Developing and Evaluating a Fully Integrated Treatment Program for Comorbid Social Anxiety and Alcohol Use Disorders

制定和评估共病社交焦虑和酒精使用障碍的完全综合治疗方案

• 批准号: 10164494
• 负责人: Kate Basia Wolitzky-Taylor
• 金额: $ 10.25万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-05-20 至 2021-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10164494
• 关键词: Address; Administrative Supplement; Administrator; Adult; Aftercare; Alcohol abuse; Alcohol consumption; Alcohols; Ambulatory Care; Behavior Therapy; COVID-19 pandemic; Caring; Clinic; Clinical; Clinical Services; Clinical Trials; Cognitive Therapy; Combined Modality Therapy; Communities; Data; Disease; Effectiveness; Emotional disorder; Enrollment; Evidence based treatment; Focus Groups; Fright; Funding; Goals; Graduation Rates; Impairment; Individual; Intervention; Link; Los Angeles; Manuals; Measures; Mental disorders; Modeling; Outcome; Outcome Measure; Outpatients; Patients; Persons; Principal Investigator; Protocols documentation; Public Health; Randomized; Randomized Clinical Trials; Reporting; Research; Research Personnel; Resources; Services; Site; Social Anxiety Disorder; Social Interaction; Social Problems; Structure; Substance Use Disorder; Sum; Surveys; Symptoms; Time; Treatment Protocols; Treatment outcome; Uncertainty; Visit; Wages; Work; active method; addiction; alcohol abuse therapy; alcohol comorbidity; alcohol related consequences; alcohol use disorder; base; cohort; community clinic; comorbidity; effectiveness evaluation; evidence base; follow-up; graduate student; group intervention; improved; improved outcome; medical specialties; meetings; novel strategies; operation; outpatient programs; programs; recruit; social anxiety; therapy development; treatment adherence; treatment center; treatment program

Abstract Social anxiety disorder and alcohol use disorder commonly co-occur, and are associated with significant impairment. The primary aims of the study for which an administrative supplement is being requested were to develop and evaluate a fully integrated behavioral intervention for comorbid social anxiety disorder and alcohol use disorder. In the first year of the project, we successfully developed an Intensive Outpatient Program (IOP) level of care group intervention to be delivered by community-based substance use disorder (SUD) specialty clinicians. The fully integrated treatment (FIT) combines principles and strategies of exposure-based cognitive behavioral therapy (CBT) for social anxiety disorder with the Matrix Model approach to the treatment of addiction (i.e., combining CBT and 12-step facilitation). Thus, Aim 1 has been completed. We have begun to evaluate its effectiveness in this real-world setting, in which adult treatment seekers with comorbid social anxiety and alcohol use disorders are randomized to (a) FIT IOP or (b) Matrix Model IOP for twelve weeks, and are assessed at baseline, mid-treatment, post-treatment, and a 6-month follow-up on engagement (Aim 2), and on alcohol use and social anxiety outcomes (Aim 3). The COVID-19 pandemic has led to a shut-down of the IOP program, group services, and any in-patient visits at the clinic site, for an indefinite period of time in Los Angeles. In-person visits for this type of research are also currently prohibited by the UCLA Vice Chancellor of Research. As a consequence, recruitment has halted, and we have managed only to provide remote sessions with the remaining patients who were already enrolled in the study, which is not in the spirit of our intervention that focuses on using the group as a platform for social anxiety exposure therapy. Moreover, even if we could do some assessments remotely (though others may not be possible), few patients are seeking remote services at the clinic currently and thus the pace of recruitment would not allow us to meet our project goals. Therefore, we are anticipating significant delays in completing our recruitment and enrollment goals, which are necessary for achieving sufficient statistical power to detect effects between two active treatments. In sum, we are unable to complete Aims 2 and 3 without supplemental funds. The supplemental funds would support the project coordinator, a graduate student researcher, and the Principal Investigator for the additional time needed to carry out the study; and importantly, would fund the clinicians and administrators at the community clinic who carry out their clinical services and referral/recruitment services that enable us to proceed with the clinical trial. Given the uncertainty of the shut-down of research and clinical operations, this supplement would enable us to provide salary coverage for staff to continue their work once we can resume activity.

摘要 社交焦虑症和酒精使用障碍通常是并存的，并与显著的 减损。要求提供行政补充资料的研究的主要目的是 开发和评估针对社交焦虑症和酒精共病的完全整合的行为干预 使用无序。在项目的第一年，我们成功地开发了强化门诊计划(IOP) 由社区物质使用障碍(SUD)专科提供的护理小组干预水平 临床医生。完全整合治疗(FIT)结合了基于暴露的认知的原则和策略 行为疗法(CBT)治疗社交焦虑障碍的矩阵模型方法治疗成瘾 (即，将CBT和12步促进相结合)。因此，目标1已经完成。我们已经开始评估它的 在这种现实世界的环境中，患有社交焦虑和酒精的成年人寻求治疗的有效性 使用障碍被随机分为(A)适合眼压或(B)矩阵模型眼压，为期12周，并在 基线、治疗中期、治疗后和对参与(目标2)和饮酒的6个月随访 和社交焦虑结果(目标3)。新冠肺炎疫情已导致眼压监测项目停摆， 团体服务，以及在洛杉矶无限期地在诊所现场进行的任何住院探视。面对面 目前，加州大学洛杉矶分校研究部副校长也禁止访问这类研究。作为一名 结果，招聘已经停止，我们只设法为剩余的人提供远程会话 已经参加这项研究的患者，这不符合我们专注于使用 将该群体作为社交焦虑暴露疗法的平台。而且，即使我们可以做一些评估 远程(尽管其他患者可能不可能)，目前很少有患者在诊所寻求远程服务 因此，招聘的速度将使我们无法实现我们的项目目标。因此，我们期待着 在完成我们的招聘和招生目标方面出现重大延误，这是实现这些目标所必需的 有足够的统计能力来检测两种有效治疗之间的效果。总而言之，我们无法完成 没有补充资金的目标2和3。补充资金将支助项目协调员a 研究生研究员和首席调查员进行研究所需的额外时间； 重要的是，将为社区诊所的临床医生和管理人员提供资金 服务和转介/招聘服务，使我们能够继续进行临床试验。考虑到不确定性 在关闭研究和临床业务的情况下，这项补充资金将使我们能够提供工资保险 一旦我们可以恢复活动，工作人员就可以继续工作。