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Member Information
Paul Crits-Christoph, PhD
Professor of Psychology in Psychiatry
Director, Center for Psychotherapy Research
Office Phone: 215-662-7993
Office Fax:
Email: crits@mail.med.upenn.edu
Websites:
http://www.med.upenn.edu/cpr/
Education: PhD, Yale University
Keywords: Drug dependence, HIV risk behaviors, psychotherapy, drug counseling
Research and/or Clinical Interests:
Testing a community-friendly manual-based drug counseling treatment for cocaine dependence, and examining its effect on HIV risk behaviors.
Summary:
We are currently conducting treatment development work to create and test a "community-friendly" manual-based individual plus group drug counseling package. The NIDA Collaborative Cocaine Treatment Study (Crits-Christoph et al., 1999) recently reported that manual-based individual drug counseling (IDC) plus group drug counseling (GDC) has superior drug use outcomes compared to cognitive-behavior therapy plus GDC, psychodynamic therapy plus GDC, and GDC alone. Proposed changes to IDC and GDC to make them more "community-friendly" include changes to both the duration and content of the treatment models. The proposed treatment development work will include (1) obtaining feedback on the new treatment manuals by a sample of 15 community-based drug counselors, (2) evaluating whether a group of drug counselors can successfully learn to implement the new manuals, (3) evaluating counselors' experiences in learning and conducting the new treatments, (4) conducting a pilot randomized evaluation of the outcomes of the new package of individual plus group drug counseling compared to group drug counseling alone, (5) obtaining ratings of treatment fidelity to assess whether the new individual and group drug counseling approaches can be differentiated from the original therapies, (6) assessing patient reactions to the new treatment, and (7) conducting a preliminary investigation of potential mediators of change of the new treatments. The pilot randomized trial will involve assignment of 40 patients meeting DSM-IV criteria for cocaine dependence to either new versions of individual plus group drug counseling or group drug counseling alone. Assessments will be done at time of intake and weekly (for urines and self-report of cocaine use) or monthly (for other outcome measures) during a 3-month treatment phase. The primary efficacy measures will be the ASI Drug Use Composite scale and a composite cocaine use measure that incorporates urine data, Addiction Severity Index Interview data, and weekly self-report of cocaine use. Mediation of drug use change will be examined by assessing beliefs about substance use, endorsement of 12-step behaviors and beliefs, and attendance/ participation in 12-step meetings at baseline, weekly for the first month and monthly thereafter. The data gathered from this treatment development project will inform the design of a subsequent larger study.
Representative Publications:
Crits-Christoph, P., Gibbons, M.B., Barber, J.P., Gallop, R., Beck, A.T., Mercer, D., Tu, X., Thase, M.E., Weiss, R.D., Frank, A. Mediators of outcome of psychosocial treatments for cocaine dependence. Journal of Consulting and Clinical Psychology (in press).
Barber, J.P., Foltz, C., Crits-Christoph, P., & Chittams, J. Therapist's adherence and competence and treatment discrimination in the NIDA Collaborative Cocaine Treatment Study. Journal of Clinical Psychology (in press).
Najavits, L.M., Runkel, R., Neuner, C., Frank, A.F., Thase , M.E. , Crits-Christoph, P., Blaine , J. (in press). Rates and symptoms of PTSD among cocaine-dependent patients. Journal of Studies on Alcohol (in press).
Woody, G.E., Gallop, R., Luborsky, L., Blaine, J., Frank A., Salloum I.M., Gastfriend, D., Crits-Christoph, P. HIV risk reduction in the National Institute on Drug Abuse Cocaine Collaborative Treatment Study. Journal of Acquired Immune Deficiency Syndrome. 33: 82-87, 2003.
