Therapeutic IVR to Augment CBT in Alcohol Dependence

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DESCRIPTION (provided by applicant): Interactive Voice Response (IVR) is a computer-based telephone system that enables users to respond with the telephone keypad to a recorded voice asking scripted questions. We have been exploring the potential of IVR as a tool for efficient data collection and for intervention. Evidence from our previous research suggests that simply calling an IVR to report drinking each day for extended period results in a reduction of alcohol consumption among heavy drinkers. In an ongoing study, we are finding evidence that daily IVR reports amplify and extend the therapeutic effect of brief intervention delivered by primary care providers to hazardous drinkers. We have now developed and tested a more elaborate "Therapeutic" IVR (TIVR) as a supplement to cognitive behavioral therapy (CBT). In addition to making daily reports, patients can use the TIVR to review and/or rehearse coping skills they learned in CBT and get personalized feedback about their clinical progress. Results from a pilot study recommended by the prior reviewers demonstrate feasibility, patient acceptance, and the potential benefits of the TIVR when used for the therapeutic enhancement of abstinence-oriented group CBT in patients with alcohol dependence. In this application we propose a randomized controlled trial of the TIVR as a supplement to group CBT for alcohol dependence. Method: Patients (N= 200) who have completed 12 sessions of group cognitive behavioral coping skills training (CBT) for alcohol dependence will be randomly assigned to one of two treatment groups: 1) CBT only, or 2) CBT plus 6 months of TIVR. We will measure alcohol consumption and alcohol-related symptoms, readiness to change, self-efficacy, situational confidence, use of coping skills, and coping behavior effectiveness at various intervals including: immediately before and after CBT, during and immediately after 6 months of TIVR, and 6 months later (i.e. 12 months post-CBT). The primary goal of this application is to test whether the TIVR enhances the therapeutic effect of CBT for alcohol dependence. Our long-term objective is to develop interventions specifically designed to capitalize on the unique advantages of IVR. The public health implications of effective, low cost interventions for alcohol dependence that can be accessed remotely are considerable.