Development and Initial Pilot Testing of a fully integrated treatment for comorbid social anxiety disorder and alcohol use disorder in a community-based SUD clinic setting.

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Publisher: Elsevier Science Publishers
Document Type: Report; Brief article
Length: 397 words

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Keywords Social anxiety; Alcohol use disorder; Integrated treatment Highlights * Combining social anxiety and alcohol treatment improved social anxiety more than standard alcohol treatment. * Combining social anxiety and alcohol treatment also improved alcohol use more than alcohol treatment. * There were no differences between groups on treatment engagement outcomes. Abstract Objectives Social anxiety disorder (SAD) and alcohol use disorder (AUD) are highly comorbid and this comorbidity is associated with poorer clinical outcomes. Integrating exposure-based treatment for SAD into the context of typical AUD treatment programs should improve engagement and treatment outcomes for this population. Methods After initial development of a fully integrated, intensive outpatient program (IOP) for individuals with comorbid SAD and AUD, patients with SAD and AUD were recruited from a community-based SUD specialty clinic (N = 56) and randomized to either (a) usual care (UC), consisting of the evidence-based Matrix Model of Addiction IOP; or (b) the Fully Integrated Treatment (FIT) for comorbid SAD and AUD IOP. Participants were assessed on indices of social anxiety and alcohol use. Results By the 6-month follow-up, those in FIT showed superior improvement to UC on number of drinking days in the past 30 days and social anxiety severity at follow-up, but there were no differences between groups on quantity of alcohol consumed on drinking days. Alcohol-related problems improved in both groups, with no statistically significant differences. Within-group improvement was observed in FIT (but not in UC) on drinking to cope with social anxiety and avoidance of social situations without alcohol, but between-group effects were non-significant. In sum, the integrated treatment of SAD and AUD led to greater reductions in both the frequency of drinking and in social anxiety symptoms than usual care. Conclusions Targeting social anxiety in the context of AUD treatment is a promising approach to improving the treatment of this common comorbidity. Author Affiliation: (a) University of California, Los Angeles, Department of Psychiatry and Biobehavioral Sciences, Integrated Substance Abuse Programs, USA (b) California State University, Dominguez Hills, Department of Psychology, USA (c) University of Washington, Department of Psychiatry, USA (d) CLARE/Matrix, USA * Corresponding author. UCLA Department of Psychiatry and Biobehavioral Sciences, ISAP 11075 Santa Monica Blvd., Suite 200, Los Angeles, CA, 90025, USA. Article History: Received 17 August 2021; Revised 6 November 2021; Accepted 12 November 2021 Byline: Kate Wolitzky-Taylor [kbtaylor@mednet.ucla.edu] (a,*), Amy Sewart (b), Mitchell Karno (a), Richard Ries (c), Janice Stimson (d)

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Gale Document Number: GALE|A687615528