Department of Psychiatry Faculty

Kathleen M. Carroll, Ph.D. Professor of Psychiatry Division of Substance Abuse MIRECC-151D 950 Campbell Ave (VAMC) West Haven, CT 06516 Tel: 203-937-3486 ext 7403 Fax: 203-937-3869 Email: kathleen.carroll@yale.edu

Education
B.A., 1980, Duke University
Ph.D., 1988, University of Minnesota

Research Interest
My long-term goal is to improve the effectiveness of substance abuse treatment through (1) more precise understanding of the treatments and mechanisms that produce the best outcomes in substance abusers, (2) development, refinement, and evaluation of innovative behavioral approaches, (3) working to increase the methodological quality of research in the field of substance abuse, (4) evaluating effective means of transferring new technologies and fostering broader use of empirically supported treatments by the clinical community, and (5) training new researchers in the most rigorous methodology of treatment outcome research.

Another general theme of our work has been evaluating how behavioral therapies and pharmacotherapies can be combined to improve outcomes in substance abuse treatment. A significant contribution in this area has been in calling for the provision of a consistently-delivered behavioral 'platform' in the context of pharmacotherapy studies as a means of enhancing power, reducing noise variance, promoting protocol adherence, and addressing ethical concerns. Behavioral platforms have become a virtual requirement for pharmacologic trials in addiction and other areas of psychiatry research, and we have recently developed guidelines for investigators in selecting behavioral platforms in clinical pharmacotherapy trials.

Although there is increasing consensus that behavioral interventions can broaden, strengthen, and extend the effects of even powerful pharmacotherapies, and that effective pharmacotherapies can dramatically enhance treatment retention and outcome for behavioral therapies, there remains a paucity of systematic investigation on identifying the most effective psychotherapy-pharmacotherapy combinations for treating substance users. Factorial designs (where the intensity or type of behavioral therapy is manipulated to identify the most effective, or cost-effective, psychotherapy/ pharmacotherapy combination) are efficient strategies for evaluating combination therapies. Nevertheless, there remain but a handful of such studies in the substance abuse treatment literature, many of which have been conducted by our group at Yale.

Publications of Note

Carroll, K.M., & Rounsaville, B.J. (in press). Efficacy and effectiveness in development treatment manuals. To appear in A.M. Nezu, & C.M. Nezu (eds.), Evidence-based Outcome Research: A Practical Guide to Conducting Randomized Clinical Trials for Psychosocial Interventions. New York: Oxford University Press.

Carroll, K.M., & Rounsaville, B.J. (in press). W(h)ither ESTs? A vision of where research on behavioural therapies should be going. Addiction.

Carroll, K.M., Easton, C.J., Nich, C., Hunkele, K.A., Neavins, T.M., Sinha, R., Ford, H.L., Vitolo, S.A., Doebrick, C.A., & Rounsaville, B.J. (2006). The use of contingency management and motivational/skills building therapy to treat young adults with marijuana dependence. Journal of Consulting and Clinical Psychology, 74, 955-966.

Carroll, K.M., & Miller, W.R. (2006). Defining and addressing the problem. In W.R. Miller & K.M. Carroll (eds). Rethinking substance abuse: What the Science Shows, and What We Should Do about It (pp. 3-7). New York: The Guilford Press.

Carroll, K.M. & Rounsaville, B.J. (2006). Behavioral therapies: The glass would be half full if only we had a glass. In W.R. Miller & K.M. Carroll (eds). Rethinking Substance Abuse: What the Science Shows and What We Should Do about It (pp. 223-239). New York: The Guilford Press.

Carroll, K.M., Nich, C., & Ball, S.A. (2005). Practice makes progress? Homework assignments and outcome in the treatment of cocaine dependence. Journal of Consulting and Clinical Psychology, 73, 749-755.

Carroll, K.M., & Onken, L.S. (2005). Behavioral therapies for drug abuse (invited review for Special Series honoring 30th Anniversary of NIDA). American Journal of Psychiatry, 162, 1452-1460. Abstracted in Clinicians Research Digest (2006; vol. 24, no. 1).

Carroll, K.M. (2005). Recent advances in the psychotherapy of drug abuse. Current Psychiatry Reports, 7, 329-336.

Carroll, K.M., Fenton, L.R., Ball, S.A., Nich, C., Frankforter, T.L., Shi, J., & Rounsaville, B.J. (2004). Efficacy of disulfiram and cognitive-behavioral therapy in cocaine-dependent outpatients: A randomized placebo-controlled trial. Archives of General Psychiatry, 61, 264-272.

Carroll, K.M., Kosten, T.R., & Rounsaville, B.J. (2004). Choosing a behavioral therapy “platform” for pharmacotherapy of substance users. Drug and Alcohol Dependence, 75, 123-134.

Carroll, K.M., & Rounsaville, B.J. (2003). Bridging the gap between research and practice in substance abuse treatment: A hybrid model linking efficacy and effectiveness research. Psychiatric Services, 54, 333-339.

Carroll, K.M.. & Nuro, K. (2002). One size can’t fit all: A stage model for psychotherapy manual development. Clinical Psychology: Science & Practice, 9, 396-406.

Carroll, K.M, Sinha, R., Nich, C., Babuscio, T., & Rounsaville, B.J. (2002). Contingency management to enhance naltrexone treatment of opioid dependence: A randomized clinical trial of reinforcement magnitude. Experimental and Clinical Psychopharmacology, 10, 54-63.

Carroll, K.M., Nich, C., Sifrey, R., Frankforter, T., Nuro, K.F., Ball, S.A., Fenton, L.R., & Rounsaville, B.J. (2000). A general system for evaluating therapist adherence and competence in psychotherapy research in the addictions. Drug and Alcohol Dependence, 57, 225-238.

Carroll, K.M. (1997). Manual guided psychosocial treatment: A new virtual requirement for pharmacotherapy trials? Archives of General Psychiatry, 54, 923-928.

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