Behavioral Treatment for Cocaine Dependent Women

Behavioral Treatment for Cocaine Dependent Women

To compare the efficacy of Community Reinforcement Approach (CRA) and 12-Step Facilitation (TSF) counseling and of voucher based reward therapy (VBRT) and a yoked, non-contingent voucher control (VC) for the treatment of cocaine dependent pregnant women or women with young children.

Subjects were randomly assigned to 1 of 4 treatment groups (CRA+VBRT, CRA+VC, TSF+VBRT, TSF+VC). VBRT voucher value increased for each successive cocaine-free urine sample obtained twice weekly during the 1st 12 weeks and was faded from the final earned value to $5 during the last 12 weeks. All subjects earned vouchers for attendance at scheduled twice weekly counseling sessions. Manual-guided CRA and TSF were provided by experienced clinicians.

Inclusion Criteria:

• Pregnant women meeting DSM IV criteria for cocaine dependence
• Women meeting DSM IV criteria for cocaine dependence with custody of a young child

Exclusion Criteria:

• Opioid dependence
• Psychosis
• Severe depression
• Current treatment with any anti-depressant or anti-psychotic medication
• Medical instability
• Inability to understand or read English