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Cognitive behavioural therapy reduced cocaine abuse compared with 12 step facilitation

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Question Is cognitive behavioural therapy (CBT) more effective than 12 step facilitation (12SF) for reducing cocaine abuse in adults?


Randomised controlled trial with 26 weeks follow up.


3 programmes of the Veterans Affairs Medical Center in San Francisco, California, USA.


128 adults (98% men, 80% African-American) who met DSM-III-R criteria for cocaine abuse (mean duration of cocaine use 19 y). Exclusion criteria included opioid dependence, diagnosis of schizophrenia, or contraindications to outpatient treatment. Follow up was 84% at 26 weeks.


Participants were allocated to CBT (n=59) or 12SF (n=69), and they all received 3 group therapy sessions and 1 individual counselling session each week for 12 weeks. In 12SF, participants were introduced to the 12 steps of Alcoholics Anonymous and Cocaine Anonymous and were encouraged to do the …

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