Please select the eligibility criteria that correspond to the clinical trial below.
Title: Integrated CBT for Substance Use and Depressive Disorders
Brief Summary: The purpose of this study is to determine whether Integrated Cognitive Behavioral Therapy or Twelve Step Facilitation Therapy is most effective for treatment of dually diagnosed veterans with depressive and substance use disorders.


Options:
A: Inclusion Criteria:

* Individuals diagnosed with one or more substance use disorders (alcohol, cannabis, and or stimulant abuse/dependence) and an independent co-occurring depressive disorder (major depression or dysthymia) will be included.

Exclusion Criteria:

* Individuals with substance induced mood disorders and individuals experiencing persistent psychotic symptoms.
* Those with life threatening or unstable medical illness, neurological disorders, or inability to read will be excluded.
* Individuals currently prescribed steroids, disulfiram, or long acting benzodiazepines will be excluded.
B: Inclusion Criteria:

1. A current Fagerstrom scale score of 6 or greater;
2. Age 13 years old or older (Under age 18, parental consent is required);
3. Able to read and understand English.

Exclusion Criteria:

1. Have current severe, uncontrolled psychiatric disorders (i.e., acute suicidality or psychosis);
2. Have current substance dependence, other than nicotine or caffeine dependence;
3. Are in recovery for pathological gambling; or
4. Are already participating in other behavioral or medication smoking cessation programs.
C: Inclusion Criteria:

* Pregnant AI females aged 12 to 19 years old at time of conception.
* Gestational age of 28 weeks or less (in order to complete intervention prior to delivery).
* Parent/guardian consent for youth under 18 years old.
* Reside within 1-hour transportation range (50 miles) of the local Indian Health Service medical facility.

Exclusion Criteria:

* Current participation in other mental or behavior health research project.
* Factors that preclude full participation, identified at baseline and after caseness review, including: unstable and severe medical, psychiatric or drug use problem; acute suicidal or homicidal ideation requiring immediate intervention; recent, severe stressful life event such as physical or sexual abuse, or victim of a violent crime that requires specific and high intensity intervention or out of home placement; or chronic pattern of unstable caretakers or living situation.
D: Inclusion Criteria for Step 1:

* alcohol dependence according to DSM-IV criteria, with alcohol as the subject's drug of choice,
* age 18-65,
* adequate cognition and English language skills to give valid consent and complete research interviews (as assessed by the mini mental state examination),
* willingness to give written consent,
* abstinence from alcohol for between 3 and 21 days (standard clinical criteria for use of acamprosate or naltrexone),
* resolution of any clinically evident alcohol withdrawal (score 0-1 on RPA hospital alcohol withdrawal scale), and a positive score on the initial comorbidity suspicion checklist (CSC).

Exclusion Criteria for Step 1:

* sensitivity to study medications or therapy with these drugs within 6 months,
* active major psychiatric disorder associated with significant suicide risk,
* pregnancy or lactation,
* advanced liver disease (hepatocellular failure, variceal bleeding, ascites or encephalopathy),
* other serious medical illness that would interfere with adherence to the study protocol.

Entry criteria to step 2:

* Completion of 3 weeks on acamprosate and/or natlrexone and/or, resolution of any clinically evident alcohol withdrawal (score 0-1 on RPA hospital alcohol withdrawal scale),
* case formulation and diagnosis for anxiety or depression (see below).

Exclusion criteria 2:

* Non-compliance on acamprosate and/or naltrexone,
* alcohol consumption at baseline levels,
* resolution of clinically evident anxiety or depression as assessed by the case formulation (see below). These patients will be offered further treatment

Answer: A