Treating complicated grief and substance use disorders: A pilot study
Portions of this work were presented at the 158th Annual Meeting of the American Psychiatric Association, Atlanta, GA, May 26, 2005; at the 67th Annual Scientific Meeting of the College on Problems of Drug Dependence, Orlando, FL, June 21, 2005; and at the 11th International Conference on Treatment of Addictive Behaviors, Santa Fe, NM, February 1, 2006.
Received 13 May 2005; received in revised form 15 November 2005; accepted 8 December 2005.
Abstract
Empirically supported treatments for co-occurring substance use disorders (SUDs) and grief problems are lacking, despite the salience of grief pathology in substance abusers. Identification of a syndrome of complicated grief, distinct from bereavement-related depression and anxiety, led to the development of a targeted treatment, but this treatment has not been tried with persons with SUDs. We recruited 16 adults with complicated grief and substance dependence or abuse into an open pilot study of a manualized 24-session treatment, incorporating motivational interviewing and emotion coping and communication skills into our efficacious complicated grief treatment. Completer and intent-to-treat analyses showed significant reductions in Inventory of Complicated Grief and Beck Depression Inventory scores, with large effect sizes. Timeline Followback percent days abstinent increased significantly in both analyses, with medium to large effect sizes, and cravings declined significantly. Study limitations notwithstanding, complicated grief and substance use treatment appears to be a promising intervention that merits further research.
ABSTRACT