Cocaine use in the general population is a significant and costly problem. Novel and innovative interventions targeting cocaine abuse are needed. The Transtheoretical Model of behavior change (TTM) offers a comprehensive framework for understanding, measuring, and intervening in behavior change and provides a strong theoretical foundation upon which effective treatments for substance abuse can be developed. The proposed Stage 1 research will pilot test a novel and innovative behavioral group therapy for cocaine users based on the TTM. In Phase 1, investigators modified the newly developed “Group Treatment for Substance Abuse: A Stages-of-Change Therapy Manual” (Velasquez, Maurer, Crouch & DiClemente, 2001) to specifically target cocaine abuse resulting in a twelve-session, group intervention and accompanying therapy manual based on the TTM stages and processes of change: six “early stage” sessions targeting the experiential processes of change, and six “later stage” sessions targeting the behavioral processes of change. In Phase 2 we are conducting a pilot trial to evaluate the TTM group therapy with cocaine abusing patients. In this between group study, groups of cocaine abusers are formed during recruitment (N=80) and are randomly assigned to one of two group treatment conditions: TTM therapy or Education/Advice. Participants are recruited from Houston and surrounding communities through the Substance Abuse Research Center at the University of Texas Health Science Center Mental Sciences institute. This study will begin its fourth and final year on June 1, 2006. The study activities planned for this final year will include conducting the last intervention group (a TTM therapy group), follow-up sessions and transcripts, and dissemination of the findings in peer reviewed journal articles and presentations at professional meetings. We expect the delivery of the TTM therapy for cocaine users to be feasible and acceptable, and to produce significant patient improvement. Cocaine outcomes will be assessed via objective (urine and drug analysis) and self-report measures. In addition, through in-depth coding and analysis of the videotaped sessions, we will explore therapist characteristics and behaviors, interpersonal characteristics and processes, and group processes. This Stage I research will contribute important theoretical and empirical information concerning the promise of a new and innovative intervention for cocaine abusers, and will provide the basis for a larger efficacy trial.
