Treatment

Treatment

Stream Description

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One in every two people will develop a mental health or substance use disorder during their lifetime. Our treatment research aims to develop and evaluate the efficacy of novel interventions to treat these disorders as well as their combination. Our research thus far has focused on the testing of psychotherapies and pharmacotherapies for individuals who have both a substance use disorder and the most common mental disorders including anxiety, depressive and psychotic disorders.

 

 

Completed Projects

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Randomised controlled trial of treatment for alcohol use problems and social phobia

Dr Claudia Sannibale, Prof Ronald Rapee, Mirjana Subotic
Funding Body: National Health and Medical Research Council
Description:

Alcohol use problems and social anxiety are common and disabling conditions that frequently co-occur.  Although there are efficacious treatments for each disorder, little is known about the best way to treat these problems when they co-exist.  Our team has developed an integrated treatment combining CBT and motivational interviewing to simultaneously address social anxiety and alcohol use disorders, and the interconnections between these problems. A randomised controlled trial of this treatment was conducted with individuals with both social anxiety and alcohol use disorder. The aim was to determine whether combined treatment would result in greater improvement in symptoms of social anxiety, alcohol use disorder or quality of life compared to CBT for alcohol alone.

Output:

Stapinski, L. et al (2015) The Clinical and Theoretical Basis for Integrated Cognitive Behavioral Treatment of Comorbid Social Anxiety and Alcohol Use Disorders, Cognitive and Behavioral Practice, doi:10.1016/j.cbpra.2014.05.004

Baillie, A. et al (2013) An investigator-blinded, randomized study to compare the efficacy of combined CBT for alcohol use disorders and social anxiety disorder versus CBT focused on alcohol alone in adults with comorbid disorders: the Combined Alcohol Social Phobia (CASP) trial protocol, BMC Psychiatry, doi:10.1186/1471-244X-13-199

Project Contacts: A/Prof Andrew Baillie
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Single-focussed versus integrated cognitive behaviour therapy for co-occurring depression and alcohol use problems

Dr Helen Stain, Dr Christopher Jackson, Professor Rhoshel Lenroot, Dr Georgie Paulik, Dr Patrick McElduff, Dr Luke Wolfenden
Funding Body: National Health and Medical Research Council
Description:

This study proposed a large-scale randomised controlled trial of cognitive behaviour therapy (CBT) for people with co-occurring depression and alcohol use problems. This study was significant, as it was one of the first to explore effective treatment approaches among people with co-occurring depressive and alcohol use problems. Resolution of these issues will better inform the treatment choices of clinicians practicing in both mental health and alcohol/other drug settings.  Importantly, this will potentially improve the match between treatment and people with depression and substance use problems, a clinically prevalent population encountered in community settings.

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The DEAL Project

Description:

Depression and alcohol misuse represent two of the major causes of disease burden in young people today. These conditions frequently co-occur and this co-occurrence is associated with increased risks and poorer outcomes than either disorder in isolation.

Integrated treatments have been shown to be effective. However, there remains a significant gap between those in need in treatment and those receiving it, particularly in young people. The increased availability of Internet-based programs to complement health care presents a unique opportunity in the treatment of these conditions. 

This study aims to evaluate whether an automated web-based self-help intervention (DEAL Project) can be effective in treating co-occurring depression and problematic alcohol use in young people. In a randomised controlled trial 104 young people (aged 18 to 25 years) with moderate depression and drinking at hazardous levels (recruited largely via social media) were randomly allocated to the DEAL Project (n = 60) or a web-based attention-control condition (HealthWatch; n = 44). The trial consisted of a 4-week intervention phase, with follow-up assessment at post-treatment, and 3- and 6-months post-baseline. The primary outcomes were change in depression severity according to the Patient Health Questionnaire-9, as well as quantity and frequency of alcohol use (TOT-AL).

The DEAL Project was associated with significant improvement in depression severity (d = 0.71) and reductions in alcohol use quantity (d = 0.99) and frequency (d = 0.76) in the short-term, compared to control. At 6-month follow-up the improvements in the intervention group were maintained, however, the differences between intervention and control group disappeared, such that between group effects were in the small to moderate range.

Overall, the DEAL Project was associated with more rapid and stable improvement in both depression and alcohol use outcomes in young people with these co-occurring conditions relative to an attention-control condition. However, long-term outcomes are less clear.

Project Contacts: Dr Mark Deady
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The training and support needs of youth mental health and substance use workers

Funding Body: Australian Government Department of Health
Description:

Young people with comorbid disorders frequently come to the attention of a diverse range of service systems (e.g., health, social welfare, educational, and criminal justice systems), and present a significant challenge to service providers. Little research has been conducted examining the confidence of workers in responding to young clients with comorbidity. The evidence that does exist suggests they lack appropriate training and support, feel overwhelmed and fearful when dealing with comorbid clients, and have difficulty accessing appropriate training or supervision. In order to address this issue, the Australian Government Department of Health funded researchers at the Centre of Research Excellence in Mental Health and Substance Use at the National Drug and Alcohol Research Centre to conduct a scoping exercise to evaluate the training and support needs of clinicians working with young clients who have AOD and/or mental health conditions. The primary aim of the scoping exercise was to provide recommendations for workforce development. By improving the capacity of the workforce to intervene with this population, the standard of care may be improved, and the enduring disability associated with mental health and AOD disorders may be reduced.

 

Download scoping exercise

 

Project Contacts: Dr Christina Marel
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Update and revision of the national comorbidity guidelines

Funding Body: Australian Government Department of Health
Description:

In 2007 the Australian Government Department of Health and Ageing funded the development of “Guidelines on the management of co-occurring alcohol and other drug and mental health conditions in alcohol and other drug treatment settings(Mills, et al., 2009). The aim of the Guidelines was to provide alcohol and other drug (AOD) workers with evidence-based information on the management of comorbid mental health conditions in AOD treatment settings. The Guidelines have been hugely popular – since publication in December 2009, over 10,000 hard-copies and electronic copies have been distributed to clinicians and treatment services across Australia, and it is a recommended text for students studying TAFE courses in alcohol, other drugs and mental health. Research pertaining to the management and treatment of comorbidity has grown considerably since this time, and as such, this project will update and revise the Guidelines to bring them up to date with the most current evidence.

Project Contacts: Dr Christina Marel

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