Increasing Treatment Adherence Among Outpatients With Depression and Cocaine Dependence: Results of a Pilot Study

Objective:This pilot study examined the effect of a modified motivational therapy intervention on outpatient treatment adherence and completion for patients with comorbid depressive disorder and cocaine dependence.Method:Depressed cocaine patients, stabilized with antidepressant medications on an inpatient psychiatric unit, were consecutively assigned on discharge to motivational therapy (N=11) or treatment-as-usual (N=12) during the first month of outpatient care. Patients were compared on treatment adherence and completion and on 1-year rehospitalization rates. Results:Motivational therapy patients attended significantly more treatment sessions during month 1, completed 30 and 90 days of outpatient care at higher rates, and experienced fewer psychiatric rehospitalizations and days in the hospital during the first year from entry into outpatient treatment.Conclusions:An outpatient program combining individual and group motivational therapy sessions holds promise for improving treatment adherence and completion among depressed patients with cocaine dependence. Am J Psychiatry 1998; 155: 1611-1613