Distress Tolerance Treatment for Substance Users

Despite recent advances in substance abuse interventions, a large percentage of clients
entering residential treatment for substance use will drop out of treatment prematurely, and
of the remaining, many will relapse soon after treatment completion. Previous research
indicates that an individual's ability to withstand psychological distress is a key factor
necessary to maintain drug and alcohol abstinence and to remain in substance use treatment
without absconding. In previous work, Dr. Bornovalova developed a specific distress tolerance
treatment called Skills for Improving Distress Intolerance (SIDI). This intervention features
skills training in behavioral and acceptance strategies and intentional clinical exposure to
emotional distress. SIDI was developed and piloted with a sample of urban drug users seeking
treatment in a residential facility. Individuals receiving SIDI exhibited greater improvement
in distress tolerance than those in two comparison groups (receiving treatment-as-usual and
supportive counseling).

Current study. The investigators received NIDA funding to conduct a randomized clinical trial
with 325 clients entering a residential substance use treatment facility. Study participants
will be randomized into two treatment groups: (1) those receiving SIDI and (2) those
receiving Supportive Counseling (SC). Participants will receive 10 treatment sessions over a
period of 4 months. Then, the investigators will follow clients for one year to examine
treatment retention and abstinence.