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Approach With Caution: A Pilot Randomised Controlled Trial of Approach Bias Modification for People Undergoing Residential Treatment for Methamphetamine Use Disorder

Manning V, Whelan D, Piercy H, Hopwood M, Maloney M, Kotler E, Okedara G, Lubman DI et al.

Drug and alcohol review, 2026

14 participants · 1 citation

Abstract

Introduction: Less than one-quarter of people who attend residential rehabilitation for methamphetamine use disorder (MUD) remain abstinent for 1 year. Approach bias modification (ApBM), a cognitive training intervention, reduces relapse rates when delivered during residential rehabilitation for alcohol use disorder. However, there has been little research on ApBM for MUD.

Methods: Twenty-four patients with MUD attending four residential treatment services in Melbourne were randomised, between March 2020 and August 2024, to 6 sessions of either ApBM (n = 10) or sham-control training (n = 14). Safety was monitored during the intervention and acceptability was assessed at the end of training. A blinded researcher assessed methamphetamine use, craving, and dependence severity at follow-ups 1 and 3 months after discharge from residential treatment.

Results: Three ApBM and five control participants experienced adverse psychological reactions to the training task, resulting in two ApBM and 1 control participants withdrawing. However, participants who completed training generally provided positive acceptability ratings (mean Endorsement and Discomfort Scale scores of 69.13 [SD = 10.93] in the ApBM group and 58.83 [SD = 13.41] in controls). Directions of differences in proportions reporting past-month abstinence at 1-month (ApBM: 5/7 [71%]; controls: 5/11 [46%]) and 3-month follow-ups (ApBM: 4/7 [57%]; controls: 3/9 [33%]) and continuous abstinence at 3-month follow-up (ApBM: 3/7…

How strong is the evidence?

Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 14 participants or records.

How the five levels of evidence work. The level is assigned automatically from the abstract and can be wrong, so check the paper.

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