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Effectiveness of Acceptance–Commitment Therapy on Craving Beliefs in Patients on Methadone Maintenance Therapy: A Pilot Study

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Abstract

The present study is designed to evaluate the efficacy of acceptance–commitment therapy (ACT) on craving beliefs in opioid dependent patients on methadone maintenance treatment (MMT). Twenty-eight opioid dependent participants, aged 18–50 years, who were on MMT based on Iran’s Ministry of Health and Medical Education published protocol, were evaluated in Mashhad during 2011–2012. The treatment group comprised fourteen participants, who received eight sessions of individual ACT alongside MMT while fourteen participants of the control group received just MMT. The effectiveness of the intervention was assessed by the craving beliefs questionnaire (CBQ), the action and acceptance questionnaire (AAQ-I) and the mean dosage of methadone the participants consumed in the last 3 days. Assessment was performed three times; the first was before the initiation of ACT (as pretest), the second was 2 weeks after ACT was terminated (as posttest), and the third one was 12 weeks after the termination of ACT (as follow-up). The extracted data were analyzed by two way ANOVA and ANCOVA using SPSS-20. While there was no significant difference in the mean methadone dosage between the treatment and the control group at pretest (p = 0.067), patients in the treatment group had a significantly lower methadone dosage at posttest (p < 0.001) and follow-up (p < 0.001) compared to the control group. There was a significant reduction in the CBQ scores between treatment and control groups at posttest (p = 0.047) and follow-up (p = 0.014). There was also a significant difference in AAQ-I score between treatment and control at posttest (p < 0.001) and follow-up (p < 0.001). It seems that short-term individual ACT is associated with a significant decline in craving beliefs in substance-dependent patients, which lasts for at least 12 weeks after the termination of ACT.

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References

  • Altınöz, A. E., Aslan, S., Uğurlu, M., Özdel, K., Sargın, A. E., & Türkçapar, M. H. (2016). Measuring the beliefs on alcohol craving by using craving beliefs questionnaire: preliminary results of its psychometric properties in a Turkish sample. Journal of Substance Use, 21(5), 455–459.

    Article  Google Scholar 

  • Ashe, M. L., Newman, M. G., & Wilson, S. J. (2015). Delay discounting and the use of mindful attention versus distraction in the treatment of drug addiction: a conceptual review. Journal of the Experimental Analysis of Behavior, 103(1), 234–248.

    Article  PubMed  Google Scholar 

  • Association, A. P. (2013). Highlights of changes from DSM-IV-TR to DSM-5. http://www.dsm5.org/Documents/changes%20from%20dsm-ivtr%20to%20dsm-5.pdf.

  • Bond, F. W., & Bunce, D. (2000). Mediators of change in emotion-focused and problem-focused worksite stress management interventions. Journal of Occupational Health Psychology, 5(1), 156–163.

    Article  PubMed  Google Scholar 

  • Drummond, D. C. (2000). What does cue-reactivity have to offer clinical research? Addiction, 95(8s2), 129–144.

    Article  Google Scholar 

  • Everitt, B. (1997). Craving cocaine cues: cognitive neuroscience meets drug addiction research. Trends in Cognitive Sciences, 1(1), 1–2.

    Article  PubMed  Google Scholar 

  • Gifford, E. V., Kohlenberg, B. S., Hayes, S. C., Antonuccio, D. O., Piasecki, M. M., Rasmussen-Hall, M. L., et al. (2004). Acceptance-based treatment for smoking cessation. Behavior Therapy, 35(4), 689–705.

    Article  Google Scholar 

  • Hayes, S. C. (2004). Acceptance and commitment therapy, relational frame theory, and the third wave of behavioral and cognitive therapies. Behavior Therapy, 35(4), 639–665. https://doi.org/10.1016/S0005-7894(04)80013-3.

    Article  Google Scholar 

  • Hayes, S. C., & Strosahl, K. D. (2004). A practical guide to acceptance and commitment therapy. Washington: Springer.

    Book  Google Scholar 

  • Hayes, S. C., Strosahl, K., Wilson, K. G., & Bissett, R. T. (2004). Measuring experiential avoidance: A preliminary test of a working model. The Psychological Record, 54(4), 553–578.

    Article  Google Scholar 

  • Heffner, M., Eifert, G. H., Parker, B. T., Hernandez, D. H., & Sperry, J. A. (2003). Valued directions: Acceptance and commitment therapy in the treatment of alcohol dependence. Cognitive and behavioral practice, 10(4), 378–383.

    Article  Google Scholar 

  • Khakbaz, H., Farhoudian, A., Azkhosh, M., Dolatshahi, B., Karami, H., & Massah, O. (2016). The effectiveness of group acceptance and commitment therapy on emotion regulation in methamphetamine-dependent individuals undergoing rehabilitation. International Journal of High Risk Behaviors and Addiction. https://doi.org/10.5812/ijhrba.28329.

    Google Scholar 

  • Khalatbari, J., & Bazarganiyan, N. (2011). Comparison the depression, anxiety and stress in intravenous drug abusers, with and without HIV/AIDS. Journal of Guilan University of Medical Sciences, 20(78), 76–83.

    Google Scholar 

  • Kiani, A., Ghasemi, N., & Pourabbas, A. (2013). The comparsion of the efficacy of group psychotherapy based on acceptance and commitment therapy, and mindfulness on craving and cognitive emotion regulation in methamphetamine addicts. Research on Addiction, 6(24), 27–36.

    Google Scholar 

  • Killen, J. D., & Fortmann, S. P. (1997). Craving is associated with smoking relapse: findings from three prospective studies. Experimental and Clinical Psychopharmacology, 5(2), 137–142.

    Article  PubMed  Google Scholar 

  • Litvin, E. B., Kovacs, M. A., Hayes, P. L., & Brandon, T. H. (2012). Responding to tobacco craving: Experimental test of acceptance versus suppression. Psychology of Addictive Behaviors, 26(4), 830–837.

    Article  PubMed  PubMed Central  Google Scholar 

  • Luoma, J. B., Kohlenberg, B. S., Hayes, S. C., & Fletcher, L. (2012). Slow and steady wins the race: a randomized clinical trial of acceptance and commitment therapy targeting shame in substance use disorders. Journal of Consulting and Clinical Psychology, 80(1), 43–53.

    Article  PubMed  Google Scholar 

  • McKay, J. R. (1999). Studies of factors in relapse to alcohol, drug and nicotine use: a critical review of methodologies and findings. Journal of Studies on Alcohol, 60(4), 566–576.

    Article  PubMed  Google Scholar 

  • Mohammadi, M., Khakbaz, H., Farhoudian, A., & Younesi, S. J. (2013). The effectiveness of acceptance and commitment group therapy on the improvement of coping skills and relapse prevention in opioid dependent males. Paper presented at the The 9th International Addiction Science Congress (poster), Tehran, Iran,

  • Otto, M. W., O’cleirigh, C. M., & Pollack, M. H. (2007). Attending to emotional cues for drug abuse: Bridging the gap between clinic and home behaviors. Science & Practice Perspectives, 3(2), 48–55.

    Article  Google Scholar 

  • Rahmanian, M., Mirjafari, A., & Hasani, J. (2006). The relationship between craving and attentional bias in opioid dependent, relapsed and abstinent individuals. Iranian Journal of Psychiatry and Clinical Psychology, 12(3), 216–222.

    Google Scholar 

  • Saedy, M., Kooshki, S., Firouzabadi, M. J., Emamipour, S., & Ardani, A. R. (2015). Effectiveness of acceptance–commitment therapy on anxiety and depression among patients on methadone treatment: A pilot study. Iranian Journal of Psychiatry and Behavioral Sciences, 9(1). https://doi.org/10.17795/ijpbs222.

  • Stotts, A. L., Masuda, A., & Wilson, K. (2009). Using Acceptance and Commitment Therapy during methadone dose reduction: rationale, treatment description, and a case report. Cognitive and Behavioral Practice, 16(2), 205–213.

    Article  PubMed  PubMed Central  Google Scholar 

  • Stotts, A. L., & Northrup, T. F. (2015). The promise of third-wave behavioral therapies in the treatment of substance use disorders. Current Opinion in Psychology, 2, 75–81.

    Article  PubMed  PubMed Central  Google Scholar 

  • Strain, E. C., Lofwall, M. R., & Jaffe, J. H. (2009). Opioid-related disorders. In B. J. Sadock, V. A. Sadock, P. Ruiz, & H. I. Kaplan (Eds.), Kaplan & Sadock’s comprehensive textbook of psychiatry (9th ed., Vol. 1, pp. 1360–1386). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.

    Google Scholar 

  • Twohig, M. P., & Crosby, J. M. (2010). Acceptance and commitment therapy as a treatment for problematic internet pornography viewing. Behavior Therapy, 41(3), 285–295.

    Article  PubMed  Google Scholar 

  • Twohig, M. P., Shoenberger, D., & Hayes, S. C. (2007). A preliminary investigation of acceptance and commitment therapy as a treatment for marijuana dependence in adults. Journal of Applied Behavior Analysis, 40(4), 619–632.

    Article  PubMed  PubMed Central  Google Scholar 

  • Vuković, O., Cvetić, T., Zebić, M., Marić, N., Britvić, D., Damjanović, A., et al. (2008). Contemporary framework for alcohol craving. Psychiatria Danubina, 20(4), 500–507.

    PubMed  Google Scholar 

  • Wetherell, J. L., Liu, L., Patterson, T. L., Afari, N., Ayers, C. R., Thorp, S. R., et al. (2011). Acceptance and commitment therapy for generalized anxiety disorder in older adults: A preliminary report. Behavior Therapy, 42(1), 127–134.

    Article  PubMed  Google Scholar 

  • Woo, S. M., & Keatinge, C. (2008). Diagnosis and treatment of mental disorders across the lifespan. New Jersey: Wiley.

    Google Scholar 

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Acknowledgements

We are grateful to all the patients who were involved in this study. We are also sincerely grateful to our colleagues Dr. Bahari and Mrs. Asadpour, who helped us in this study.

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Authors and Affiliations

  1. Tehran Branch, Islamic Azad University, Tehran, Iran

    Mozhgan Saedy, Shirin Kooshki, Mahmoud Jamali Firouzabadi & Susan Emamipour

  2. Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

    Amir Rezaei Ardani, Leila Darabi Mahboub & Mahya Mojahedi

Authors
  1. Mozhgan Saedy
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  2. Amir Rezaei Ardani
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  3. Shirin Kooshki
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  4. Mahmoud Jamali Firouzabadi
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  5. Susan Emamipour
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  6. Leila Darabi Mahboub
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  7. Mahya Mojahedi
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Contributions

Mozhgan Saedy conceived and designed the study and performed the psychotherapeutic intervention. Amir Rezaei Ardani and Mahya Mojahedi participated in designing the evaluation, the interpretation of the clinical data and the revision of the manuscript. Shirin Kooshki and Mahmoud Jamali Firouzabadi participated in the interpretation of the clinical data. Susan Emamipour performed the statistical analysis. Leila Darabi Mahboub participated in performing the psychometric evaluation and clinical data collection. Mahya Mojahedi also drafted the manuscript. All authors read and approved the final manuscript.

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Correspondence to Mahya Mojahedi.

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Saedy, M., Rezaei Ardani, A., Kooshki, S. et al. Effectiveness of Acceptance–Commitment Therapy on Craving Beliefs in Patients on Methadone Maintenance Therapy: A Pilot Study. J Rat-Emo Cognitive-Behav Ther 36, 288–302 (2018). https://doi.org/10.1007/s10942-018-0287-5

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  • DOI: https://doi.org/10.1007/s10942-018-0287-5

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