Goal Management Training for Methamphetamine Addiction

Intervention

Intervention code Treatment: Other

Goal Management Training+ (GMT) – active intervention GMT+ (i.e., an abbreviated and population [methamphetamine use disorder]-tailored adaptation of GMT [Levine et al., 2011]) is a therapist-guided group-based cognitive remediation intervention that includes instruction and practise tasks to train the executive functions that facilitate goal setting, self-regulation and advantageous decision-making. The program includes 4 modules / sessions delivered via PowerPoint presentations, and a take-hom .... Goal Management Training+ (GMT) – active intervention GMT+ (i.e., an abbreviated and population [methamphetamine use disorder]-tailored adaptation of GMT [Levine et al., 2011]) is a therapist-guided group-based cognitive remediation intervention that includes instruction and practise tasks to train the executive functions that facilitate goal setting, self-regulation and advantageous decision-making. The program includes 4 modules / sessions delivered via PowerPoint presentations, and a take-home “paper and pencil” journal to practise between sessions. Each session trains a specific executive function. Session 1 (Be Aware) trains sustained attention; participants are taught to notice when their thoughts are drifting and to apply mindfulness strategies to stay in the present moment. Session 2 (Pause) trains inhibitory control; participants are taught to ‘pause’ and refocus on a current task. Session 3 (Envision Goals) trains working memory; participants are taught strategies to maintain their goals “on line”. Session 4 (Decide) trains decision-making; participants are taught to apply future-based thinking and to use long-term goals to guide current decision-making. Each session provides instructional content, interactive activities to demonstrate how cognition-related errors can contribute to substance use, and related discussions. Facilitators will lead discussions about how these errors occur in everyday life and then provide strategies to strengthen cognitive control skills. In addition to the 4 sessions, participants are provided with a journal to engage in daily practise of the GMT+ strategies, aiding transfer of these skills to everyday life goals. The first session will be conducted after each participant has undergone detoxification. GMT+ will be facilitated by clinical psychology doctoral students with a minimum of 6 years of training in psychology. The program will be delivered in a face to face group setting at urban residential rehabilitation centres and will include between 4-6 participants. There are four 90-minute weekly sessions, and four weeks of daily journal activities, which take approximately 10 minutes per day to complete. Intervention adherence will be monitored with a session attendance checklist. The facilitators will mark down participant attendance at the beginning and end of each session, in order to record entire session attendance.
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Comparison

Control group Active

Brain Health Workshop – control intervention Brain Health Workshop (BHW) is a therapist-guided group psychoeducation program designed to match GMT+ in terms of format, group discussions, time spent with facilitators, and between-session homework duration. BHW will serve as an active control while maintaining a health promotion orientation. BHW includes 4 sessions that provide PowerPoint content, group-based discussions and interactive activities, and a journal to reflect on the health-related co .... Brain Health Workshop – control intervention Brain Health Workshop (BHW) is a therapist-guided group psychoeducation program designed to match GMT+ in terms of format, group discussions, time spent with facilitators, and between-session homework duration. BHW will serve as an active control while maintaining a health promotion orientation. BHW includes 4 sessions that provide PowerPoint content, group-based discussions and interactive activities, and a journal to reflect on the health-related content in between sessions. Each week focuses on a different element of brain health and healthy living. Week 1 delivers content on basic brain anatomy and cognition, the impact of long-term methamphetamine use on cognition, and an introduction to neuroplasticity. Weeks 2-4 deliver content on healthy lifestyle practices that are related to neuroplasticity. Week 2 focuses on healthy exercise, Week 3 focuses on healthy diet, and Week 4 focuses on healthy sleep. Each session provides information about the benefit of a health-oriented lifestyle on the brain and includes interactive activities to foster active participation in the program. These activities provide health-oriented educational content but will not actively train cognition. Facilitators will lead discussions about participants’ current lifestyles and how to enhance healthy living in everyday life. Participants are provided with a journal to engage in daily reflections of healthy living suggestions (e.g., reflecting on sleep quality or diet changes). The first session will be conducted after each participant has undergone detoxification. BHW will be facilitated by clinical psychology doctoral students with a minimum of 6 years of training in psychology. The program will be delivered in a face to face group setting at urban residential rehabilitation centres and will include between 4-6 participants. There are four 90-minute weekly sessions, and four weeks of daily journal activities, which take approximately 10 minutes per day to complete. Intervention adherence will be monitored with a session attendance checklist. The facilitators will mark down participant attendance at the beginning and end of each session, in order to record entire session attendance.
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Outcomes

Outcome: Change in executive function from pre-post interventions, assessed using the overall summary score on the Behavior Rating Inventory of Executive Function- Adult Version (BRIEF-A).
Timepoint: Baseline: One week before the interventions. Post-intervention: Within one week following completion of the interventions.

Outcome: Feasibility of the program assessed by the proportion of participants who complete GMT+, indicated by an audit of the study database.
Timepoint: Within one week following completion of the interventions

Outcome: Acceptability of the program compared to the control interventions, assessed by the proportion of people who withdraw consent prior to engaging in GMT+, indicated by an audit of study databases, and participants positive rating of GMT+ on a 4-item acceptability scale.
Timepoint: Within one week following completion of the interventions