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Evidence-based Principles of Treatment (EPT) for Drug Abuse & Other Problems

Evidence-based Principles of Treatment (EPT) for Drug Abuse & Other Problems. Funded by the National Institute on Drug Abuse 2004 –2007 [R01 DA016600-02] Frank S. Pearson, Ph.D., Principal Investigator National Development & Research Institutes, Inc.,

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Evidence-based Principles of Treatment (EPT) for Drug Abuse & Other Problems

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  1. Evidence-based Principles of Treatment (EPT) for Drug Abuse & Other Problems • Funded by the National Institute on Drug Abuse 2004 –2007 [R01 DA016600-02] • Frank S. Pearson, Ph.D., Principal Investigator • National Development & Research Institutes, Inc., • Deborah Podus, Ph.D., Co-PI/Project Director • Michael Prendergast, Ph.D., Co-Principal Investigator • UCLA Integrated Substance Abuse Programs (ISAP)

  2. Background: Theory (1999) • NIDA lists 13 principles of effective treatment: • National Institute on Drug Abuse. (1999) • Principles of Drug Addiction Treatment [Web Page]. URL http;//165.112.78.61/PODAT1.html [2002, June 20].

  3. Evidence-based Principles of Treatment (EPT) – the current Meta-Analytic Review • Focuses on principles of effective treatment more than on treatment modalities • Draws on the coding systems and the data found in • NDRI’s CDATE meta-analyses (Lipton & Pearson) • UCLA’s ISAP meta-analyses (Prendergast & Podus) • The new EPT project expands to: • Moderators of treatment effectiveness • Reports published since the close of the two earlier projects (1995 and 1996) to 2007

  4. NIDA Principles  EPT Hypotheses • NIDA # 1: Matching treatment settings, interventions, and services to each individual's particular problems and needs is critical to his or her ultimate success in returning to productive functioning in the family, workplace, and society. • EPT Hypothesis 1: Studies in which treatment settings, interventions, and/or services were matched to each individual’s particular problems and needs will have a larger mean effect size than studies in which such matched treatment was not delivered.

  5. NIDA Principles  EPT Hypotheses • NIDA # 5: The appropriate duration of treatment for an individual depends on his or her problems and needs... Research indicates that for most patients, the threshold of significant improvement is reached at about 3 months in treatment. • EPT Hypothesis 3: … [Next slide]

  6. NIDA Principles  EPT Hypotheses • EPT Hypothesis 3: Studies in which the reported average length of time that subjects actually participated in treatment was greater than or equal to 3 months will have a larger mean effect size than studies in which the average length of time that subjects actually participated in treatment was less than 3 months. • EPT Hypothesis 3: Studies in which the planned time in treatment was greater than or equal to 3 months will have a larger mean effect size than studies in which the panned time in treatment was less than 3 months.

  7. NIDA Principles  EPT Hypotheses • NIDA # 6: Counseling (individual and/or group) and other behavioral therapies are critical components of effective treatment for addiction. • EPT Hypothesis 11: Counseling programs that usebehavioral / cognitive behavioral techniqueswill have a larger mean effect size than counseling programs using other principles or unstructured counseling.

  8. NIDA Principles  EPT Hypotheses • NIDA # 8: Addicted or drug-abusing individuals with coexisting mental disorders should have both disorders treated in an integrated way. • EPT Hypothesis 12: Programs of integrated treatment for individuals withco-occurring mental illness and substance abuse disorder(COD) will have a larger mean effect size than programs using unintegrated treatment, i.e., separate or serial treatment.

  9. NIDA Principles  EPT Hypotheses • NIDA # 13: Participation in self-help support programs during and following treatment often is helpful in maintaining abstinence. • EPT Hypothesis 14 : Programs that include self-help support programs during and following treatment will have a larger mean effect size than programs that do not.

  10. Example for Hypothesis 3 • EPT Hypothesis 3 (NIDA principle 5: “the threshold of significant improvement is reached at about 3 months in treatment”) • … is investigated as a moderator variable for counseling programs.

  11. Length of Tx as Moderator Variable in Counseling Programs

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