Integrated Cognitive Behaviour Therapy for Co-Occurring Substance Misuse and Major Depression: Lessons from a Youth Mental Health Service

Abstract

Objective: The aim of this paper is to describe a 20-week integrated cognitive behavioural therapy (CBT) program addressing co-occurring substance misuse and major depression in young people. Method: Participants were aged between 15 and 25 years, met DSM-IV criteria for major depressive disorder and had at least weekly illicit drug use and/or weekly alcohol use exceeding the Australian national guidelines on alcohol. Results: Between December 2004 and January 2007, an integrated CBT program was offered to 60 young people with co-occurring depression and substance misuse who presented to a youth-specific mental health service. Young people attended for a median of 10.5 sessions. Conclusions: We describe the components of a 20-week integrated CBT program for young people with co-occurring depression and comorbid substance misuse, as well as the challenges associated with providing such treatment. While integrated treatment approaches are recommended as best practice for this population, further evaluation is necessary to determine their effectiveness within routine clinical settings.