Integrating Behavioral and Symbolic Interventions in Cocaine Use Disorder: A Prospective Single-Case Study of the Integrated Psychotherapy Method

Cocaine Use Disorder (CUD) presents persistent clinical challenges, with high relapse rates and limited evidence guiding the integration of symptom-focused and meaning-oriented interventions. This article presents a prospective single-case experimental design (SCED) examining the application of the Integrated Psychotherapy Method (IPM), a phase-based integrative model grounded in Living Systems Theory, with a 43-year-old White Brazilian male with a 20-year history of cocaine use disorder. Treatment comprised a cognitive-behavioral symptom stabilization phase (B1) followed by a symbolic-existential integration phase (B2), with assessments at baseline, across both phases, and at 12-month follow-up. Quantitative outcomes were assessed using the ASSIST, OQ-45.2, and WHOQOL-BREF and analyzed through Reliable Change Index, Tau-U, and trend analyses. Idiographic qualitative data documented experiential and symbolic processes of change. Results indicated clinically reliable and sustained reductions in cocaine involvement and psychological distress, alongside meaningful improvements in quality of life maintained at follow-up. Qualitative analysis revealed a progression from behavioral regulation to identity reorganization and symbolic integration. The case illustrates how a structured, phase-oriented integrative psychotherapy can support durable change in CUD and offers translatable recommendations for clinicians and students.