Category: Treatment - CBT

Symposium

Coordinated Anxiety Learning and Management for Addiction Recovery Centers: Adherence, Outcomes, Moderators, and Mediators

Saturday, November 18
10:15 AM - 11:45 AM
Location: Aqua Salon E & F, Level 3, Aqua Level

Keywords: Addictive Behaviors | Transdiagnostic | Anxiety
Presentation Type: Symposium

The majority of individuals with comorbid anxiety and substance use disorders who receive treatment are treated for their addiction in specialty clinics but do not receive treatment for their anxiety disorders, which are associated with poorer substance use treatment outcomes and greater disability than those with substance use disorders (SUD) only. The present study aimed to develop and evaluate an adaptation of a computerized, therapist-directed CBT program for anxiety disorders (CALM) to increase access to EBTs for anxiety in this comorbid population. 


The CALM program was adapted to be suitable for delivery in addictions treatment centers for patients with comorbid anxiety and SUD. After training addictions treatment counselors to deliver the brief, group-based treatment, which we called CALM for Addiction Recovery Centers (CALM ARC), we conducted a randomized clinical trial (N = 75) comparing usual care at the SUD treatment clinic (UC) to UC + CALM ARC. Outcomes (measured at baseline, post-treatment, and 6-mo follow-up) include measures of feasibility, acceptability, and anxiety and substance use symptom outcomes.


Therapists demonstrated competency in delivering the treatment and high fidelity to the protocol. Patients in CALM ARC showed steeper anxiety and depression symptom decline slopes across treatment and through follow-up than in UC. At post-treatment, patients in CALM ARC reported greater improvements in quality of life, fewer drinking days in the past month, fewer days of drug use in the past month, and had greater percentages of negative urinalysis. Some of these findings, but not all, were maintained at a 6-mo follow-up. Few predictors and moderators of outcome were observed. Change in anxiety sensitivity mediated change in anxiety outcomes. Changes in anxiety symptoms mediated change in substance use outcomes.


Delivery of CBT for anxiety in addictions counseling centers is feasible and acceptable and results in significant benefit following treatment. Longer durations of treatment or additional booster sessions may be warranted to improve maintenance of treatment gains over longer follow-up periods.

Kate Wolitzky-Taylor

Associate Professor
UCLA

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