Editors' note

This chapter reviews empirically validated psychological therapies for adults with substance use problems. There is not a corresponding chapter in this section for psychopharmacologic treatment for substance dependence because psychopharmacology in these disorders is much more limited and may be substance class specific. Psychopharmacologic approaches are covered in the chapters on the specific disorders, while the psychological therapies, almost all of which fall into the broader psychological therapy categories, can extend across the classes of substances that are frequently misused. CBT, especially when accompanied by contingency management, is effective in cocaine and opioid dependence, while CBT alone is effective in cocaine and cannabis abuse. Contingency management with vouchers may also, by itself, be effective in cocaine and opioid abuse as well. Behavioral couples therapy appears to be effective in reducing opioid and cocaine use. Motivational interviewing appears effective in alcohol or cannabis misuse in adults. Other forms of psychological/psychosocial therapy may be effective for other types of substance misuse, but the empirical evidence is not as strong. Often these interventions are combined with some psychopharmacologic intervention that has been shown to reduce, in some instances, craving for the particular substance. Sections of this chapter are adapted from Carroll, 2000; Carroll & Onken, 2005, McGovern & Carroll, 2003, and Rounsaville & Carroll, 1997, and are used here with permission.

Introduction

During the past 10–15 years, tremendous gains have been made in the development of effective psychological therapies for drug abuse and dependence for adults.