Implementation and Preliminary Evaluation of a 12-Week Cognitive Behavioural and Motivational Enhancement Group Therapy for Cannabis Use Disorder.

Background: The purpose of this paper is to provide a preliminary evaluation of treatment outcomes, retention and client satisfaction following a 12-week combined cognitive behavioural therapy (CBT) and motivational enhancement therapy (MET) group treatment for cannabis use disorder (CUD) delivered in an outpatient setting. Implementation of the program is also described. Methods: A retrospective observational cohort study was conducted using data collected from medical records and self-report assessments. Participants were treatment-seeking cannabis users at the Centre for Addiction and Mental Health, Toronto. Cannabis use, cannabis-related problems, craving, withdrawal symptoms, self-efficacy for remaining abstinent, depression and anxiety were assessed pre- and post-treatment. Treatment retention was calculated by inspecting clinic attendance records, and client satisfaction was evaluated using an anonymous feedback survey. Potential predictors of treatment outcomes and retention were investigated in exploratory analyses. Results: Cannabis use was lower and days of abstinence higher post-treatment (vs pre-treatment). Post-treatment improvements in cannabis-related problems, craving, withdrawal symptoms, self-efficacy and mood were also observed. Completion of group treatment (⩾75% of sessions attended) was 57% and moderate levels of treatment satisfaction were reported. Conclusions: This study provides preliminary evidence that a 12-week combined CBT and MET treatment for cannabis use disorder delivered in a novel group setting improves cannabis use outcomes. Potential predictors of reduced cannabis use and retention were identified. Future controlled studies are warranted, and strategies for increasing retention should be explored.

Randomized trial of working memory training as an adjunct to inpatient substance use disorder treatment.

Despite interest in computerized working memory training as a transdiagnostic intervention, little is known about its feasibility and efficacy in addiction treatment settings. This double-blind, randomized controlled trial examined the efficacy of working memory training for improving performance on standardized measures of executive function during inpatient substance use disorder treatment. Secondary outcomes included delay discounting, adherence to cognitive training, and posttreatment relapse. Adults (N = 110) entering inpatient alcohol or drug treatment were randomized to active (adaptive) or control (nonadaptive) training conditions, with up to 25 training sessions spanning inpatient and postdischarge phases. In generalized estimating equation (GEE) analyses, the experimental group showed relatively greater improvements on the primary outcome (digit span performance) based on Time × Treatment interactions in per-protocol (p < .05) and intent-to-treat (p = .07) models. Similar results were observed for one secondary outcome. Lower working memory performance at baseline predicted significantly greater delay discounting; however, no time or treatment effects on discounting were observed. Adherence to cognitive training was generally good during inpatient treatment, but suboptimal overall. These results suggest that implementing cognitive training is feasible in inpatient settings, and that adaptive working memory training can potentially lead to near-transfer effects for select cognitive outcomes. However, further work is necessary to establish training effects on clinical outcomes and to improve adherence in outpatient contexts. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

The monster in the mirror: reasons for wanting to change appearance.

PURPOSE: Many adults are dissatisfied with their body, regardless of their weight, and weight loss is commonly perceived as an effective solution to this dissatisfaction. The main purpose of this study was to examine the reasons for wanting to modify one's bodily appearance (shape and weight), and to compare these reasons by sex, age, and weight group. METHODS: The sample consisted of 796 French-speaking Canadian adults (100 men, 696 women; M age = 27.00 years, SD = 7.88, range 18-64; M body mass index = 24.99 kg/m(2), SD = 6.37, range 12.6-66.5 kg/m(2)) who were asked online whether or not they wanted to change their appearance and if so, why. Answers were subjected to a content analysis wherein recurrent themes were grouped and labeled. RESULTS: Most participants (83.2%) wanted to change their appearance. Women, participants with a higher BMI, and older participants were significantly more likely to report this desire. The three most frequently evoked reasons were body dissatisfaction, well-being, and health/shape. CONCLUSIONS: The results suggest that body dissatisfaction constitutes the primary motive for change for both men and women of all ages, especially for those who are of healthy weight or underweight. Women and younger adults seem to be under the impression that in changing their appearance they will be more comfortable in their own skin. Men, older adults, and overweight adults, on the other hand, are more preoccupied by their health/shape and seldom relate their appearance to their psychological balance.