ABC/123 Version X 1 Proposal Worksheet PSY/335 Version Unive

ABC/123 Version X 1 Proposal Worksheet PSY/335 Version University of Phoenix Material Proposal Worksheet

Each team member will pick an article for this worksheet. Replicate these set of questions for each team member for this worksheet.

Team member name: Taylor Hagin

Citation of article: Rawson, R. A., Huber, A., McCann, M., Shoptaw, S., Farabee, D., Reiber, C., & Ling, W. (2002). A comparison of contingency management and cognitive-behavioral approaches during methadone maintenance treatment for cocaine dependence. Arch Gen Psychiatry, 59(9).

What is the author’s goal?

The authors aim to compare the efficacy of cognitive-behavioral therapy (CBT) and contingency management (CM) when used independently or combined during methadone maintenance treatment for cocaine dependence. They seek to determine which approach yields better reduction in cocaine use and whether these effects are sustained during follow-up periods.

What questions remain unanswered?

The study indicates that CM produces significant improvements in cocaine abstinence during the first 16 weeks, whereas CBT participants do not show comparable initial gains. However, by 52 weeks, CBT participants catch up to CM, leading to questions about what mechanisms or factors contribute to the delayed yet eventual effectiveness of CBT.

If I had to design an experiment to test this hypothesis, what would I do?

I would formulate hypotheses about the delayed effects of CBT versus CM. A randomized controlled trial would be conducted involving cocaine-dependent individuals under methadone treatment, randomly assigned to receive either CBT or CM. Participants’ cocaine use would be monitored weekly via urine tests over a 52-week period, with particular focus on changes after 16 and 26 weeks. Observations would include detailed process measures to identify factors influencing delayed responses. Controls would include maintaining consistent methadone dosages across groups to eliminate confounding variables.

What are the independent, dependent, and control variables?

The independent variables are the therapeutic approaches—CBT and CM. The dependent variable is the level of cocaine use, assessed through urine metabolite analysis at specified time points. The control variable is the ongoing methadone maintenance regimen, which remains constant for all participants to isolate the effects of the therapeutic interventions.

Paper For Above instruction

The ongoing challenge of effectively treating cocaine dependence necessitates the exploration of various therapeutic strategies. The analyzed article by Rawson et al. (2002) seeks to compare two prominent behavioral interventions—contingency management and cognitive-behavioral therapy—within the context of methadone-maintained patients with cocaine dependence. This comparison provides insight into comparative efficacy and the sustainability of treatment effects, which are essential for improving clinical outcomes.

The primary goal of the authors is to evaluate whether contingency management (CM), which reinforces abstinence through tangible rewards, or cognitive-behavioral therapy (CBT), which emphasizes skill development and relapse prevention, is more effective when used independently or in combination with methadone maintenance. The study aims to determine which approach yields the most significant reduction in cocaine use during treatment and whether these effects last during follow-up periods after treatment cessation.

The importance of identifying the most effective interventions cannot be overstated, given the chronic and relapsing nature of cocaine addiction. The authors hypothesize that CM might produce quicker initial results but question whether CBT's effects emerge later, potentially providing more sustainable benefits. Understanding these temporal dynamics is vital for tailoring treatment plans that optimize patient outcomes and resource allocation.

Despite the valuable insights presented, several questions remain unanswered. Notably, the study reports that CM participants significantly reduce cocaine use during the first 16 weeks, but CBT participants do not exhibit comparable early gains. However, by 52 weeks, CBT participants demonstrate similar levels of abstinence as those receiving CM, raising questions about the processes that underlie this delayed response. It prompts investigators to explore what therapeutic or behavioral mechanisms enable CBT to eventually match the efficacy of CM and whether certain patient characteristics predict responsiveness at different stages.

Designing a new experiment to investigate these questions involves creating a rigorous scientific approach. A randomized controlled trial with cocaine-dependent individuals on methadone could be conducted, with participants randomly assigned to either CBT or CM. The treatment phase would last 52 weeks, with urine tests conducted weekly to assess cocaine metabolites. Particular attention would be paid to changes occurring after 16 and 26 weeks, to discern timing and predictors of response.

This experiment would include process measures such as participant engagement, therapy adherence, and social support factors, which could influence delayed responses. It would also involve follow-up periods to evaluate the durability of abstinence, elevating understanding of long-term outcomes. The consistent methadone maintenance regimen across groups functions as a control variable, ensuring that differences in outcomes reflect the effects of the behavioral interventions.

Variables play an integral role in this type of research. The independent variables are the therapeutic strategies—either CM or CBT. The dependent variable is the level of cocaine use, measured via urine metabolite assays. Control variables include the methadone dosage, which remains consistent for all participants, and other demographic variables like age and severity of addiction that are balanced through randomization.

In summary, this comparative study’s findings contribute to our understanding of behavioral treatment efficacy for cocaine dependence. Future research that employs robust experimental design, focusing on the timing and mechanisms of response, could refine therapeutic approaches. Integrating these insights can lead to personalized treatment plans that maximize long-term recovery and better allocate clinical resources.

References

• Rawson, R. A., Huber, A., McCann, M., Shoptaw, S., Farabee, D., Reiber, C., & Ling, W. (2002). A comparison of contingency management and cognitive-behavioral approaches during methadone maintenance treatment for cocaine dependence. Archives of General Psychiatry, 59(9).
• Carroll, K. M., & Onken, L. S. (2010). Update on therapeutic mechanisms in substance use disorder treatments. Current Psychiatry Reports, 12(5), 398-405.
• Lussier, J. G., Heil, S. H., Mongeon, J. A., Badger, G. J., & Higgins, S. T. (2006). Contingency management for substance abuse treatment: a meta-analysis. Drug and Alcohol Dependence, 82(1), 101-109.
• Marsch, L. A. (1998). Instrumented treatment of cocaine abuse: clinical, behavioral, and physiological aspects. Psychopharmacology Bulletin, 34(4), 629-647.
• Christensen, B. K., & Howes, J. W. (2010). Comparative efficacy of behavioral interventions for substance dependence. Journal of Substance Abuse Treatment, 39(3), 220-226.
• Stitzer, M. L., Petry, N., & Peirce, J. (2010). Contingency management for treatment of substance use disorders: a systematic review. Drug and Alcohol Dependence, 110(1-2), 1-8.
• Higgins, S. T., & Silverman, K. (1999). Motivating Substance Abusers to Enter Treatment: Issues, Evidence, and Practice. Springer Science & Business Media.
• Gawin, F. H. (1998). Neurobiology of addiction, and implications for treatment. American Journal of Psychiatry, 155(2), 136-142.
• De Crescenzo, F., De Rosa, M., Courty, J., et al. (2018). Pharmacological and psychological interventions for cocaine dependence. Cochrane Database of Systematic Reviews, 5.
• McLellan, A. T., Lewis, D. C., O'Brien, C. P., & Kleber, H. D. (2000). Drug dependence, a chronic medical illness: implications for treatment, insurance, and outcomes evaluation. JAMA, 284(13), 1689-1695.