Motivational Therapy for Substance Users With Depression

The primary objective of the study is to test the incremental efficacy and outcomes of an
aftercare program of Cognitive Behavioral Therapy combined with motivational therapy
(CBT-MT) relative to treatment as usual (TAU) in improving depression, substance use, and
healthcare outcomes in a population with drug dependence and comorbid major depressive
disorder (MDD). The investigators expect that among drug-dependent patients with comorbid
MDD, CBT-MT will yield better clinical outcomes relative to TAU in reducing depressive
symptoms and substance use and improving healthcare outcomes during treatment.

Secondary Objectives:

1. Test efficacy and outcomes of CBT-MT and TAU

2. Evaluate the differential effect of CBT-MT versus TAU on HIV-risk behavior of
participants,

3. To evaluate the impact of cognitive functioning on treatment retention and outcomes,
and

4. To explore additional psychosocial, demographic, and diagnostic factors (e.g., age,
gender, education level, motivation for change, social support) that may be associated
with treatment outcome and retention in this high need population.

This study will include approximately 80 participants randomized to either 12 weeks of
motivational therapy or treatment as usual. Both treatments will meet once weekly for 60
minutes. Participants will be recruited from the Adult Partial Hospitalization program at
UCLA. During the active treatment phase, participants will attend clinic weekly for
collection of data and urine specimens.

1. For those randomly assigned to CBT-MT, they will meet with a therapist in a group
format for 60-minute sessions once weekly.

a. Each CBT-MT session will begin with 20 minutes of motivational therapy (MT),
followed by 40 minutes of CBT content.

2. Those randomly assigned to TAU, they will attend a weekly 60-minute Dual Recovery
Anonymous self-help group.