A Transtheoretical Model Group Therapy for Cocaine

Cocaine use in the general population is a significant and costly problem. Novel and
innovative interventions targeting cocaine abuse are needed. The Transtheoretical Model of
behavior change (TTM) offers a comprehensive framework for understanding, measuring, and
intervening in behavior change and provides a strong theoretical foundation upon which
effective treatments for substance abuse can be developed. The proposed Stage 1 research
will pilot test a novel and innovative behavioral group therapy for cocaine users based on
the TTM. In Phase 1, investigators will modify the newly developed Group Treatment for
Substance Abuse: A Stages-of-Change Therapy Manual (Velasquez, Maurer, Crouch & DiClemente,
2001) to specifically target cocaine abuse resulting in a twelve-session, group intervention
and accompanying therapy manual based on the TTM stages and processes of change: six "early
stage" sessions targeting the experiential processes of change, and six "later stage"
sessions targeting the behavioral processes of change. Phase 2 will consist of a pilot trial
to evaluate the TTM group therapy with cocaine abusing patients. A randomized, controlled,
between groups design will be used in which cocaine abusers (N=80) are assigned to one of
two group treatment conditions: TTM therapy or Education/Advice. Participants will be
recruited from Houston and surrounding communities through the Substance Abuse Research
Center at the University of Texas Health Science Center Mental Sciences Institute. We expect
the delivery of the TTM therapy for cocaine users to be feasible and acceptable, and to
produce significant patient improvement. Cocaine outcomes will be assessed via objective
(urine and drug analysis) and self-report measures. This Stage I research will contribute
important theoretical and empirical information concerning the promise of a new and
innovative intervention for cocaine abusers, and will provide the basis for a larger
efficacy trial.

Inclusion Criteria:

Inclusion Criteria: Male and female adults (ages 18-65 years old), of any race, who meet
DSM-IV criteria for cocaine abuse or dependence disorder will be recruited. In addition,
eligible participants must be:

- (1) judged to be in generally good physical and psychiatric health except for
possible acute drug related problems;

- (2) willing and able to participate in the 6-week, group outpatient treatment;

- (3) able to provide the name of at least one person who can generally locate their
whereabouts; and

- (4) willing to be followed for 3 months after treatment ends.

Potential subjects with simple drug charges whose legal contacts are willing to forego
data revelation will be included. Although cocaine dependence will be the primary drug for
which patients are seeking treatment, we will not exclude participants who are abusing
additional substances.

Exclusion Criteria:

Individuals will be ineligible for study participation based on the following criteria:

- (1) current diagnosis of an Axis I psychiatric disorder other than cocaine
dependence;

- (2) current psychiatric symptoms requiring medication;

- (3) severe medical, cognitive and /or psychiatric impairment that precludes
cooperation with study protocol;

- (4) substance withdrawal symptoms requiring medical attention;

- (5) currently receiving other psychosocial therapy for substance abuse with the
exception of AA, NA or CA;

- (6) impending incarceration;

- (7) inability to read, write, speak English;

- (8) inability or unwillingness to participate in the 6-week, group outpatient
treatment (e.g., halfway house or other aftercare program restrictions).