Addictions Research: CAMH Research Annual Report 2002

The Addictions Section conducts clinical research, both experimental and applied, in all aspects of addiction. In the past year, the section has undergone a formal internal and external review, the results of which will serve to strengthen and guide the development of our work.

Gambling Research
The Gambling Research stream, headed by Dr. Tony Toneatto, is committed to developing empirically supported psychotherapies for problem gambling, exploring the role of pharmacotherapies for problem gambling, and contributing to the knowledge of the cognitive and behavioural phenomenology of gambling. This area of research continues to attract considerable research grant funding and to establish collaborations with several scientists within CAMH and throughout Canada.

Psychopharmacology Research
The Psychopharmacology Research stream (Drs. Bruna Brands, David Marsh, Peter Selby and Beth Sproule) is committed to expanding the range of pharmacological tools to treat substance use disorders. This goal is accomplished by evaluating novel medications, integrating existing medications into treatment settings and approaches, and applying statistical methods to predict treatment outcome. Dr. Sproule is the newest scientist in our section, joining us in January, 2002. Dr. Selby was successful in obtaining funding from Health Canada for a program directed at educating pregnant woman who smoke.

Treatment Outcome Research
The Treatment Outcome Research stream consists of three clinics headed by psychologists; the goal of this group is to address comorbid addiction populations requiring specialized care.

The Anger and Addiction Clinic, headed by Dr. Lorne Korman, provides novel, empirically-supported treatments for clients with concurrent anger, aggression and substance use problems. The Dialectical Behaviour Therapy Clinic (Dr. Shelley McMain) is committed to the specialized treatment of borderline personality disorder (with or without a concurrent addiction) using the principle of dialectical behaviour therapy. The Eating Disorders and Addictions Clinic (Dr. Christine Courbasson) is developing new clinical approaches to treat concurrent eating disorders and substance use disorders. All three clinics also provide consultation and training to other mental heath care professionals throughout Canada and beyond.

In addition, a new psychologist, Dr. Rebecca Dempster, has recently been recruited. Dr. McMain received a commitment of funding from the CAMH Foundation for a study treating suicidal behaviour in people who have borderline personality disorder. Recently, Drs. McMain and Korman have completed evaluating the effectiveness of dialectical behaviour therapy for people diagnosed with concurrent borderline personality and substance use disorders. This small sample pilot study has demonstrated significant benefits of dbt compared to treatment as usual for this patient sample. Drs. McMain and Korman have been presenting the results of this research at conferences and workshops through-out Canada and internationally.

Clinical Services Research
The Clinical Services Research stream (Dr. Tony Toneatto) was formed after recommendations from an external review of the existing clinical follow-up services at the Russell Street site. Clinical Services Research conducts rigorous evaluation research, both controlled and naturalistic, of individual addiction treatment programs. The goal is to improve both the content and delivery of clinical treatment and to experimentally evaluate treatment innovations. We are set to begin an evaluation of the Guided Self-Change program, one of the major clinical programs for addictions at CAMH. We hope to evaluate the treatment components to identify predictors of positive outcome and means of improving this treatment. We are collaborating with several other programs to conduct similar evaluations.