Four-Session Transcending Self Therapy for Substance use, Depression, and Treatment Retention among Veterans with Substance use Disorders: A Pilot Study

Objective: Increased rates of Substance Use Disorders (SUDs) have been found among veterans compared to the general population. Efficacious interventions that reduce substance abuse in veterans are of central importance. To address this need, the Four-Session Mind Freedom Plan (MFP) Integrative-Cognitive Behavior Therapy-based treatment was developed. MFP is an adjunctive individual therapy for group-based intensive SUD treatment. We conducted a preliminary investigation into whether veterans assigned to MFP show significantly improved treatment outcomes compared to treatment-as-usual (TAU) individual therapy.Methods: Participants were N=35 veterans enrolled in a four-week intensive outpatient program (IOP) at an urban Veterans Administration Medical Center. Those slated for IOP were assigned randomly to four weekly sessions of either MFP or TAU. At baseline, veterans completed psychometric assessments of SUD and mental health. At IOP completion, participants completed mental health and neurocognitive assessments.Results: Compared to the TAU group, MFP patients were twice as likely to complete IOP treatment (100% vs 50%; p=0.002) and to be abstinent in the final week of IOP (84.6% vs 40.9%; p=0.01). MFP-assigned patients (but not TAU patients) also showed significant reductions in depression over time (group X time interaction, p=0.002), and showed trends toward being less likely to transition to a higher level of SUD care (p=0.06) and for quality of life scores to increase more over time (group X time interaction, p=0.068).Conclusions: These preliminary data indicate that MFP may be an effective individual therapy supplement to group-based SUD therapy in veterans. A multi-site clinical trial of MFP with more practitioners and assessments could replicate and establish generalizability of these findings.