Drama Therapy for Substance Use Disorders

(Co-ATT Trial)

Overseen By William-Bernard Reid-Varley, MD MPH

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Boston Medical Center

Disqualifiers: Incarcerated, Pregnant, Inability to consent

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 12

Duration: 12 weeks

10 Participants Needed

Trial Summary

What is the purpose of this trial?

Drama Therapy involves of the use of theatrical techniques (such as script development, acting exercises, improvisation, etc.) to help treat patients' mental illness and improve their functioning and overall sense of wellbeing. This study will evaluate the effectiveness of a specific version of drama therapy for the treatment of patients suffering from both mental illness (such as depression, bipolar disorder, schizophrenia, etc.) and one or more substance use disorders. The study will also assess participants feelings and thoughts about the drama therapy intervention (such as whether or not they enjoyed it and if/how they found it helpful). The drama therapy intervention will consist of one group drama therapy session per week, for a total of twelve weeks (i.e., total twelve sessions) followed by a single performance (with composition of the audience determined by unanimous agreement of the participants) of the dramatic work (script) produced by the participants during the course of the drama therapy intervention.

Will I have to stop taking my current medications?

The trial does not specify whether you need to stop taking your current medications. It includes participants who are currently taking medications and those who are not.

What data supports the effectiveness of the treatment Co-Active Therapeutic Theatre (Co-ATT) for Substance Use Disorders?

Research shows that theater-based projects can help people recovering from substance use disorders by improving social and occupational participation, with 86% of participants remaining abstinent for 6 weeks after the intervention. Additionally, drama therapy has been used successfully in other mental health treatments, helping patients understand themselves and others better, which may also benefit those with substance use disorders. ^{1 2 3 4 5}

Is drama therapy for substance use disorders safe for humans?

Research on psychosocial therapies, like those for substance use disorders, shows that serious adverse events (unexpected negative effects) are rare and not typically related to the therapy itself. This suggests that such therapies, including drama therapy, are generally safe for humans. ^{6 7 8 9 10}

How is Co-Active Therapeutic Theatre (Co-ATT) different from other treatments for substance use disorders?

Co-Active Therapeutic Theatre (Co-ATT) is unique because it uses drama therapy, which involves acting and role-playing, to help individuals express emotions and explore personal issues related to substance use. This approach is different from traditional treatments that may focus more on medication or talk therapy, as it provides a creative and interactive way to engage patients in their recovery process. ^{9 11 12 13 14}

Research Team

William-Bernard Reid-Varley, MD MPH

Principal Investigator

Boston Medical Center, Psychiatry Department

Eligibility Criteria

This trial is for individuals who are dealing with both a mental health issue (like depression, bipolar disorder, or schizophrenia) and a substance use disorder. Specific details about eligibility criteria were not provided.

Inclusion Criteria

I have been diagnosed with a mental health condition and a substance use problem, both currently active.

Enrolled in the Addiction Psychiatry Treatment Program (APTP) at Boston Medical Center (scheduled for follow-up appointments with therapist and/or psychiatrist in APTP)

I am currently taking medication.

Exclusion Criteria

Pregnant women

Incarcerated persons

Inability to understand and/or sign informed consent form

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants undergo drama therapy sessions once a week for twelve weeks, culminating in a single performance of the dramatic work produced during the therapy

12 weeks

12 visits (in-person)

Follow-up

Participants are monitored for changes in psychiatric symptoms, substance use, and overall functioning

3 months

Treatment Details

Interventions

• Co-Active Therapeutic Theatre (Co-ATT)

Trial Overview The study tests Co-Active Therapeutic Theatre (Co-ATT), which uses drama techniques to treat mental illness and improve wellbeing in patients with dual-diagnosis of mental health and substance abuse issues. It includes weekly group sessions over three months plus one final performance.

Participant Groups

Group I: Co-Active Therapeutic Theatre (Co-ATT) Experimental Treatment 1 Intervention

Drama therapy will be used to treat participants with co-occurring primary psychiatric and substance use disorders

Who Is Running the Clinical Trial?

Boston Medical Center

Lead Sponsor

Trials

410

Recruited

890,000+

Findings from Research

In a study involving 1,687 substance-abusing participants over 27,198 person-weeks, 12% experienced serious adverse events (SAEs), but none were deemed related to the psychosocial interventions being tested.

There were no significant differences in the incidence rates of SAEs between those receiving standard care and those receiving additional interventions like contingency management or motivational enhancement, suggesting that these psychosocial treatments are safe in terms of serious adverse events.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Serious adverse events in randomized psychosocial treatment studies: safety or arbitrary edicts? Petry, NM., Roll, JM., Rounsaville, BJ., et al.[2021]

Multidimensional Family Therapy (MDFT) has been shown to be more effective than other treatments like group therapy and cognitive-behavioral therapy for adolescents with severe drug use and psychiatric issues, particularly in addressing cannabis abuse.

MDFT integrates various therapeutic techniques and focuses on the family system, which helps improve emotional expression and parental involvement, leading to better outcomes in adolescent development and substance abuse treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Multidimensional family therapy: which influences, which specificities?]. Bonnaire, C., Bastard, N., Couteron, JP., et al.[2014]

In a study involving 137 participants, the adapted START NOW psychotherapy was found to be as effective as standard treatment-as-usual (TAU) for opioid use disorder, with similar attendance and drug use outcomes over 32 weeks.

START NOW psychotherapy is freely available and could be particularly beneficial in low-resource settings, making it a valuable option for treating opioid use disorder alongside medications like buprenorphine.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Noninferiority Clinical Trial of Adapted START NOW Psychotherapy for Outpatient Opioid Treatment. Truong, A., Kablinger, A., Hartman, C., et al.[2023]

References

1. United States pubmed.ncbi.nlm.nih.gov

Theater-Based Community Engagement Project for Veterans Recovering From Substance Use Disorders. [2016]

2. United States pubmed.ncbi.nlm.nih.gov

Development of a behavior analytically derived alcohol-specific role-play assessment instrument. [2019]

3. United States pubmed.ncbi.nlm.nih.gov

[The use of theatre in the psychosocial readaptation of patients with mental disorders: participants' perspectives]. [2017]

4. England pubmed.ncbi.nlm.nih.gov

Clinical effectiveness of dramatherapy in the recovery from neuro-trauma. [2019]

5. United States pubmed.ncbi.nlm.nih.gov

Drama therapy as a means of rehabilitation for schizophrenic patients: our impressions. [2018]

6. England pubmed.ncbi.nlm.nih.gov

Changing provider practices, program environment, and improving outcomes by transporting multidimensional family therapy to an adolescent drug treatment setting. [2019]

7. England pubmed.ncbi.nlm.nih.gov

Study protocol: a dissemination trial of computerized psychological treatment for depression and alcohol/other drug use comorbidity in an Australian clinical service. [2021]

8. United States pubmed.ncbi.nlm.nih.gov

Serious adverse events in randomized psychosocial treatment studies: safety or arbitrary edicts? [2021]

9. France pubmed.ncbi.nlm.nih.gov

[Multidimensional family therapy: which influences, which specificities?]. [2014]

10. United States pubmed.ncbi.nlm.nih.gov

Noninferiority Clinical Trial of Adapted START NOW Psychotherapy for Outpatient Opioid Treatment. [2023]

11. United States pubmed.ncbi.nlm.nih.gov

Trauma-informed Drug Screens for Veterans with Co-occurring Disorders: A Case Series. [2021]

12. England pubmed.ncbi.nlm.nih.gov

Network therapy for addiction: bringing family and peer support into office practice. [2019]

13. United States pubmed.ncbi.nlm.nih.gov

Use of milieu as a problem-solving strategy in addiction treatment. [2005]

14. Switzerland pubmed.ncbi.nlm.nih.gov

Effect of Assertive Community Treatment for Patients with Substance Use Disorder: A Systematic Review. [2019]