The effects of craving on implicit cognitive mechanisms involved in risk behavior: can dialectical behavior therapy in therapeutic communities make a difference? A pilot study

Purpose: The purpose of this paper is to examine pre- to post-change in two components of implicit cognitive functioning following craving induction – attentional bias (AB) and executive control – of patients in a long-term drug-free residential treatment center that incorporated dialectical behavioral therapy (DBT) with usual therapeutic community (TC) practices. Design/methodology/approach: Three groups of alcohol and cannabis dependent female adolescents were compared: pre-treatment (n=12), following four months of treatment (n=11), and following 12 months of treatment (n=7). Findings: The results indicate significantly lower AB (as measured by visual probe task) and improved response inhibition (as measured by stop signal task) under craving conditions, after 12 months of DBT. Research limitations/implications: Naturalistic character of the study did not allow the use of repeated measures design, drug using control groups, randomized clinical trial, or performing a longitudinal follow-up. However, the findings show that DBT for drug abusing female adolescents in a long-term residential setting may be an effective intervention to enhance cognitive and executive functions critical to the risk chain involved in relapse and recidivism, supporting the implementation of DBT in TC residential settings. Originality/value: This is the first research paper that examined effects of DBT+TC on substance dependent female adolescents’ cognitive mechanisms using well-validated behavioral tasks. The research provides some empirical evidence for the improvement in AB and response inhibition under craving conditions following treatment.