Treatment for Comorbid Social Anxiety and Alcohol Use Disorders.
| Status: | Recruiting |
|---|---|
| Conditions: | Anxiety, Healthy Studies, Psychiatric |
| Therapuetic Areas: | Psychiatry / Psychology, Other |
| Healthy: | No |
| Age Range: | 18 - 65 |
| Updated: | 5/4/2018 |
| Start Date: | March 15, 2018 |
| End Date: | April 30, 2020 |
| Contact: | Nick Pistolesi, BA |
| Email: | Npistolesi@mednet.ucla.edu |
| Phone: | 310-267-5324 |
Developing and Evaluating a Fully Integrated Treatment Program for Comorbid Social Anxiety and Alcohol Use Disorders
Alcohol use disorders (AUD) and social anxiety disorder (SAD) are highly comorbid and
associated with significant impairment. Social anxiety comorbidity is associated with poorer
addiction treatment engagement and outcomes. Thus, addressing underlying SAD symptoms that
may lead to and maintain alcohol problems, as well as undermine successful treatment for AUD,
is warranted. This proposal aims to develop and evaluate a fully integrated outpatient
program for comorbid SAD and AUD that weaves evidence-based treatment for SAD (i.e.,
exposure-based cognitive behavioral therapy) into a traditional, evidence-based treatment for
AUD.
First, the investigators will develop the protocol for the fully integrated treatment (FIT).
The overarching goal of FIT will be to simultaneously deliver AUD and SAD treatment.
Development will be an iterative process guided by previous research (including our own), and
by input from clinicians, administrators, and patients in an outpatient substance use
disorder treatment clinic. After the protocol is developed, the investigators will use their
established clinician training procedures to train clinicians at their community partnered
clinic to competently deliver the intervention. After protocol development and clinician
training, the investigators will conduct a pilot randomized clinical trial (RCT) comparing
the efficacy of our fully integrated treatment (FIT) for comorbid alcohol use and social
anxiety disorders to usual care (UC) in the community substance use disorder specialty
clinic. The goals of the RCT will be to gather data regarding acceptability, feasibility, and
preliminary efficacy of the FIT protocol. The investigators will randomize treatment-seeking
participants (N = 60) who have comorbid SAD and AUD. The investigators will assess treatment
engagement, social anxiety outcomes, and alcohol use outcomes at baseline, 3-months, and
6-months from baseline. The investigators will also gather qualitative and quantitative
acceptability data from patients after completing FIT, which may guide final refinements of
FIT prior to testing in a larger-scale grant.
The knowledge gained from this investigation has the potential to significantly improve the
treatment of alcohol use disorders and make a significant public health impact. The focus on
direct translation to community practice paradigms and the emphasis on full mental health and
addiction treatment integration significantly advance the field.
associated with significant impairment. Social anxiety comorbidity is associated with poorer
addiction treatment engagement and outcomes. Thus, addressing underlying SAD symptoms that
may lead to and maintain alcohol problems, as well as undermine successful treatment for AUD,
is warranted. This proposal aims to develop and evaluate a fully integrated outpatient
program for comorbid SAD and AUD that weaves evidence-based treatment for SAD (i.e.,
exposure-based cognitive behavioral therapy) into a traditional, evidence-based treatment for
AUD.
First, the investigators will develop the protocol for the fully integrated treatment (FIT).
The overarching goal of FIT will be to simultaneously deliver AUD and SAD treatment.
Development will be an iterative process guided by previous research (including our own), and
by input from clinicians, administrators, and patients in an outpatient substance use
disorder treatment clinic. After the protocol is developed, the investigators will use their
established clinician training procedures to train clinicians at their community partnered
clinic to competently deliver the intervention. After protocol development and clinician
training, the investigators will conduct a pilot randomized clinical trial (RCT) comparing
the efficacy of our fully integrated treatment (FIT) for comorbid alcohol use and social
anxiety disorders to usual care (UC) in the community substance use disorder specialty
clinic. The goals of the RCT will be to gather data regarding acceptability, feasibility, and
preliminary efficacy of the FIT protocol. The investigators will randomize treatment-seeking
participants (N = 60) who have comorbid SAD and AUD. The investigators will assess treatment
engagement, social anxiety outcomes, and alcohol use outcomes at baseline, 3-months, and
6-months from baseline. The investigators will also gather qualitative and quantitative
acceptability data from patients after completing FIT, which may guide final refinements of
FIT prior to testing in a larger-scale grant.
The knowledge gained from this investigation has the potential to significantly improve the
treatment of alcohol use disorders and make a significant public health impact. The focus on
direct translation to community practice paradigms and the emphasis on full mental health and
addiction treatment integration significantly advance the field.
In this study, potential participants will be screened either by University of California,
Los Angeles (UCLA) staff or at the Matrix Institute on Addiction to determine whether they
may have social anxiety and alcohol use disorder symptoms. If they screen positive for these
symptoms, they will be invited to come in for a comprehensive baseline assessment consisting
of interviews, questionnaires, and a behavioral assessment. Eligible participants will be
randomly assigned to either receive standard Matrix treatment consisting of a 9-hour per week
Intensive Outpatient Program (IOP) lasting approximate 2-3 months; or FIT, an Intensive
Outpatient Program (also 9 hours per week for approximately 2-3 months) consisting of
cognitive behavioral therapy (CBT) for social anxiety disorder that is woven into the alcohol
recovery program. After treatment, participants will complete another assessment, and then
will complete one several months later.
Los Angeles (UCLA) staff or at the Matrix Institute on Addiction to determine whether they
may have social anxiety and alcohol use disorder symptoms. If they screen positive for these
symptoms, they will be invited to come in for a comprehensive baseline assessment consisting
of interviews, questionnaires, and a behavioral assessment. Eligible participants will be
randomly assigned to either receive standard Matrix treatment consisting of a 9-hour per week
Intensive Outpatient Program (IOP) lasting approximate 2-3 months; or FIT, an Intensive
Outpatient Program (also 9 hours per week for approximately 2-3 months) consisting of
cognitive behavioral therapy (CBT) for social anxiety disorder that is woven into the alcohol
recovery program. After treatment, participants will complete another assessment, and then
will complete one several months later.
Inclusion Criteria:
- Participants must be currently enrolled in the IOP at Matrix Institute (our community
partner) for the treatment of their alcohol use disorder;
- fluent in English;
- meet the DSM-5 criteria for social anxiety disorder and alcohol use disorder
Exclusion Criteria:
- marked cognitive impairment
- moderate to severe suicidality
- unstable manic or psychotic symptoms.
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