Computer Training in CBT for Spanish-speaking Alcohol Users

酒精使用障碍在拉丁裔中是一个严重的问题，他们是最大的少数民族群体 在美国。拉丁裔往往不太可能接受心理健康和药物滥用治疗 服务比非拉丁裔和非裔美国人更多，在临床和研究中的代表性严重不足 样本。为了解决改善获得经验性治疗的机会的问题，我们开发了一种 认知行为疗法的计算机辅助版本(基于计算机的认知行为训练 治疗，CBT4CBT)，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CBT4CBT计划，使其适用于广泛的拉丁裔个人 以西班牙语为主要/首选语言的酒精使用障碍患者，并评估其治疗效果 人口。如果CBT4CBT被发现是一种有效的治疗辅助手段，那么它将相对便宜 并在广泛的项目中直接传播和实施。因此，它还将代表一种 向更广泛地提供循证治疗迈出了重要的一步 这是为了解决美国严重的健康差距和美国国立卫生研究院的优先事项。 首先，我们建议将我们的个性化、交互式、基于网络的培训计划(CBT4CBT)调整为西班牙语- 与酒精使用障碍的人交谈。第二，我们建议进行初始阶段1的随机 加用CBT4CBT-西班牙-酒精常规治疗慢性前列腺癌的可行性和疗效评价 以社区为基础的治疗计划在90名讲西班牙语的人群中实现 DSM-5酒精使用障碍标准。参与者将被随机分为两种情况之一：(1)标准 在康涅狄格州精神卫生中心的西班牙裔诊所接受治疗(ST)，或(2)可进入 CBT4CBT-西班牙语-酒精项目。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.