Computer Training in CBT for Spanish-speaking Alcohol Users

酒精使用障碍是拉丁美洲人的一个重大问题，他们代表了最大的少数民族群体 在美国拉丁裔人往往不太可能接受心理健康和药物滥用治疗 服务比非拉丁美洲人和非洲裔美国人，在临床和研究中的代表性非常低 样品为了解决改善经验验证疗法的可及性问题，我们开发了一种 认知行为治疗的计算机辅助版本（认知行为治疗的计算机辅助训练） 治疗，CBT 4CBT），并已证明其作为标准门诊辅助治疗的有效性和持久性 治疗我们现在建议调整CBT 4CBT计划，以供广泛的拉丁美洲人使用 主要/首选语言为西班牙语的酒精使用障碍患者，并评估其在这方面的疗效。 人口如果发现CBT 4CBT是一种有效的治疗辅助手段， 并且易于在广泛的项目中传播和实施。因此，它也将代表一个 这是使循证疗法更广泛地适用于这一重要和 服务不足的人群，因此解决美国的关键健康差距和NIH的优先事项。 我们建议，首先，调整我们的个性化，互动，基于网络的培训计划（CBT 4CBT）为西班牙语- 有酒精使用障碍的说话人。第二，我们建议进行初始阶段1随机 一项试验，评估了在常规治疗中添加CBT 4CBT-Spanish-Alcohol的可行性和有效性， 社区为基础的治疗计划，在人口90西班牙语的个人谁满足目前 DSM-5酒精使用障碍标准参与者将被随机分配到以下两个条件之一：（1）标准 治疗（ST）在康涅狄格州精神卫生中心的西班牙裔诊所，或（2）ST与访问 CBT4CBT-Spanish-Alcohol program.治疗效果的长期持久性和/或延迟出现 将通过六个月的随访进行评估。

Alcohol use disorders are a significant problem among Latinos, who represent the largest ethnic minority group in the United States. Latinos tend to be less likely to receive mental health and substance abuse treatment services than non-Latinos and African Americans, and are highly underrepresented in clinical and research samples. To address the issue of improving access to empirically validated therapies, we have developed a computer-assisted version of cognitive behavioral therapy (Computer Based Training for Cognitive Behavioral Therapy, CBT4CBT) and have demonstrated its efficacy and durability as an adjunct to standard outpatient treatment. We now propose to adapt the CBT4CBT program for use with a broad range of Latino individuals with alcohol use disorders whose principal/preferred language is Spanish and to evaluate its efficacy in this population. If CBT4CBT is found to be an effective adjunct to treatment, it would be comparatively inexpensive and straightforward to disseminate and implement in a wide range of programs. It would thus also represent a significant step in making evidence-based therapies more broadly available to this important and underserved population and hence to address a critical health disparity in the US and an NIH priority. We propose to, first, adapt our individualized, interactive, web-based training program (CBT4CBT) for Spanish- speaking individuals with alcohol use disorders. Second, we propose to conduct an initial Stage 1 randomized trial evaluating the feasibility and efficacy of adding CBT4CBT-Spanish-Alcohol to treatment as usual in a community based treatment program in a population of 90 Spanish-speaking individuals who meet current DSM-5 criteria for alcohol use disorder. Participants will be randomized to one of two conditions: (1) standard treatment (ST) at the Hispanic Clinic of the Connecticut Mental Health Center, or (2) ST with access to the CBT4CBT-Spanish-Alcohol program. The long-term durability and/or delayed emergence of treatment effects will be evaluated through a six month follow-up.