Cognitive-behavioural therapy for substance use disorders in people with psychotic disorders: Randomised controlled trial
Open accessAbstract
Background: Few randomised controlled trials have been aimed specifically at substance use reduction among people with psychotic disorders. Aims: To investigate whether a 10-session intervention consisting of motivational interviewing and cognitive-behavioural therapy (CBT) was more efficacious than routine treatment in reducing substance use and improving symptomatology and general functioning. Method: A community sample of people with a psychotic disorder and who reported hazardous alcohol, cannabis and/or amphetamine use during the preceding month was recruited. Participants were randomly allocated to motivational interviewing/CBT (n=65) or treatment as usual (n=65), and were assessed on multiple outcomes at baseline, 15 weeks, 6 months and 12 months. Results: There was a short-term improvement in depression and a similar trend with regard to cannabis use among participants who received the motivational interviewing/CBT intervention, together with effects on general functioning at 12 months. There was no differential benefit of the intervention on substance use at 12 months, except for a potentially clinically important effect on amphetamine use. Conclusions: The motivational interviewing/CBT intervention was associated with modest improvements.
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These interventions have also been associated with positive mental health outcomes, such as improved well-being, following treatment in people who use methamphetamine.
“These interventions have also been associated with positive mental health outcomes, such as improved well-being, following treatment in people who use MA.34”
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 [34]
The Results report short-term improvement in depression and improved general functioning after motivational interviewing/CBT. However, these mental-health outcomes are reported for participants with psychotic disorders and substance use generally, not specifically for those who use methamphetamine; the paper discusses amphetamine users separately in relation to substance use. Page numbers are unavailable in our copy. (LLM, conf=0.86)
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“therapy which has been found to reduce the severity of substance abuse and psychiatric symptoms compared to other treatments.(9)”
ResultHjorthøj, C. R., Fohlmann, A., & Nordentoft, M. (2009) · Addictive Behaviors · doi:10.1016/j.addbeh.2009.02.003 · Cited by 43 · see citing works
Tran, M. T. N., Luong, Q. H., Le Minh, G., Dunne, M. P., & Baker, P. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.512076 · Cited by 42 · see citing works
“(63) showed 42% of ATS dependence in the community were diagnosed with schizophrenia or schizoaffective disorder.”
BackgroundRBANS neuropsychological profiles within schizophrenia samples recruited from non-clinical settings
Loughland, C. M., Lewin, T. J., Carr, V. J., Sheedy, J., & Harris, A. W. F. (2006) · Schizophrenia Research · doi:10.1016/j.schres.2006.08.022 · Cited by 42 · see citing works
Self-citationReasons for substance use among people with psychotic disorders: Method triangulation approach.
Thornton, L. K., Baker, A., Johnson, M. P., KAY‐LAMBKIN, F. J., & Lewin, T. J. (2011) · Psychology of Addictive Behaviors · doi:10.1037/a0026469 · Cited by 40 · see citing works
Self-citationTreatment development for psychosis and co-occurring substance misuse: A descriptive review
Barrowclough, C., Haddock, G., Fitzsimmons, M., & Johnson, R. (2006) · Journal of Mental Health · doi:10.1080/09638230600998920 · Cited by 40 · see citing works
Beaulieu, S., Saury, S., Sareen, J., Tremblay, J., Schütz, C. G., McIntyre, R. S., & Schaffer, A. (2012) · Annals of Clinical Psychiatry · doi:10.1177/104012371202400105 · Cited by 38 · see citing works
“117 Therefore, the assessment in this paper does not suggest a significant advantage with MI plus CBT. ACT .”
A review of psychological and pharmacological treatment options for methamphetamine dependence
Ciketic, S., Hayatbakhsh, M. R., Doran, C. M., Najman, J. M., & McKetin, R. (2012) · Journal of Substance Use · doi:10.3109/14659891.2011.592900 · Cited by 36 · see citing works
Treatment of substance use disorders in schizophrenia
Bennett, M. E., Bradshaw, K., & Catalano, L. T. (2016) · The American Journal of Drug and Alcohol Abuse · doi:10.1080/00952990.2016.1200592 · Cited by 35 · see citing works
“found no differences between experimental and control conditions (44,48,51).”
BackgroundBaker, A., Turner, A., KAY‐LAMBKIN, F. J., & Lewin, T. J. (2009) · Addictive Behaviors · doi:10.1016/j.addbeh.2009.02.002 · Cited by 34 · see citing works
Self-citationBaker, A., RICHMOND, R. L., KAY‐LAMBKIN, F. J., Filia, S., Castle, D. J., Williams, J. M., Lewin, T. J., Clark, V. L., Callister, R., & Palazzi, K. L. (2017) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/0004867417714336 · Cited by 34 · see citing works
Self-citationTreatment of amphetamine abuse/use disorder: a systematic review of a recent health concern
Khoramizadeh, M., Effatpanah, M., Mostaghimi, A., Rezaei, M., Mahjoub, A., & Shishehgar, S. (2019) · DARU Journal of Pharmaceutical Sciences · doi:10.1007/s40199-019-00282-3 · Cited by 33 · see citing works
“5%) follow-ups with no significant between-group differences [22].”
BackgroundMethodKlimas, J., Field, C. J., Cullen, W., O’Gorman, C. S., Glynn, L. G., Keenan, E., Saunders, J. A., Bury, G., & Dunne, C. P. (2012) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd009269.pub2 · Cited by 31 · see citing works
Muriungi, S. K., & Ndetei, D. M. (2013) · South African Journal of Psychiatry · doi:10.4102/sajpsychiatry.v19i2.401 · Cited by 37 · see citing works
Graham, H. L., Copello, A. G., Griffith, E., Freemantle, N., McCrone, P., Clarke, L., Walsh, K. S., Stefanidou, C. A., Rana, A., & Birchwood, M. J. (2015) · Acta Psychiatrica Scandinavica · doi:10.1111/acps.12530 · Cited by 30 · see citing works
Associations between psychotic symptoms and substance use in young offenders
Degenhardt, L. J., Coffey, C., Hearps, S. J. C., Kinner, S. A., Borschmann, R., Moran, P., & Patton, G. C. (2015) · Drug and Alcohol Review · doi:10.1111/dar.12280 · Cited by 28 · see citing works
Treatment for amphetamine psychosis
SHOPTAW, S. J., Kao, U. H., & Ling, W. W. (2008) · doi:10.1002/14651858.cd003026.pub2 · Cited by 28 · see citing works
Siddiqui, S., Mehta, D. D., Coles, A. S., Selby, P. L., Solmi, M., & Castle, D. J. (2024) · Schizophrenia Bulletin · doi:10.1093/schbul/sbae101 · Cited by 22 · see citing works
McCarter, K. L., Halpin, S. A., Baker, A., KAY‐LAMBKIN, F. J., Lewin, T. J., Thornton, L. K., Kavanagh, D. J., & Kelly, B. J. (2016) · BMC Psychiatry · doi:10.1186/s12888-016-0937-z · Cited by 22 · see citing works
Self-citationKaner, E., Brown, N., & Jackson, K. (2011) · Mental Health and Substance Use · doi:10.1080/17523281.2011.533449 · Cited by 22 · see citing works
Assessing the capacity of parents with mental illness: Parents with mental illness and risk
Boursnell, M. (2012) · International Social Work · doi:10.1177/0020872812445197 · Cited by 21 · see citing works
Muriungi, S. K., & Ndetei, D. M. (2013) · South African Journal of Psychiatry · doi:10.7196/sajp.401 · Cited by 20 · see citing works
Martinez Agulleiro, L., Patil, B., Firth, J., Sawyer, C., Amann, B. L., Fonseca, F., Torrens, M., Perez, V., Castellanos, F. X., Kane, J. M., et al. (2023) · Psychological Medicine · doi:10.1017/s003329172300123x · Cited by 19 · see citing works
“…behavioral therapy, motivational interviewing, and contingency reinforcement have demonstrated short-term efficacy in some trials, other studies have shown no effects (Baker et al., 2006; Cather et al., 2017; Gelkopf et al., 2012; Gold et al., 2018; Lum et al., 2018; Williams et al., 2010).”
BackgroundRichardson, T. H., Dasyam, B., Courtney, H., White, L., Tedbury, J., Butt, J., & Newman‐Taylor, K. (2019) · British Journal of Clinical Psychology · doi:10.1111/bjc.12222 · Cited by 19 · see citing works
Harm Reduction for Injection Drug Users with Infective Endocarditis: A Systematic Review
Bahji, A., Yanagawa, B., & Lamba, W. (2020) · The Canadian Journal of Addiction · doi:10.1097/cxa.0000000000000080 · Cited by 19 · see citing works
Mental illness and substance use: An Australian perspective
Munro, I., & Edward, K. (2008) · International Journal of Mental Health Nursing · doi:10.1111/j.1447-0349.2008.00541.x · Cited by 19 · see citing works
Bradizza, C. M., Maisto, S. A., Vincent, P. C., Stasiewicz, P. R., Connors, G. J., & Mercer, N. D. (2009) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0017320 · Cited by 18 · see citing works
“…studies providing group and/or individual treatment have found rates of return to post-treatment alcohol and drug use are similarly high (e.g., Baker et al., 2006; Graeber, Moyers, Griffith, Guajardo, & Tonigan, 2003; Hellerstein, Rosenthal & Miner, 2001; Kavanagh et al., 2004; Meisler,…”
BackgroundAssociation between alcoholic interventions and abstinence rates for alcohol use disorders
Gao, J., Cao, J., Guo, T., & Xiao, Y. (2018) · Medicine · doi:10.1097/md.0000000000013566 · Cited by 17 · see citing works
Alammehrjerdi, Z., Briggs, N., Biglarian, A., Mokri, A., & Dolan, K. A. (2019) · Journal of Psychoactive Drugs · doi:10.1080/02791072.2019.1578445 · Cited by 18 · see citing works
“These findings are consistent with the results of other studies in terms of both significance and magnitude of effects (Baker, Boggs, and Lewin 2001; Baker et al. 2006, 2005).”
BackgroundResultInfluentialNursing considerations for dual diagnosis in mental health
Edward, K., & Munro, I. (2009) · International Journal of Nursing Practice · doi:10.1111/j.1440-172x.2009.01731.x · Cited by 17 · see citing works
Bradley, A. C., Baker, A., & Lewin, T. J. (2007) · Australian & New Zealand Journal of Psychiatry · doi:10.1080/00048670701332300 · Cited by 17 · see citing works
Self-citationPredictors of stimulant abuse treatment outcomes in severely mentally ill outpatients
Angelo, F., McDonell, M. G., Lewin, M. R., Srebnik, D. S., Lowe, J. M., Roll, J. M., & Ries, R. K. (2012) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2012.11.017 · Cited by 16 · see citing works
Psychosocial Interventions in Reducing Cannabis Use in Early Phase Psychosis
Aydin, C. M., Tibbo, P. G., & Ursuliak, Z. (2016) · The Canadian Journal of Psychiatry · doi:10.1177/0706743716639931 · Cited by 15 · see citing works
Petros, R., Walker, D. D., Pierce, A. R., & Monroe‐DeVita, M. (2023) · Journal of Dual Diagnosis · doi:10.1080/15504263.2023.2226024 · Cited by 15 · see citing works
“Authors concluded that MIþCBT is acceptable to the population with possible harm reduction benefits.”
BackgroundMethodInfluentialHjorthøj, C. R., Fohlmann, A., Larsen, A., Madsen, M. T. R., Vesterager, L., Gluud, C. N., Arendt, M. C. B. B., & Nordentoft, M. (2008) · Trials · doi:10.1186/1745-6215-9-42 · Cited by 15 · see citing works
Implications of research on comorbidity for the nature and management of substance misuse
Mueser, K. T., Kavanagh, D. J., & Brunette, M. F. (2007) · Translation of Addictions Science Into Practice · doi:10.1016/b978-008044927-2/50063-8 · Cited by 14 · see citing works
Epidemiological trends and the advances of treatments of amphetamine‐type stimulants (ATS) in China
Sun, H., Chen, H., Yang, F., Lü, L., & Kosten, T. R. (2014) · American Journal on Addictions · doi:10.1111/j.1521-0391.2014.12116.x · Cited by 14 · see citing works
The influence of cannabis use expectancies on cannabis use and psychotic symptoms in psychosis
Hides, L. M., Kavanagh, D. J., Dawe, S., & Young, R. M. (2008) · Drug and Alcohol Review · doi:10.1080/09595230802130158 · Cited by 13 · see citing works
Lykke, J., Oestrich, I. H., Austin, S. F., & Hesse, M. (2010) · Journal of Dual Diagnosis · doi:10.1080/15504260903498763 · Cited by 12 · see citing works
“Cognitive behavioral interventions, often used in conjunction with motivational interviewing, have shown some promise in the treatment of dual diagnosis (Barrowclough et al., 2001, Haddock et al., 2003, Baker et al., 2006).”
MethodClinical Outcomes From a 10-Week Follow-Up Psychoeducational Program for Dual Diagnosis
Chilton, J., Crone, D., & Tyson, P. J. (2018) · Journal of Dual Diagnosis · doi:10.1080/15504263.2018.1431420 · Cited by 12 · see citing works
“The measure has sound psychometric properties (Zigmond & Snaith, 1983), and has been previously used in a similar population group (Baker et al., 2006). iii) The Warwick-Edinburgh Mental Well-being Scale (WEMWBS) (Tennant et al., 2007) is a measure of mental well-being focusing entirely on positive…”
&NA; (1988) · The Nurse Practitioner · doi:10.1097/00006205-198805000-00009 · Cited by 12 · see citing works
Giguère, S., Potvin, S., Beaudoin, M., Dellazizzo, L., Giguère, C., Fürtös, A., Gilbert, K., Phraxayavong, K., & Dumais, A. (2023) · Journal of Personalized Medicine · doi:10.3390/jpm13050766 · Cited by 10 · see citing works
Doppeldiagnose Psychose und Sucht - Grundlagen und Therapie
Gouzoulis‐Mayfrank, E. (2008) · Zeitschrift für Kinder- und Jugendpsychiatrie und Psychotherapie · doi:10.1024/1422-4917.36.4.245 · Cited by 10 · see citing works
Australians Living with and Managing Hepatitis C
O’Brien, A. P., Cross, W. M., Higgs, P., Munro, I., Bloomer, M. J., & Chou, K. (2010) · Issues in Mental Health Nursing · doi:10.3109/01612841003629532 · Cited by 10 · see citing works
“Investigating substance abuse in people with psychotic disorders, Baker et al. (2006) found little evidence of treatment-specific benefits with no significant differences between the treatment and control groups.”
BackgroundInfluentialCognitive-behavioural treatment for amphetamine-type stimulants (ATS)-use disorders
Harada, T., Tsutomi, H., Mori, R., & Wilson, D. B. (2019) · Campbell Systematic Reviews · doi:10.1002/cl2.1026 · Cited by 9 · see citing works
“…such as women (Ruglass, Hien, Hu, & Campbell, 2014), MSM (Reback & Shoptaw, 2014; Santos et al., 2014; Shoptaw et al., 2008), people with co‐occurring disorders (Baker et al., 2006; Barrowclough et al., 2009; Beutler et al., 2003), and ethnic minorities (Witkiewitz, Greenfield, & Bowen, 2013).”
Schizophrenia and psychotic disorders
Bucci, S., & Tarrier, N. (2010) · Cambridge University Press eBooks · doi:10.1017/cbo9780511781919.012 · Cited by 9 · see citing works
Self-citationStuart, A., Baker, A. L., Bowman, J., McCarter, K., Denham, A. M. J., Lee, N., Colyvas, K., & Dunlop, A. (2017) · BMJ Open · doi:10.1136/bmjopen-2016-015383 · Cited by 7 · see citing works
“Treatment retention can be difficult for MA users in psychological treatment.21 Pharmacotherapies have been used in conjunction with the aim of improving treatment engagement and retention;21 however, research on the efficacy of pharmacotherapies to date has produced inconsistent results.22 There is no evidence to sug…”
BackgroundSelf-citationSequential behavioral treatment of smoking and weight control in bipolar disorder
Filia, S., Baker, A., Kulkarni, J., & Williams, J. M. (2012) · Translational Behavioral Medicine · doi:10.1007/s13142-012-0111-1 · Cited by 7 · see citing works
“Several studies have found MI to be an effective and feasible treatment option for tackling comorbid substance use (mainly cannabis and alcohol) among people with psychosis [39–42] and smoking cessation in people with psychosis [24, 25].”
BackgroundSelf-citationdeVille, M., Baker, A., Lewin, T. J., Bucci, S., & Loughland, C. M. (2010) · Psychiatry Research · doi:10.1016/j.psychres.2010.08.025 · Cited by 7 · see citing works
“, 2004), provided a unique opportunity to combine the two data sources (Loughland et al., 2004; Baker et al., 2006) in order to examine associations between substanceuse, course of psychotic disorder and neuropsychological functioning.”
BackgroundSelf-citationChallenges to relapse prevention: Psychiatric care of Indigenous in-patients
Nagel, T. M., Thompson, C., & Spencer, N. (2008) · Advances in Mental Health · doi:10.5172/jamh.7.2.112 · Cited by 7 · see citing works
- Authors
- Baker, A., Bucci, S., Lewin, T. J., Kay-Lambkin, F., Constable, P. M., & Carr, V. J.
- Affiliations
- University of Newcastle Australia (AU)
- Corresponding author
- Baker, Amanda
- Venue
- British Journal of Psychiatry
- Publisher
- Royal College of Psychiatrists
- Published
- 2006-05
- Volume
- 188
- Issue
- 5
- Pages
- 439-448
- ISSN
- 0007-1250 (ISSN-L)
- 1472-1465
- OpenAlex
- W1986489757
- Cited by
- 159
- References
- 40
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 5 · 2023: 7 · 2022: 2 · 2021: 2 · 2020: 2 · 2019: 7 · 2018: 11 · 2017: 6 · 2016: 7 · 2015: 7 · 2014: 7 · 2013: 10 · 2012: 10
- FWCI
- 10.74
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The British Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Research Explorer (The University of Manchester) (publishedVersion, other-oa)
- Funders
- Medical Research Council
- National Health and Medical Research Council (100967)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- cognitive behavioral therapy, motivational interviewing, substance use disorders, psychosis, alcohol consumption, cannabis use, amphetamine use, depression, general functioning, brief intervention
- MeSH terms
- Adolescent, Adult, Female, Humans, Male, Middle Aged, New South Wales, Psychotic Disorders, Cognitive Behavioral Therapy, Treatment Outcome, Substance-Related Disorders
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