Department of Psychology, University of Oviedo, Spain.
Psychol Addict Behav. 2011 Mar;25(1):174-9. doi: 10.1037/a0021451.
The aims of this study were to assess the effectiveness of the Community Reinforcement Approach (CRA) plus vouchers treatment in a cohort of Spanish cocaine-dependent outpatients, and to examine the maintenance of treatment effects after the voucher intervention was discontinued. Sixty-four adult outpatients were randomly assigned to one of two treatment conditions, CRA plus vouchers or standard care. The vouchers program was implemented from weeks 1 to 24. Among patients assigned to the CRA plus vouchers condition, 65.5% completed 12 months of treatment versus 28.6% of those assigned to the standard care condition (p = .003). At the 12-month assessment, 58.6% of patients assigned to the CRA plus vouchers condition were abstinent, compared with 25.7% in the standard care condition (p = .008); furthermore, 34.5% of patients assigned to the CRA plus vouchers condition achieved twelve months of continuous cocaine abstinence, versus 17.1% in the standard care condition. Those treated in the CRA plus vouchers condition also achieved greater improvements in psychosocial functioning than those treated in the standard care condition. Overall, these results reveal an extension of the effectiveness of the CRA plus vouchers treatment to a community sample of cocaine-dependent outpatients, while also supporting the maintenance of treatment effects for 6 months after completion of the voucher program.
本研究旨在评估社区强化治疗（CRA）加券治疗方案在西班牙可卡因依赖门诊患者中的有效性，并在券干预停止后检验治疗效果的维持情况。64 名成年门诊患者被随机分配到两种治疗条件之一，CRA 加券治疗或标准护理。券方案从第 1 周到第 24 周实施。在被分配到 CRA 加券治疗条件的患者中，65.5%完成了 12 个月的治疗，而被分配到标准护理条件的患者中只有 28.6%（p =.003）。在 12 个月的评估中，58.6%被分配到 CRA 加券治疗条件的患者保持戒断，而在标准护理条件下为 25.7%（p =.008）；此外，34.5%被分配到 CRA 加券治疗条件的患者实现了 12 个月的连续可卡因戒断，而在标准护理条件下为 17.1%。接受 CRA 加券治疗的患者在心理社会功能方面也取得了更大的改善，而接受标准护理的患者则没有。总的来说，这些结果表明 CRA 加券治疗方案对可卡因依赖门诊患者的社区样本具有扩展的有效性，同时也支持在券方案完成后 6 个月内维持治疗效果。
