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.
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Methamphetamine use is associated with an array of psychological difficulties that may affect one's response to treatment.
“In summary, it appears that MA use is associated with an array of psychological difficulties that may affect one’s response to treatment.20”
From Protocol for a systematic review of psychological treatment for methamphetamine use: An analysis of methamphetamine use and mental health symptom outcomes (2017) · cites this paper as [20]
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“In summary, it appears that MA use is associated with an array of psychological difficulties that may affect one’s response to treatment.(20) Psychological treatment, incorporating elements such as psychotherapy, psychoeducation and relapse prevention are major treatments for MA use that focus on abstinence and reduci…”
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- Authors
- KAY‐LAMBKIN, F. J., BAKER, A. L., MCKETIN, R., & LEE, N.
- Affiliations
- UNSW Sydney (AU)
- University of Newcastle Australia (AU)
- Corresponding author
- KAY‐LAMBKIN, FRANCES J.
- Venue
- Drug and Alcohol Review
- Publisher
- Wiley
- Published
- 2010-09
- Volume
- 29
- Issue
- 5
- Pages
- 475-482
- ISSN
- 0959-5236 (ISSN-L)
- 1465-3362
- OpenAlex
- W1522970367
- Cited by
- 24
- References
- 27
- Citations by year
- 2023: 1 · 2022: 2 · 2021: 1 · 2019: 6 · 2018: 2 · 2017: 1 · 2015: 2 · 2014: 2 · 2013: 1 · 2012: 3
- FWCI
- 1.63
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Drug and Alcohol Review (publishedVersion)
- PubMed (publishedVersion)
- ANU Open Research (Australian National University) (submittedVersion)
- NOVA (University of Newcastle Australia) (submittedVersion)
- Funders
- NSW Ministry of Health
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- stepped care, adaptive treatment strategies, methamphetamine use, depression, comorbidities, cognitive behavioral therapy, motivational interventions, integrated treatment, treatment efficiency
- MeSH terms
- Adult, Depressive Disorder, Female, Humans, Male, Methamphetamine, Middle Aged, Motivation, Pilot Projects, Cognitive Behavioral Therapy, Diagnosis, Dual (Psychiatry), Evidence-Based Medicine, Amphetamine-Related Disorders, Young Adult
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