6 - Cognitive-Behavioral and Motivational Enhancement Treatments for Cannabis Dependence

Summary

Cognitive-behavioral (CBT) and motivational enhancement treatments (MET) are two of the most researched and most empirically supported approaches to the treatment of alcohol and drug use disorders (e.g., Carroll et al., 1998; Miller et al., 1995; Project MATCH Research Group, 1997). They were the first to be adapted for the treatment of cannabis dependence in controlled research trials and, consequently, have generated the most research. Although theoretically distinct, CBT and MET may be complementary (e.g., Baer et al., 1999) and have often been combined into a single intervention in the treatment of cannabis dependence. In this chapter we provide an overview of these therapeutic strategies, discuss their application to cannabis dependence treatment, and review the empirical literature on their efficacy.

The core of CBT is the development of coping skills to deal with high-risk situations for drug use (Marlatt & Gordon, 1985; Monti et al., 2002). As an action-oriented set of strategies, CBT is perhaps best suited to individuals who already have a commitment to changing their substance using behavior. MET, on the other hand, uses principles of motivational interviewing (MI) and was developed specifically to deal with ambivalence regarding change (Miller & Rollnick, 1991, 2002). As such, MET may be most appropriate for those contemplating change or those who would profit from solidifying their commitment to change before engaging in additional treatment. However, studies have shown that brief motivational interventions alone were sufficient to engender reductions in drug use.