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The Successive Cohort Design: A Model for Developing New Behavioral Therapies for Drug Use Disorders, and Application to Behavioral Couple Treatment

Epstein, Elizabeth E. PhD* †; McCrady, Barbara S. PhD* †; Morgan, Thomas J. PsyD*; Cook, Sharon M. MS*; Kugler, Greta MS*; Ziedonis, Douglas MD, MPH

Addictive Disorders & Their Treatment: March 2007 - Volume 6 - Issue 1 - p 1-19
doi: 10.1097/01.adt.0000210707.49703.2c
Original Articles

The purpose of this article is to present a new model, coined “successive cohort design” (SCD), for developing and testing psychosocial therapies, and to illustrate the model with a description of a specific treatment developed. Using this SCD, we developed an outpatient Behavioral Couple Therapy for Drug Abuse (BCTD) manual under a National Institute on Drug Abuse Stage 1 Behavioral Therapy Development grant. After a start-up period during which an initial manual was written, 3 cohorts of couples were treated in weekly, 6-month outpatient, manual-guided BCTD, over a 2.5-year period. After each sample wave, the assessment and/or treatment protocol was revised based on our experience of treating that cohort. In total, 24 couples were treated, 12 in the first cohort, 6 in the second, and 6 in the third. Participants were assessed at baseline and 6 and 9 months later. The outcome data are reported elsewhere.1 This SCD for Stage 1 research is offered as a useful and viable therapy development model.

*Center of Alcohol Studies, Rutgers-The State University of New Jersey, USA

From the Department of Psychiatry, University of Medicine and Dentistry of New Jersey, Piscataway, New Jersey, USA

Reprints: Elizabeth E. Epstein, PhD, Center of Alcohol Studies, 607 Allison Road, Rutgers -The State University of New Jersey, Piscataway, New Jersey 08854, USA (e-mail:

Received for publication December 23, 2005; accepted March 24, 2006

© 2007 Lippincott Williams & Wilkins, Inc.