AUTHOR=Schluter Magdalen G. , Hodgins David C. , Stea Jonathan N. , Kilborn Michelle L. 

TITLE=Promoting self-change in cannabis use disorder: Findings from a randomized trial

JOURNAL=Frontiers in Psychiatry

VOLUME=13

YEAR=2022

URL=https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2022.1015443

DOI=10.3389/fpsyt.2022.1015443

ISSN=1664-0640

ABSTRACT=<sec><title>Background</title><p>A growing body of literature supports the efficacy of cognitive-behavioral therapy (CBT) and motivational interviewing (MI) for the treatment of problematic cannabis use, diagnostically referred to as cannabis use disorder, though most individuals do not access formal treatment. Stepped-care-type models emphasize interventions across a continuum of severity and there is a need for more treatment options across this continuum. This project focused on the evaluation of the least intensive of the individual interventions – promotion of self-directed recovery.</p></sec><sec><title>Methods</title><p>Using a three-arm randomized control trial design, adults (<italic>N</italic> = 186) with problematic cannabis use and who wished to recover with minimal professional support were recruited from across Canada and randomized to receive a self-directed treatment workbook based on CBT and MI principles (WB; <italic>n</italic> = 61), the workbook plus a single MI session (WMI; <italic>n</italic> = 61) or a delayed treatment control (DT; <italic>n</italic> = 65) condition. Participants completed 3-month and 6-month follow-up assessments.</p></sec><sec><title>Results</title><p>Across conditions, GEE modeling revealed that the baseline to 3-month slopes differed significantly from zero, <italic>ps</italic> &lt; 0.001. Participants in the WMI condition reduced their frequency of use to a greater extent than the WB alone, <italic>p</italic> = 0.005, and DT groups, <italic>p</italic> = 0.02. Chi-square analysis revealed that participants in the WMI condition also showed greater rates of abstinence at 3-months follow-up than participants in the WB or DT condition, <italic>p</italic> = 0.046. Changes in the frequency of cannabis use between 3-months and 6-months did not differ significantly between groups, <italic>p</italic>s &gt; 0.05. For quantity of cannabis use, a significant effect of time emerged, <italic>p</italic> = 0.002. However, no between-group effects were significant from baseline to 3-months, or from 3- to 6-months, <italic>p</italic>s <underline>&gt;</underline> 0.06.</p></sec><sec><title>Conclusion</title><p>Overall, results support the utility of a brief self-directed workbook in combination with a single MI session at promoting changes in cannabis use. This self-directed intervention has the potential to fill an important need in that the self-directed intervention can attract individuals who wish to recover with minimal professional support.</p></sec><sec><title>Clinical trial registration</title><p>[<ext-link ext-link-type="uri" xlink:href="https://www.isrctn.com/" xmlns:xlink="http://www.w3.org/1999/xlink">https://www.isrctn.com/</ext-link>], identifier [ISRCTN426 32893].</p></sec>