The Impact of Cognitive Behavioral Therapy for Substance Use Disorders on Veterans’ Interpersonal Difficulties

Abstract

Background: Substance use disorders (SUDs) negatively impact veterans and their relationships with others. Although there are several evidence-based treatments for SUD symptoms, there is less research on whether reduction in SUD symptoms coincides with reduction in interpersonal difficulties. Methods: In this study we examined the relationship between SUD and relationships in a national sample of 458 veterans who received approximately 12 sessions of Cognitive Behavioral Therapy for Substance Use Disorders (CBT-SUD) through the Veterans Health Administration (VHA). Results: Parallel latent growth curve modeling (LGCM) indicated that self-reported alcohol use, drug use, and interpersonal difficulties decreased over the course of treatment. Alcohol and drug use were positively associated with each other and with interpersonal difficulties at each time point, and baseline alcohol and drug use were negatively associated with the reduction of use over time. However, there was little evidence that reductions in substance use led to a reduction in interpersonal difficulties (or vice-versa). Conclusions: Findings highlight promising strategies to further understand how CBT-SUD may enhance reductions in substance use as well as improve relationships with family and friends.

Keywords:

• Alcohol
• substance use
• cognitive-behavioral therapy
• veterans
• relationships

Declaration of interest

The authors declare that they have no conflict of interest. The authors alone are responsible for the content and writing of the article. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Department of Veterans Affairs or the United States Government.

Ethical approval

This was not a clinical trial. The Institutional Review Board (IRB) at the University of California, San Francisco determined that, given the nature of this as program evaluation of a quality improvement initiative, IRB review was not required.

Data availability statement

Due to the nature of this program evaluation project, participants did not agree for their data to be shared publicly, so supporting data is not publicly available.

Additional information

Funding

Jerika Norona’s and Catherine Baxley’s efforts were supported by the VISN 21 Sierra-Pacific Mental Illness Education and Clinical Center (MIRECC). Dr. Borsari’s contribution is the result of work supported with resources and the use of facilities at the San Francisco VA Medical Center and the Northern California Institute for Research and Education. This project was supported by the National Evidence-Based Psychotherapy Training Program, Department of Veterans Affairs Office of Mental Health and Suicide Prevention and the VISN 6 Mental Illness Research, Education and Clinical Center. This evaluation did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.