Combining cognitive behavioral therapy and contingency management to enhance their effects in treating cannabis dependence: less can be more, more or less.

Carroll, Kathleen M.; Nich, Charla; LaPaglia, Donna M.; Peters, Erica N.; Easton, Caroline J.; Petry, Nancy M.

doi:10.1111/j.1360-0443.2012.03877.x

Cited by 91Substance Abuse Treatment and OutcomesCannabis and Cannabinoid ResearchPsychotherapy Techniques and Applications

Combining cognitive behavioral therapy and contingency management to enhance their effects in treating cannabis dependence: less can be more, more or less.

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Carroll, Kathleen M., Nich, Charla, LaPaglia, Donna M., Peters, Erica N., Easton, Caroline J., Petry, Nancy M.·2012·Addiction

DOI 10.1111/j.1360-0443.2012.03877.xPMC PMC3509418

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Abstract

AIMS: To evaluate reciprocal enhancement (combining treatments to offset their relative weaknesses) as a strategy to improve cannabis treatment outcomes. Contingency management (CM) with reinforcement for homework completion and session attendance was used as a strategy to enhance cognitive-behavioral therapy (CBT) via greater exposure to skills training; CBT was used as a strategy to enhance durability of CM with rewards for abstinence. SETTING: Community-based out-patient treatment program in New Haven, Connecticut, USA. DESIGN: Twelve-week randomized clinical trial of four treatment conditions: CM for abstinence alone or combined with CBT, CBT alone or combined with CM with rewards for CBT session attendance and homework completion. PARTICIPANTS: A total of 127 treatment-seeking young adults (84.3% male, 81.1% minority, 93.7% referred by criminal justice system, average age 25.7 years). MEASUREMENTS: Weekly urine specimens testing positive for cannabis, days of cannabis use via the time-line follow-back method. FINDINGS: Within treatment, reinforcing homework and attendance did not significantly improve CBT outcomes, and the addition of CBT worsened outcomes when added to CM for abstinence (75.5 versus 57.1% cannabis-free urine specimens, F = 2.25, P = 0.02). The CM for abstinence condition had the lowest percentage of cannabis-negative urine specimens and the highest mean number of consecutive cannabis-free urine specimens (3.3, F = 2.33, P = 0.02). Attrition was higher in the CBT alone condition, but random effect regression analyses indicated this condition was associated with the greatest rate of change overall. Cannabis use during the 1-year follow-up increased most rapidly for the two enhanced groups. CONCLUSIONS: Combining contingency management and cognitive-behavioural therapy does not appear to improve success rates of treatment for cannabis dependence in clients involved with the criminal justice system.

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A 12-session CBT intervention alone showed greater reduction in cannabis use frequency compared with the same CBT duration paired with abstinence-based CM or adherence-based CM over 12 months.
“one study showed that, when delivered alone, a 12-session CBT intervention showed greater reduction in the frequency of cannabis use compared with the same CBT duration paired with abstinence-based CM or adherence-based CM over 12 months 42.”
From Psychosocial and pharmacological interventions for the treatment of cannabis use disorder (2018) · cites this paper as [42]

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Self-citation

Authors: Carroll, K. M., Nich, C., LaPaglia, D. M., Peters, E. N., Easton, C. J., & Petry, N. M.
Affiliations: Yale University (US)
UConn Health (US)
Corresponding author: Carroll, Kathleen M.
ORCID: Carroll, Kathleen M.
Nich, Charla
LaPaglia, Donna M.
Peters, Erica N.
Easton, Caroline J.
Petry, Nancy M.
Venue: Addiction
Publisher: Wiley
Published: 2012-05-08
Volume: 107
Issue: 9
Pages: 1650-1659
ISSN: 0965-2140 (ISSN-L)
1360-0443
DOI: 10.1111/j.1360-0443.2012.03877.x
PMC: PMC3509418
OpenAlex: W2164765166
Cited by: 91
References: 60
Citations by year: 2026: 4 · 2025: 5 · 2024: 7 · 2023: 6 · 2022: 4 · 2021: 4 · 2020: 3 · 2019: 3 · 2018: 8 · 2017: 5 · 2016: 10 · 2015: 13 · 2014: 11 · 2013: 7 · 2012: 1
FWCI: 7.63
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: Addiction (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: Yale University
National Institute on Alcohol Abuse and Alcoholism (P60AA003510)
National Institute on Drug Abuse (R37DA015969, U10-DA-13038, P50DA009241, K05DA000457, R01DA019078, P50-DA-0-9241, U10DA013038, T32DA007238)
Topics: Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Health Sciences › Medicine › Pharmacology › Cannabis and Cannabinoid Research
Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Keywords: cannabis use disorder, contingency management, cognitive behavioral therapy, combination therapy, treatment discontinuation, young adults, criminal justice involvement, treatment durability
MeSH terms: Adult, Ambulatory Care, Analysis of Variance, Marijuana Abuse, Combined Modality Therapy, Female, Follow-Up Studies, Humans, Male, Patient Compliance, Reward, Cognitive Behavioral Therapy, Treatment Outcome

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Combining cognitive behavioral therapy and contingency management to enhance their effects in treating cannabis dependence: less can be more, more or less.

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