The purpose of this study is to determine whether Integrated Cognitive Behavioral Therapy or Twelve Step Facilitation Therapy is most effective for treatment of dually diagnosed veterans with depressive and substance use disorders.

Depression is the most frequent co-occuring mental health disorder among adults with substance use disorders, and such comorbidity is often associated with poorer treatment outcomes. Although there is an urgent need for effective treatments specific for dual-diagnosis adults, few studies have been conducted to address this need.

Comparison: This study will compare substance use and depression symptoms of individuals in two different psychotherapy groups: Integrated Cognitive Behavioral Therapy and Twelve Step Facilitation Therapy. Symptoms and substance use will be compared during the active treatment phase (24 weeks) and for one year following the end of the active treatment.

Inclusion Criteria:

• Individuals diagnosed with one or more substance use disorders (alcohol, cannabis, and or stimulant abuse/dependence) and an independent co-occurring depressive disorder (major depression or dysthymia) will be included.

Exclusion Criteria:

• Individuals with substance induced mood disorders and individuals experiencing persistent psychotic symptoms.
• Those with life threatening or unstable medical illness, neurological disorders, or inability to read will be excluded.
• Individuals currently prescribed steroids, disulfiram, or long acting benzodiazepines will be excluded.