Social skills training teaches patients how to form and maintain interpersonal relationships.

Stress management teaches individuals relaxation strategies and other ways to reduce tension and manage stress.

Although more research has been done examining psychosocial treatments for alcohol addiction, recent studies indicate differences between various therapies in cocaine treatment. For example, one study compared cocaine-addicted patients randomly assigned to either behavioral counseling, based on the community reinforcement model, or drug abuse counseling, based on a disease model (Higgins et al., 1993). The study found that 58 percent of the patients in the behavioral counseling group completed the 24-week, outpatient treatment, compared to only 11 percent in the drug abuse counseling group. Further, at 8 weeks, 68 percent of the behavioral counseling group maintained complete abstinence from cocaine, compared to only 11 percent in the other group; at 16 weeks, 42 percent of the behavioral and 5 percent of the drug abuse group had maintained abstinence. Even with pharmacotherapy for depression, psychosocial therapy may provide added benefits according to a study in which patients were randomly assigned to one of four conditions: relapse prevention therapy (a cognitive behavioral approach) and antidepressant medication (desipramine); clinical management and antidepressant; relapse prevention and placebo; or clinical management and placebo (Carroll et al., 1994a). Although neither the psychosocial therapy nor pharmacotherapy condition was associated with treatment retention or reduction in cocaine use, the more intensive relapse prevention approach was associated with higher abstinence in patients with more severe addiction and greater responses to treatment by depressed patients. In a follow-up study at one year, this research group found that the effect of psychotherapy increased over time, producing a delayed, but significantly improved outcome (Carroll et al., 1994b).

Treating accompanying psychiatric symptoms with pharmacotherapy and other means also has been shown to be useful in alcoholism treatment. A randomized controlled trial found depressed patients treated with the antidepressant, desipramine, remained abstinent from alcohol longer than controls (Mason et al., 1996). Another study with actively drinking, depressed outpatients found a marked reduction in alcohol consumption (McGrath et al., 1996). Similarly, treatment of anxiety with buspirone resulted in longer retention, reduced anxiety, and fewer drinking days in anxious alcoholics (Kranzler et al., 1994).



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