Table 2.
Reviews of CBT Efficacy for AOD
| Author (Date) | Country of Origin | Article Type | Sample Description | Key Outcomes | Key Findings |
|---|---|---|---|---|---|
| Cognitive Behavioral Therapy | |||||
| Carroll (1997)19 | USA, with USA-based studies | Narrative review | 24 randomized clinical trials targeting smoking, alcohol, cannabis, cocaine, polysubstance use | Rates of abstinence/relapse, quantity and frequency of use, psychosocial functioning measures | -Evidence strongest for smoking -Evidence strongest in comparison to minimal treatment control conditions -Efficacy in comparison to attention-control and active intervention mixed |
| Irvin et al (1999)20 | USA, with international sample of studies | Meta-analysis | 26 randomized and uncontrolled trials targeting smoking, alcohol, cocaine, polysubstance use | Rates of abstinence/ relapse separated by self-report and biochemical validation, psychosocial functioning measures | -Evidence strongest for alcohol -Evidence strongest in comparison to minimal treatment and attention control conditions -Efficacy in comparison to active intervention not supported -Larger effect sizes when combined with pharmacotherapy and when outcomes were measured at early follow-up |
| Magill and Ray (2009)21 | USA, with international sample of studies | Meta-analysis | 53 randomized trials targeting alcohol, cannabis, cocaine, opioids, polysubstance use | Quantity and frequency of use, psychosocial functioning measures | -Evidence strongest for cannabis -Efficacy in comparison to minimal treatment, attention control, treatment as usual, and active conditions -Larger effect sizes when combined with another psychosocial treatment, pharmaco-therapy and when outcomes were measured at early follow-up |
| Magill et al (2019)22 | USA, with international sample of studies | Meta-analysis | 30 randomized trials targeting alcohol, cannabis, cocaine, opioids, polysubstance use | Quantity and frequency of use | -Evidence strongest in comparison to minimal treatment, attention control, and treatment as usual -Efficacy in comparison to active intervention not supported -Larger effect sizes for early follow-up and quantity outcomes |
| Cognitive BehavioralTherapy combined with another psychosocial therapy | |||||
| Riper et al (2014)27 | Netherlands, with international sample of studies | Meta-analysis | 32 randomized and non-randomized trials of CBT combined with motivational interviewing for alcohol use and co-occurring major depressive disorder | Rates of abstinence/ relapse, quantity and frequency of use, depression symptoms | -Evidence strongest in comparison to treatment as usual -Efficacy of combined treatment compared to either treatment alone not reported -Larger effect sizes for integrated treatment, non-randomized studies |
| Carroll and Kiluk (2017)1 | USA, with international sample of studies | Narrative review | Broad overview of CBT for substance use history, efficacy, effectiveness, and implementation | Rates of abstinence/relapse, quantity and frequency of use | -CBT combined with motivational interviewing or contingency management may offer added benefit at early stages of treatment |
| Farronato et al (2013)28 | Switzerland, with international sample of studies | Systematic review | 8 randomized clinical trials of CBT combined with contingency management for cocaine use | Abstinence determined by self-report or biochemical validation use, retention in treatment | -Contingency management associated with early treatment gains -CBT associated with durable outcomes -Evidence mixed for added benefit of combination over either treatment alone |
| Cognitive BehavioralTherapy combined with pharmacotherapy | |||||
| Ray et al (2020)29 | USA, with international sample of studies | Meta-analysis | 30 randomized trials targeting alcohol, cocaine, opioid use | Quantity and frequency of use | -Evidence strongest in comparison to usual care combined with pharmacotherapy -Efficacy in comparison to active intervention plus pharmacotherapy not supported -Larger effect sizes for alcohol studies |
| van Amsterdam et al (2022)30 | Netherlands, with international sample of studies | Systematic review | 28 randomized trials targeting alcohol use | Rates of abstinence/ relapse, quantity and frequency of use | -Greater proportion of studies supporting added value of combining pharmacotherapy with psychotherapy than combining psychotherapy with pharmacotherapy |
| Cognitive Behavioral Therapy delivered in a digital format | |||||
| Kiluk (2019)34 | USA, with USA-based studies | Narrative review | 6 randomized clinical trials of CBT4CBT | Rates of abstinence/ relapse, quantity and frequency of use, secondary measures of mechanistic outcomes (eg, coping skills) | -Evidence supporting use as addition to usual care and as stand-alone treatment (with minimal therapist facilitation) -Acquisition of coping skills may help explain therapeutic benefit |
| Shams et al (2021)35 | Canada, with international studies | Systematic review | 54 randomized and non-randomized trials, as well as program overviews of eCBT for substance use | Product descriptions, mechanism-outcome relationships | -Tailoring and consideration of cognitive functioning are important to outcome -Engagement with programs and a focus on the user experience are important future research implications |
| Kiluk et al (2019)37 | USA, with international sample of studies | Meta-analysis | 15 randomized clinical trials of digital-format CBT interventions | Quantity and frequency of use | -Evidence strongest in comparison to minimal treatment or as an addition to usual care -No evidence of superior efficacy to in-person CBT |
| Mechanisms and moderators of Cognitive Behavioral Therapy | |||||
| Morgenstern and Longabaugh (2000)39 | USA, with USA-based studies | Systematic review | 10 mediation studies of randomized clinical trials of CBT efficacy | Rates of abstinence/ relapse, quantity and frequency of use, secondary measures of mechanistic outcomes (eg, coping skills) | -No clear support for CBT mechanisms |
| Magill et al (2021)42 | USA, with USA-based studies | Systematic review | 15 mediation studies of randomized clinical trials of CBT efficacy | Rates of abstinence/ relapse, quantity and frequency of use, secondary measures of mechanistic outcomes (eg, coping skills) | -Evidence for CBT mechanisms limited -Clearest support for coping skills, self-efficacy, craving as CBT mechanisms -Mechanisms may not be unique to CBT and could be moderated by client or relationship factors. |
Note: Studies reported in the order they were reported in the current review manuscript.
Abbreviation: CBT, Cognitive Behavioral Therapy.