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A 12-Week CBT + Motivation Program for Cannabis Use Disorder: Patients Used Less and Felt Better

After 12 weeks of group therapy combining cognitive behavioral therapy and motivational enhancement, cannabis use disorder patients used less cannabis, had fewer cravings, and improved on depression, anxiety, and self-efficacy.

Trick, Leanne et al.·Substance abuse : research and treatment·2023·Preliminary EvidenceRetrospective Cohort·1 min read
Withdrawal (166)Addiction (1380)Mental Health (840)Quitting (221)
RTHC-04987Retrospective CohortPreliminary Evidence2023RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Retrospective Cohort
Evidence
Preliminary Evidence
Sample
Participants were treatment-seeking cannabis users at the Centre for Addiction and Mental Health, Toronto.
Participants
Participants were treatment-seeking cannabis users at the Centre for Addiction and Mental Health, Toronto.

What This Study Found

Cannabis use disorder (CUD) is increasingly recognized as a real clinical condition, but treatment options have been slow to develop. This study evaluated a structured 12-week outpatient group therapy program at Toronto's Centre for Addiction and Mental Health — one of Canada's premier addiction treatment centers.

The program combined two evidence-based approaches: cognitive behavioral therapy (CBT), which helps patients identify and change thought patterns and behaviors that drive cannabis use, and motivational enhancement therapy (MET), which builds internal motivation to change. The group format added peer support and shared accountability.

The results were encouraging across the board. After treatment, participants showed lower cannabis use, more days of abstinence, fewer cannabis-related problems, reduced cravings, less severe withdrawal symptoms, and improved self-efficacy (confidence in their ability to stay abstinent). Depression and anxiety scores also improved.

Treatment retention — always a challenge in addiction treatment — was assessed by tracking clinic attendance. Client satisfaction, measured by anonymous feedback, was positive. The researchers also explored what predicted better outcomes and retention, looking for patterns that could help match patients to treatment.

This is important practical evidence because most cannabis treatment research has tested individual therapy. Group therapy is more cost-effective and more widely scalable, making it relevant for the many treatment programs facing long waitlists for cannabis-related concerns.

Key Numbers

12-week program. Treatment setting: outpatient group therapy at Centre for Addiction and Mental Health, Toronto. Post-treatment improvements: lower cannabis use, more abstinence days, reduced craving, fewer withdrawal symptoms, improved self-efficacy, lower depression and anxiety scores. Client satisfaction was positive. Specific effect sizes and retention rates were measured but detailed in the full paper.

How They Did This

Retrospective observational cohort study using medical records and self-report assessments from treatment-seeking cannabis users at the Centre for Addiction and Mental Health, Toronto. Pre- and post-treatment measures: cannabis use, cannabis-related problems, craving, withdrawal symptoms, self-efficacy, depression, and anxiety. Treatment retention calculated from attendance records. Client satisfaction assessed via anonymous feedback survey. Exploratory analyses examined predictors of outcomes and retention.

Why This Research Matters

As cannabis use increases and more people develop problematic use patterns, accessible treatment options are urgently needed. Individual therapy is effective but expensive and limited in availability. This group-based CBT+MET program showed meaningful improvements in a real-world clinical setting, offering a scalable model that other treatment centers could adopt. The combination of reduced use AND improved mental health symptoms is particularly valuable since depression and anxiety commonly co-occur with CUD.

The Bigger Picture

This connects to the withdrawal and quitting studies throughout the database. RTHC-00037 (Budney's withdrawal timeline) established that cannabis withdrawal is real and clinically significant. RTHC-00053 (voucher-based therapy) tested a different behavioral approach. This study adds a group CBT+MET model to the treatment toolkit. Together, they show that behavioral treatments for CUD work — the question is which approaches work best for which patients.

What This Study Doesn't Tell Us

Retrospective design without a control group — improvements could partly reflect natural recovery, regression to the mean, or motivation to change that existed before treatment began. Self-report measures are subject to social desirability bias, especially in a treatment setting. No long-term follow-up to assess whether improvements persisted after the 12-week program ended. Single-center study at a well-resourced addiction hospital — results may differ in less specialized settings.

Questions This Raises

  • ?How do outcomes compare to individual therapy or other group formats?
  • ?Do improvements persist at 6 and 12 months post-treatment?
  • ?Would adding pharmacotherapy (like NAC or gabapentin) to the group program improve outcomes?
  • ?Which patients benefit most from group versus individual treatment?

Trust & Context

Key Stat:
Evidence Grade:
Retrospective observational study without a control group. The consistent improvements across multiple measures are encouraging, but the lack of comparison group and randomization means the evidence is preliminary.
Study Age:
Published in 2023. Treatment research for cannabis use disorder continues to expand as CUD gains clinical recognition.
Original Title:
Implementation and Preliminary Evaluation of a 12-Week Cognitive Behavioural and Motivational Enhancement Group Therapy for Cannabis Use Disorder.
Published In:
Substance abuse : research and treatment, 17, 11782218231205840 (2023) — Substance Abuse: Research and Treatment is a peer-reviewed journal focusing on addiction research.
Database ID:
RTHC-04987

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-ControlFollows or compares groups over time
This study
Cross-Sectional / Observational
Case Report / Animal Study

Looks back at existing records to find patterns.

What do these levels mean? →

Read More on RethinkTHC

Cite This Study

RTHC-04987·https://rethinkthc.com/research/RTHC-04987

APA

Trick, Leanne; Butler, Kevin; Bourgault, Zoe; Vandervoort, Julianne; Le Foll, Bernard. (2023). Implementation and Preliminary Evaluation of a 12-Week Cognitive Behavioural and Motivational Enhancement Group Therapy for Cannabis Use Disorder.. Substance abuse : research and treatment, 17, 11782218231205840. https://doi.org/10.1177/11782218231205840

MLA

Trick, Leanne, et al. "Implementation and Preliminary Evaluation of a 12-Week Cognitive Behavioural and Motivational Enhancement Group Therapy for Cannabis Use Disorder.." Substance abuse : research and treatment, 2023. https://doi.org/10.1177/11782218231205840

RethinkTHC

RethinkTHC Research Database. "Implementation and Preliminary Evaluation of a 12-Week Cogni..." RTHC-04987. Retrieved from https://rethinkthc.com/research/trick-2023-implementation-and-preliminary-evaluation

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Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.

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