Effectiveness of a personality-oriented self-regulation training in rehabilitation patients with cannabis dependence: study protocol of a multicentre randomised controlled trial

For many people struggling with addiction, the path to recovery is not a simple matter of wanting to stop. It is often a battle between what they know they should do and what they actually do when stress hits. Scientists have long understood that addiction involves a breakdown in the ability to manage emotions and control impulses. When a person feels overwhelmed, anxious, or sad, the brain often reaches for the substance as a quick fix, bypassing the logical plans made during calmer moments. This gap between intention and action is a central puzzle in modern psychology. Researchers are now looking closely at a specific type of mental skill: the ability to keep moving toward a goal even when feelings are turbulent. They call this affective-volitional self-regulation. It is the capacity to stay on track when the emotional weather turns stormy. If this skill is weak, even the best intentions can crumble under pressure.

A team of researchers in Germany is testing a new way to help people rebuild this skill. They are running a large study involving patients in rehabilitation clinics who are dependent on cannabis. The study compares the standard care these patients receive against a new, specialized training program called Personality-Oriented Self-Regulation Training. The researchers want to know if this specific training can teach patients how to better manage their emotions and stick to their goals when things get difficult. The work is still in progress, and the final results are not yet available, but the study design offers a clear look at how science is trying to solve the problem of why people relapse even when they want to get better.

The study takes place in two specialized rehabilitation hospitals in Germany. These facilities treat people who have been admitted for medical and psychological recovery from substance use disorders. The researchers are focusing on patients who have a primary or secondary diagnosis of cannabis dependence. While many of these patients also use other substances, the study includes them as long as cannabis is a significant part of their struggle. The researchers are careful to exclude patients with severe psychotic disorders, as these conditions would make it difficult for them to participate in the group-based training. The goal is to create a group of participants who are stable enough to engage in the exercises but still face the core challenges of addiction.

The core of the experiment is a comparison between two groups. One group receives the standard treatment that these hospitals already provide. This standard care is a comprehensive program that includes individual therapy, group sessions on addiction, sports, and social counseling. It is a well-established approach that covers many bases. The other group receives this same standard care, but with an added layer: the new training program. This program is designed to be a direct response to the specific problem of losing control under stress. It is not a replacement for the usual therapy but a supplement meant to target the mental muscles that often fail when emotions run high.

The new training program is built on three main ideas from psychology. First, it looks at what truly motivates a person, ensuring their goals feel like their own choices rather than forced rules. Second, it helps them build a life that feels meaningful, so they have positive reasons to stay sober. Third, and most importantly, it teaches them how to handle the moment when stress threatens to derail them. The program runs for eleven weeks and consists of eleven distinct modules. The first session is one-on-one, where a therapist helps the patient clarify their personal values and life goals. The remaining ten sessions are held in small groups of up to eight people. Each session lasts ninety minutes and follows a strict manual to ensure every patient gets the same high-quality instruction.

The exercises in the program are practical and focused on real-life struggles. Patients learn to recognize their emotional states before they spiral out of control. They practice differentiating between a feeling and a reaction, learning that a bad mood does not have to lead to a bad decision. They work on interrupting the automatic urge to act on impulse. As the weeks go on, the training moves from understanding these concepts to applying them in daily life. Patients learn how to handle setbacks without giving up and how to maintain their focus even when they are tired or upset. The ultimate aim is to make these skills automatic, so that when a difficult situation arises, the patient has a toolbox of strategies ready to use.

To measure whether this approach works, the researchers have set up a rigorous testing schedule. Before the training begins, every participant fills out a detailed questionnaire to assess their natural tendency to act or to get stuck in worry. This helps the researchers balance the two groups so that they are similar in their starting abilities. Then, at the beginning of the study and again at the end of the eleven-week program, the patients take tests that measure their ability to regulate their emotions and control their impulses. The main focus is on four specific skills: the ability to calm oneself down, the ability to stop an impulse, the ability to start an action even when it is hard, and the ability to stay connected to one's own values.

The researchers are also looking at whether the training changes how impulsive a person is, specifically in terms of acting on strong emotions or taking unnecessary risks. These are behaviors often linked to relapse. To ensure the results are accurate, the people collecting the data and analyzing the numbers do not know which patients received the new training and which received only the standard care. This "blinding" prevents their expectations from influencing the outcome. The study is designed to include all patients who start the program, even if they drop out later, to get a realistic picture of how the treatment works in the real world.

The study is currently recruiting patients and is expected to run through late 2026. The researchers have planned for a sample size of about ninety people in each group to ensure they have enough data to see a clear effect. They are aware that the training is delivered by a single psychologist across both hospitals, which is a strength for consistency but a limitation for how widely the results can be applied. They also note that the patient population in these clinics is mostly male, which means the findings might not apply equally to women. Despite these limitations, the study is designed to be a solid test of a theory-driven idea.

The researchers are not claiming to have found a magic cure. They are testing a specific hypothesis: that by teaching people how to manage their emotions and stick to their goals under pressure, they can improve the chances of long-term recovery. If the results show that the training group improves more than the standard care group, it would suggest that focusing on self-regulation skills is a powerful addition to addiction treatment. If there is no difference, it would suggest that other factors are more important. The study is a step toward understanding the mechanics of change, moving beyond simple motivation to the complex work of maintaining that motivation when life gets hard. The final answers will come once the data is fully analyzed, but the design itself offers a clear roadmap for how science is tackling the difficult problem of addiction.