of this study was to test whether ACT would increase treatment attendance and reduce methamphetamine use and related harms compared to cognitive behavior therapy (CBT). One hundred and four treatment-seeking adults with methamphetamine abuse or dependence were randomly assigned to receive 12 weekly 60-minute individual sessions of ACT or CBT. Attrition was 70% at 12 weeks and 86% at 24 weeks postentry. Per intention-to-treat analysis, there were no significant differences between the treatment groups in treatment attendance (median 3 sessions), and methamphetamine-related outcomes; however, methamphetamine use (toxicology-assessed and self-reported), negative consequences, and dependence severity significantly improved over time in both groups. Although ACT did not improve treatment outcomes or attendance compared to CBT, it may be a viable alternative to CBT for methamphetamine use disorders. Future rigorous research in this area seems warranted.
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Several controlled trials report substance use reductions following ACT, alongside more sustained benefits than other therapy modalities for both wellbeing and substance use.
“Several controlled trials report substance use reductions following ACT, alongside more sustained benefits than other therapy modalities for both wellbeing and substance use (Bahrami & Asghari, 2017; Lanza et al., 2014; Smout et al., 2010; Thekiso et al., 2015).”
From “I don’t want to take buprenorphine for the rest of my life”: Acceptance and Commitment Therapy for a Client Struggling to Reduce Low-Dose Buprenorphine (a Hermeneutic Single-Case Efficacy Design) (2023) · cites this paper as Smout et al., 2010
It may be that, while opioid-substitution medication is required to manage the acute difficulties of withdrawal, ACT addresses the underlying psychological difficulties perpetuating substance misuse.
“It may be that, while opioid-substitution medication is required to manage the acute difficulties of withdrawal, ACT addresses the underlying psychological difficulties perpetuating substance misuse (Cami & Farre, 2003; Smout et al., 2010).”
From “I don’t want to take buprenorphine for the rest of my life”: Acceptance and Commitment Therapy for a Client Struggling to Reduce Low-Dose Buprenorphine (a Hermeneutic Single-Case Efficacy Design) (2023) · cites this paper as Smout et al., 2010
Only three studies have compared ACT with CBT and have shown equivalent effectiveness in the short term.
“Only three studies have compared ACT with CBT and these have shown equivalent effectiveness in the short-term [149,150,151].”
From Cognitive behavioral therapy and acceptance and commitment therapy for the discontinuation of long-term benzodiazepine use in insomnia and anxiety disorders (2021) · cites this paper as [149]
Cites
(1998) · The Journal of Clinical Psychiatry · Cited by 19,139 · see citing works
WARE, J. E., KOSINSKI, M., & KELLER, S. D. (1996) · Medical Care · doi:10.1097/00005650-199603000-00003 · Cited by 17,392 · see citing works
(1993) · Cited by 7,136 · see citing works
Motivational interviewing: preparing people for change.
Miller, W. R., & Rollnick, S. (2002) · Cited by 7,002 · see citing works
Cognitive-Behavioral Treatment of Borderline Personality Disorder
Cary, G. L. (1994) · American Journal of Psychotherapy · doi:10.1176/appi.psychotherapy.1994.48.1.155 · Cited by 6,300 · see citing works
(1999) · Cited by 5,934 · see citing works
The mini international neuropsychiatric interview
Lecrubier, Y., Sheehan, D. V., Hergueta, T., & Weiller, E. (1998) · European Psychiatry · doi:10.1016/s0924-9338(99)80239-9 · Cited by 5,882 · see citing works
Measuring experiential avoidance: A preliminary test of a working model
Hayes, S. C., Strosahl, K., Wilson, K. G., Bissett, R. T., Pistorello, J., Toarmino, D., Polusny, M. A., Dykstra, T. A., Batten, S. V., Bergan, J., et al. (2004) · The Psychological Record · doi:10.1007/bf03395492 · Cited by 2,140 · see citing works
Factor structure of the working alliance inventory
Tracey, T. J., & Kokotovic, A. M. (1989) · Psychological Assessment: A Journal of Consulting and Clinical Psychology · doi:10.1037/1040-3590.1.3.207 · Cited by 1,501 · see citing works
Mindfulness and acceptance: expanding the cognitive-behavioral tradition
(2005) · Choice Reviews Online · doi:10.5860/choice.42-6797 · Cited by 1,273 · see citing works
ROLLNICK, S., HEATHER, N., GOLD, R., & HALL, W. (1992) · British Journal of Addiction · doi:10.1111/j.1360-0443.1992.tb02720.x · Cited by 818 · see citing works
Some Conceptual and Statistical Issues in Analysis of Longitudinal Psychiatric Data
Gibbons, R. D. (1993) · Archives of General Psychiatry · doi:10.1001/archpsyc.1993.01820210073009 · Cited by 719 · see citing works
Acceptance-based treatment for smoking cessation
Gifford, E. V., Kohlenberg, B. S., Hayes, S. C., Antonuccio, D. O., Piasecki, M. M., Rasmussen-Hall, M. L., & Palm, K. M. (2004) · Behavior Therapy · doi:10.1016/s0005-7894(04)80015-7 · Cited by 499 · see citing works
The prevalence of psychotic symptoms among methamphetamine users
McKetin, R., McLaren, J., Lubman, D. I., & Hides, L. M. (2006) · Addiction · doi:10.1111/j.1360-0443.2006.01496.x · Cited by 393 · see citing works
A multi‐site comparison of psychosocial approaches for the treatment of methamphetamine dependence
Rawson, R. A., Marinelli‐Casey, P., Anglin, M. D., Dickow, A., Frazier, Y., Gallagher, C., Galloway, G. P., Herrell, J., Huber, A., McCann, M. J., et al. (2004) · Addiction · doi:10.1111/j.1360-0443.2004.00707.x · Cited by 387 · see citing works
NORDAHL, T. E., Salo, R. E., & Leamon, M. H. (2003) · Journal of Neuropsychiatry · doi:10.1176/jnp.15.3.317 · Cited by 370 · see citing works
(1998) · Europe PMC (PubMed Central) · Cited by 336 · see citing works
Raistrick, D., Bradshaw, J., Tober, G., Weiner, J., ALLISON, J., & Healey, C. (1994) · Addiction · doi:10.1111/j.1360-0443.1994.tb03332.x · Cited by 295 · see citing works
Hayes, S. C., Wilson, K. G., Gifford, E. V., Bissett, R., Piasecki, M., Batten, S. V., Byrd, M., & Gregg, J. (2004) · Behavior Therapy · doi:10.1016/s0005-7894(04)80014-5 · Cited by 283 · see citing works
A systematic review of cognitive and behavioural therapies for methamphetamine dependence
Lee, N., & Rawson, R. A. (2008) · Drug and Alcohol Review · doi:10.1080/09595230801919494 · Cited by 256 · see citing works
Rawson, R. A., McCann, M. J., Flammino, F., Shoptaw, S., Miotto, K., Reiber, C., & Ling, W. (2006) · Addiction · doi:10.1111/j.1360-0443.2006.01312.x · Cited by 238 · see citing works
Baker, A., Lee, N. K., Claire, M., Lewin, T. J., Grant, T., Pohlman, S., Saunders, J. B., Kay‐Lambkin, F., Constable, P., Jenner, L., et al. (2005) · Addiction · doi:10.1111/j.1360-0443.2005.01002.x · Cited by 227 · cited 7× · see citing works
“Depression symptom severity was assessed using the Beck Depression Inventory (BDI-II) (25), the most widely used self-reported measure of depression and previously used in methamphetamine treatment outcome studies (9, 26).”
BackgroundMethodInfluentialTreatment of methamphetamine use disorders: an update
Rawson, R. A., Gonzales, R. E., & Brethen, P. (2002) · Journal of Substance Abuse Treatment · doi:10.1016/s0740-5472(02)00256-8 · Cited by 211 · see citing works
Smith, K. W., & Larson, M. J. (2003) · The American Journal of Drug and Alcohol Abuse · doi:10.1081/ada-120020517 · Cited by 188 · see citing works
(2004) · Cited by 182 · see citing works
Baker, A., Boggs, T. G., & Lewin, T. J. (2001) · Addiction · doi:10.1046/j.1360-0443.2001.96912797.x · Cited by 114 · cited 1× · see citing works
“The intensity of CBT protocols has ranged from 2 individual sessions ( 8 , 9 ) to the Matrix program comprising 36 group CBT sessions plus adjunctive services ( 10 ).”
BackgroundThe Matrix Model of Outpatient Stimulant Abuse Treatment: History and Description
Obert, J. L., McCann, M., Marinelli‐Casey, P., Weiner, A., Minsky, S., Brethen, P., & Rawson, R. A. (2000) · Journal of Psychoactive Drugs · doi:10.1080/02791072.2000.10400224 · Cited by 111 · see citing works
Correlates of Outpatient Drug Treatment Drop-Out Among Methamphetamine Users
Maglione, M., Chao, B., & Anglin, M. D. (2000) · Journal of Psychoactive Drugs · doi:10.1080/02791072.2000.10400232 · Cited by 75 · see citing works
Violent Crime, Aggression and Amphetamine: what are the implications for drug treatment services?
Wright, S. (2001) · Drugs Education Prevention and Policy · doi:10.1080/09687630124890 · Cited by 50 · see citing works
Methamphetamine use and depressive symptoms among heterosexual men and women
Semple, S. J., Patterson, T. L., & Rant, I. (2005) · Journal of Substance Use · doi:10.1080/1465989042000271264 · Cited by 28 · see citing works
Leeds Dependence Questionnaire: New Data from a Large Sample of Clinic Attenders
Heather, N., Raistrick, D., Tober, G., Godfrey, C., & Parrott, S. (2001) · Addiction Research & Theory · doi:10.3109/16066350109141753 · Cited by 23 · see citing works
A brief cognitive behavioural intervention for regular amphetamine users. A treatment guide.
Baker, A., KAY‐LAMBKIN, F. J., Lee, N., Claire, M., & Jenner, L. (2003) · Cited by 21 · see citing works
ACT for Substance Abuse and Dependence
Wilson, K. G., & Byrd, M. R. (2004) · Springer eBooks · doi:10.1007/978-0-387-23369-7_7 · Cited by 18 · see citing works
Commitment to Abstinence and Relapse to Tobacco, Alcohol, and Opiates
Hall, S. M., & Havassy, B. E. (1986) · PsycEXTRA Dataset · doi:10.1037/e496822006-009 · Cited by 17 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
The efficacy of Acceptance and Commitment Therapy: An updated systematic review and meta-analysis
Öst, L.-G. (2014) · Behaviour Research and Therapy · doi:10.1016/j.brat.2014.07.018 · Cited by 476 · see citing works
Chiesa, A., & Serretti, A. (2014) · Substance Use & Misuse · doi:10.3109/10826084.2013.770027 · Cited by 348 · see citing works
Acceptance and Commitment Therapy (ACT) to reduce depression: a systematic review and meta-analysis
Bai, Z., Luo, S., Zhang, L., Wu, S., & Chi, I. (2020) · Journal of Affective Disorders · doi:10.1016/j.jad.2019.09.040 · Cited by 321 · see citing works
Magill, M., Ray, L., Kiluk, B., Hoadley, A., Bernstein, M., Tonigan, J. S., & Carroll, K. (2019) · Journal of Consulting and Clinical Psychology · doi:10.1037/ccp0000447 · Cited by 315 · see citing works
An initial meta-analysis of acceptance and commitment therapy for treating substance use disorders
Lee, E. B., An, W., Levin, M. E., & Twohig, M. P. (2015) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2015.08.004 · Cited by 271 · see citing works
Evolving the future: Toward a science of intentional change
Wilson, D. S., Hayes, S. C., Biglan, A., & Embry, D. D. (2014) · Behavioral and Brain Sciences · doi:10.1017/s0140525x13001593 · Cited by 255 · see citing works
Jonsson, U., Alaie, I., Parling, T., & Arnberg, F. K. (2014) · Contemporary Clinical Trials · doi:10.1016/j.cct.2014.02.005 · Cited by 175 · see citing works
Mindfulness-Based Interventions in Psychiatry
Shapero, B. G., Greenberg, J., Pedrelli, P., de Jong, M., & Desbordes, G. (2018) · Focus · doi:10.1176/appi.focus.20170039 · Cited by 172 · see citing works
“Different treatment delivery formats such as individual therapy sessions (18), one day workshops (19), telephone delivered therapy (20), a smartphone app (20), and web-based therapy (21) have been used in prior research.”
MethodHacker, T., Stone, P., & MacBeth, A. (2016) · Journal of Affective Disorders · doi:10.1016/j.jad.2015.10.053 · Cited by 130 · see citing works
Katz, D., & Toner, B. (2013) · Mindfulness · doi:10.1007/s12671-012-0132-3 · Cited by 131 · see citing works
Substance abuse and psychological flexibility: the development of a new measure
Luoma, J., Drake, C. E., Kohlenberg, B. S., & Hayes, S. C. (2011) · Addiction Research & Theory · doi:10.3109/16066359.2010.524956 · Cited by 131 · see citing works
Lanza, P. V., García, P. F., Lamelas, F. R., & González‐Menéndez, A. (2014) · Journal of Clinical Psychology · doi:10.1002/jclp.22060 · Cited by 101 · see citing works
González-Menéndez, A., Fernández, P., Rodríguez, F., & Villagrá, P. (2014) · International Journal of Clinical and Health Psychology · doi:10.1016/s1697-2600(14)70033-x · Cited by 81 · see citing works
“In contrast, in a RCT, Smout et al. (2010) reported no differences in the efficacy of both interventions for meta-amphetamine consumers.”
BackgroundMethodResultCognitive-behavioural treatment for amphetamine-type stimulants (ATS)-use disorders
Harada, T., Tsutomi, H., Mori, R., & Wilson, D. B. (2018) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd011315.pub2 · Cited by 76 · see citing works
A meta-analysis of dropout rates in acceptance and commitment therapy
Ong, C. W., Lee, E. B., & Twohig, M. P. (2018) · Behaviour Research and Therapy · doi:10.1016/j.brat.2018.02.004 · Cited by 69 · see citing works
The promise of third-wave behavioral therapies in the treatment of substance use disorders
Stotts, A. L., & Northrup, T. F. (2015) · Current Opinion in Psychology · doi:10.1016/j.copsyc.2014.12.028 · Cited by 70 · see citing works
The empirically supported status of acceptance and commitment therapy: An update.
Smout, M. F., Hayes, L., Atkins, P. W. B., Klausen, J., & Duguid, J. E. (2012) · Clinical Psychologist · doi:10.1111/j.1742-9552.2012.00051.x · Cited by 61 · see citing works
Self-citationExploring cultural competence in acceptance and commitment therapy outcomes.
Woidneck, M. R., Pratt, K. M., Gundy, J. M., Nelson, C. R., & Twohig, M. P. (2012) · Professional Psychology Research and Practice · doi:10.1037/a0026235 · Cited by 60 · see citing works
Chapoutot, M., Peter-Derex, L., Bastuji, H., Leslie, W., Schoendorff, B., Heinzer, R., Siclari, F., Nicolas, A., Lemoine, P., Higgins, S., et al. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph181910222 · Cited by 59 · see citing works
Stuart, A. M., Baker, A. L., Denham, A. M. J., Lee, N. K., Hall, A., Oldmeadow, C., Dunlop, A., Bowman, J., & McCarter, K. (2020) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2019.09.005 · Cited by 49 · see citing works
Ashe, M. L., Newman, M. G., & Wilson, S. J. (2015) · Journal of the Experimental Analysis of Behavior · doi:10.1002/jeab.122 · Cited by 45 · see citing works
Acceptance and Commitment Therapy for drug abuse in incarcerated women
Villagrá Lanza, P., & González Menéndez, A. (2013) · Psicothema · doi:10.7334/psicothema2012.292 · Cited by 39 · see citing works
“ACT has also been effi cacious in the treatment of cannabis dependence (Twohig, Shoenberger, & Hayes, 2007), methamphetamine (Smout et al., 2010), methadone (Stotts et al.”
BackgroundYıldız, E. (2020) · Perspectives In Psychiatric Care · doi:10.1111/ppc.12482 · Cited by 40 · see citing works
Psychosocial interventions for stimulant use disorder
Minozzi, S., Saulle, R., Amato, L., Traccis, F., & Agabio, R. (2024) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd011866.pub3 · Cited by 32 · see citing works
Fang, S., & Ding, D. (2023) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2023.03.015 · Cited by 33 · see citing works
Karekla, M., Constantinou, P., Ioannou, M., Gloster, A. T., & Kareklas, I. (2019) · Clinical Psychology in Europe · doi:10.32872/cpe.v1i3.33058 · Cited by 29 · see citing works
Kuru, T., & Çelenk, S. (2021) · Anatolian Journal of Psychiatry · doi:10.5455/apd.136695 · Cited by 26 · see citing works
Hall, K., Simpson, A., O'donnell, R., Sloan, E., Staiger, P. K., Morton, J., Ryan, D., Nunn, B., Best, D., & Lubman, D. I. (2018) · Clinical Psychologist · doi:10.1111/cp.12162 · Cited by 22 · see citing works
Hersi, M., Corace, K., Hamel, C., Esmaeilisaraji, L., Rice, D., Dryburgh, N., Skidmore, B., Garber, G., Porath, A., Willows, M., et al. (2023) · PLoS ONE · doi:10.1371/journal.pone.0292745 · Cited by 13 · see citing works
“In consideration of all • CM (voucher based), gay and bisexual men-specific CBT alone or with CM were all favored to CBT alone [77, 85, 93], and interventions involving CM (voucher based) were favored to gb men-specific CBT [77, 85, 93] • Gay specific CBT was favored to Gay social support therapy for both meth use/ ab…”
ResultInfluentialNavigating Evidence, Challenges, and Caution in the Treatment of Stimulant Use Disorders
Bahji, A., Danilewitz, M., & Crockford, D. (2023) · Brain Sciences · doi:10.3390/brainsci13101416 · Cited by 9 · see citing works
Knock, E., Siefried, K. J., Bedi, G., Albert, S., Day, R. O., Ezard, N., Ross, M., Liknaitzky, P., & Brett, J. (2025) · Addiction · doi:10.1111/add.70187 · Cited by 9 · see citing works
Hemmat, A., Dept.of Clinical Psychology, F. O. M., Hemmat, J., Dept.of Clinical Psychology, F. O. M., Pirzeh, R., Dept.of Psychiatry, F. O. M., Dadashi, M., & Social Detriments of Health Research Center, Z. U. O. M. S. (2018) · Journal of Advances in Medical and Biomedical Research · doi:10.30699/jambs.30.142.10 · Cited by 6 · see citing works
Shepherd, K., Pritty, B., Tickle, A., & Moghaddam, N. (2023) · International Journal of Mental Health and Addiction · doi:10.1007/s11469-021-00729-2 · Cited by 3 · see citing works
“It may be that, while opioid-substitution medication is required to manage the acute difficulties of withdrawal, ACT addresses the underlying psychological difficulties perpetuating substance misuse (Cami & Farre, 2003; Smout et al., 2010).”
Background
- Authors
- Smout, M. F., Longo, M., Harrison, S., Minniti, R., Wickes, W., & White, J. M.
- Affiliations
- Centre for Treatment of Anxiety Disorders, Thebarton, South Australia, Australia
- The University of Queensland (AU)
- Drug and Alcohol Services South Australia, Warinilla Clinic, Norwood, South Australia, Australia
- The University of Adelaide (AU)
- Corresponding author
- Smout, Matthew F.
- Venue
- Substance Abuse
- Publisher
- SAGE Publications
- Published
- 2010-04
- Volume
- 31
- Issue
- 2
- Pages
- 98-107
- ISSN
- 0889-7077 (ISSN-L)
- 1547-0164
- OpenAlex
- W2171048870
- Cited by
- 129
- References
- 34
- Citations by year
- 2026: 1 · 2025: 8 · 2024: 7 · 2023: 7 · 2022: 7 · 2021: 9 · 2020: 6 · 2019: 15 · 2018: 15 · 2017: 9 · 2016: 3 · 2015: 7 · 2014: 14 · 2013: 4 · 2012: 9
- FWCI
- 4.65
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Substance Abuse (publishedVersion)
- PubMed (publishedVersion)
- Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Keywords
- methamphetamine dependence, acceptance and commitment therapy, cognitive behavioral therapy, psychosocial interventions, treatment attendance, treatment discontinuation, substance use harm, treatment-seeking patients
- MeSH terms
- Adolescent, Adult, Aged, Assertiveness, Behavior Therapy, Female, Hair, Humans, Male, Methamphetamine, Middle Aged, Patient Compliance, Cognitive Behavioral Therapy, Amphetamine-Related Disorders
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