Research on individuals with anxiety and alcohol dependence earns Hazelden award

Matt G. Kushner, Ph.D., professor of Psychiatry, University of Minnesota (Minneapolis) has earned the latest Dan Anderson Research Award for his study examining the effectiveness of a hybrid cognitive behavioral therapy in the treatment of individuals with co-occurring anxiety disorders and alcohol dependence. The award, which is sponsored by the Butler Center for Research at Hazelden, honors a single published article by a researcher who has advanced the scientific knowledge of addiction treatment and recovery.

Kushner earned the award for his study, “Hybrid cognitive behavioral therapy versus relaxation training for co-occurring anxiety and alcohol disorder: A randomized clinical trial,” published in 2013 in the Journal of Consulting and Clinical Psychology. The study focused on 344 individuals undergoing residential treatment for a substance use disorder – all of whom also had a current diagnosis of social phobia, generalized anxiety disorder, or panic disorder. Participants were randomly assigned to receive either Cognitive Behavioral Therapy (CBT) or Progressive Muscle Relaxation Training (PMRT). The CBT treatment was a hybrid approach developed by Kushner and his colleagues and focused specifically on disrupting the psychological processes linking feelings of anxiety to alcohol use. The primary aim of the study was to examine whether the CBT approach, relative to the PMRT treatment, improved alcohol use outcomes in the four months following treatment.

Kushner and his colleagues concluded from the work that disrupting the psychological linkages between anxiety feelings and the inclination to use alcohol appear to be more important than simply reducing anxiety in these patients through conventional psychiatric and psychological treatments. 

“Individuals with an anxiety disorder are two to four times more likely to be dependent on alcohol than are others in the general U.S. community” said Kushner. “The strong correlation between them suggests that important etiologic and/or maintaining processes link these conditions.” 

Dr. Ken Winters, also a professor of Psychiatry at the University of Minnesota, nominated Kushner for the award, stating “This paper is a seminal contribution with the potential to change both the practice of alcohol treatment and to alter the course of comorbidity research.”      

As predicted, the group of patients receiving the hybrid CBT had significantly better alcohol outcomes four months after treatment. They were significantly less likely than PMRT participants to relapse to any alcohol use and had significantly fewer drinking days. In addition, both groups experienced a significant reduction in anxiety symptoms in the four months following treatment. These data, along with supplemental analyses, provide compelling evidence that aiming treatment at the conjunction of anxiety and alcohol use is more effective than treating the conditions as independent problems.  

“Our Scientific Panel of Advisors was extremely impressed with the scientific rigor of this study, and the fact that Dr. Kushner and his colleagues developed and tested a CBT approach that specifically focused on decoupling the association between drinking alcohol and the reduction of anxiety symptoms,” stated Dr. Audrey Klein, executive director of the Butler Center for Research at the Hazelden Foundation. “Anxiety disorders such as generalized anxiety disorder and panic disorder are diagnoses that we commonly see in patients seeking residential treatment at Hazelden. The clinical importance of treating the anxiety issues is paramount, particularly given the fact that experiencing the adverse symptoms of anxiety may place an abstinent person at increased risk of relapse.”

Dr. Kushner will accept the award and a $2,000 honorarium from Hazelden later this year. The award is named for the late Dan Anderson, Ph.D., former president of Hazelden and one of the major architects of the Minnesota Model—today known as the Hazelden model—which is the interdisciplinary approach to addiction treatment that has been implemented worldwide.