LETS ACT RCT in press at Addiction

September 14, 2017

Congratulations to our many BRANE Lab members and their colleagues for their recent publication in Addiction:

The Effect of a Behavioral Activation Treatment for Substance Use on Post-treatment Abstinence: A Randomized Controlled Trial

Stacey B. Daughters, Ph.D., Jessica F. Magidson, Ph.D., Deepika Anand, Ph.D., C.J. Seitz-Brown, M.A., Yun Chen, B.A. & Sydney Baker, B.S.


Aims: to compare outcomes for a behavioral activation group treatment for substance use (LETS ACT), versus a time and group size matched control condition delivered in a residential treatment setting.
Design: single-site two-arm parallel-group randomized clinical trial with follow-up assessment at 3, 6 and 12 months post-treatment.Setting: residential substance use treatment facility in the USA.
Participants: participants were 263 adults [mean age 42.7 [11.8]; 29.3% female; 94.7% African American; 72.6% court mandated] whose insurance dictated 30-day (65.4%) or 90-day (34.6%) treatment duration.
Intervention and comparator: LETS ACT (n=142) is a treatment originally developed for depression and modified for substance use. It teaches participants to increase positively reinforcing value-driven activities in order to counter depression and relapse. The control group (SC; n=121) received time and group-size matched supportive counseling. Treatment was delivered in five or eight one-hour sessions depending on patient length of stay.
Measurements: percent abstinent at follow-up, percent of substance use days among those reporting use, depressive symptoms (BDI), and adverse consequences of drug use (SIP-AD).
Findings: LETS ACT had significantly higher abstinence rates at 3 months (odds ratio=2.2, 95% confidence interval=1.3-3.7), 6 months (odds ratio=2.6, 95% confidence interval=1.3-5.0), and 12 months (odds ratio=2.9, 95% confidence interval=1.3-6.1) post-treatment compared with SC. LETS ACT participants reported significantly fewer adverse consequences from substance use at 12 months post-treatment (B=4.50, SE=2.17, 95% confidence interval=0.22-8.78). Treatment condition had no effect on percent substance use days among those who resumed use or on change in depressive symptoms; the latter decreased over time only in those who remained abstinent after residential treatment irrespective of condition (B=0.43, SE=0.11, 95% confidence interval=0.22-0.65).

Conclusions: a behavioral activation group treatment for substance use (LETS ACT) appears to increase the likelihood of abstinence and reduce adverse consequences from substance use up to 12 months post-treatment.