Showing papers by "Kenneth M. Carpenter published in 2006"
TL;DR: Stroop performance may have prognostic utility among drug-dependent patients in a cognitive-behavioral coping skills intervention and may highlight the mechanisms associated with changing substance use in this treatment modality.
178 citations
TL;DR: There may be a limit on the extent to which behavioral therapy can overcome poor adherence to oral naltrexone, and future research should consider combinations of behavioral methods with new long-acting injectable or implantable nALTrexone formulations.
Abstract: The effectiveness of antagonist maintenance with oral naltrexone for opioid dependence has been limited by high dropout rates. Behavioral Naltrexone Therapy (BNT) was developed to improve retention on oral naltrexone by integrating voucher incentives, Motivational and Cognitive Behavioral therapies, and a significant other for monitoring medication adherence. In a 6-month, randomized, controlled trial in heroin dependent patients, BNT (N = 36) improved retention in treatment compared to a standard treatment control (Compliance Enhancement (CE); N = 33) (log rank = 4.28; p = .04). Most patients retained beyond 3 months achieved abstinence from opioids, but retention at 6 months was only 22% on BNT and 9% on CE. A systematic review of related controlled trials revealed similar effect sizes in the small to medium range, and substantial dropout. There may be a limit on the extent to which behavioral therapy can overcome poor adherence to oral naltrexone. Future research should consider combinations of behavioral methods with new long-acting injectable or implantable naltrexone formulations.
85 citations
TL;DR: The Behavioral Therapy for Depression in Drug Dependence (BTDD) as discussed by the authors was developed to target the density of potential reinforcers in a patient's environment to reduce both depression and illicit substance use using therapeutic techniques from three operant based treatment programs, Community Reinforcement Approach, Changing Reinforcement Events, and Treatment-plan Contingency Management.
Abstract: Limited access to positive reinforcers is a central feature in behavioral formulations of substance use and depression, and evidence suggests both disorders share similar environmental contexts. The Behavioral Therapy for Depression in Drug Dependence (BTDD) was developed to target the density of potential reinforcers in a patient's environment to reduce both depression and illicit substance use using therapeutic techniques from three operant based treatment programs, Community Reinforcement Approach, Changing Reinforcement Events, and Treatment-plan Contingency Management. Results of an uncontrolled Stage Ia trial (n = 29), indicated 48% of the participants demonstrated at least a 50% reduction in baseline depression scores during the 16-session treatment program. Those designated as treatment responders completed more out-of-session behavioral activities, attended more treatment sessions, and demonstrated less benzodiazepine use during the program than non-responders. There were no changes in opiate and cocaine use. BTDD may be a useful adjunct to methadone maintenance for treating comorbid depressive disorders.
17 citations
TL;DR: The results suggest that temperament dimensions may be important for identifying substance dependent patients more likely to benefit from pharmacological interventions for comorbid depressive disorders.
14 citations
TL;DR: The Type A-Type B model is useful for identifying untreated problem drinkers at risk for developing alcohol dependence and may facilitate the development of more targeted prevention efforts.
8 citations
Journal Article•
TL;DR: In this paper, the authors present four principles that may play an important role in facilitating behavioral change among substance-dependent patients, including the practice of specific coping skills, the use of competing reinforcers, the importance of clinician-patient verbal interactions, and the utilization of social networks.
Abstract: There has been significant progress in developing, standardizing, and testing psychosocial interventions for drug and alcohol dependence. A variety of treatments have been empirically supported for decreasing drug and alcohol use among treated substance dependent populations. Empirically-supported treatments vary in their theoretical orientation and the types of therapeutic techniques employed, but research suggests certain common principles or treatment ingredients among them. This article reviews four principles that may play an important role in facilitating behavioral change among substance-dependent patients. These principles include: the practice of specific coping skills, the use of competing reinforcers, the importance of clinician-patient verbal interactions, and the utilization of social networks. Treatment programs that emphasize a particular principle are discussed and examples of how each principle is utilized in a clinical context are provided.
3 citations