Computer Based Training in DBT-S Behavioral Analysis

描述(由申请人提供)：物质使用障碍(SUD)与边缘性人格障碍(BPD)并存，构成严重和复杂的公共卫生问题。物质滥用者辩证行为疗法(简称S疗法)是一种综合性的心理社会治疗方法，对物质依赖型边缘人格障碍(BPD)患者有效。 在第一阶段，我们利用原型开发的迭代过程，为药物治疗提供者开发和评估了一个创新的基于计算机的培训原型-S行为链分析。我们在一项试验性随机对照试验中测试了原型的有效性，比较了DBT-S CBT(n=12)和对照CBT(n=13)在来自常规药物治疗方案的治疗提供者中的样本。结果表明，DBT-S CBT在促进知识增长、回忆病程策略、提高戒毒患者的自我效能感、促进随后几周的技能使用等方面效果显著。我们建议在第二阶段大幅扩展课程内容及其评估。我们将再次使用迭代开发过程，依靠广泛的最终用户测试以及来自科学和DBT专家小组的反馈。完成后，我们将开始RCT评估(N=120)，我们将把CBT(n=40)与其他标准培训方法进行比较，特别是讲师指导培训(n=40)和文本(n=40)。除了在第一阶段评估的结果变量外，我们还将包括一项基于绩效的临床应用测试，其中角色扮演将被录像并编码以确保遵守。

DESCRIPTION (provided by applicant): Substance use disorders (SUD) co-occurring with borderline personality disorder (BPD) pose serious and complex public health problems. Dialectical Behavior Therapy for Substance Abusers (DBT-S) is a comprehensive psychosocial treatment, efficacious for substance-dependent individuals with borderline personality disorder (BPD). In Phase I, we developed and evaluated an innovative computer-based training (CBT) prototype of DBT-S Behavioral Chain Analysis (BCA) for drug treatment providers using an iterative process of prototype development. We tested the prototype's efficacy in a pilot randomized controlled trial (RCT) comparing DBT-S CBT (n=12) to control CBT (n=13) in a sample of treatment providers from routine drug treatment program. Results demonstrated the DBT-S CBT was efficacious at producing knowledge gains, recall of course strategies, increased self-efficacy among treating drug-addicted BPD patients, and promoting skill use in the subsequent weeks. We propose to significantly expand the course content and its evaluation in Phase II. We will again use an iterative process of development, relying on extensive end-user testing as well as feedback from a panel of scientific and DBT experts. Upon completion, we will begin a RCT evaluation (N=120) where we will compare the CBT (n=40) to other standard training methods, specifically instructor-led training (n=40) and text (n=40). In addition to the outcome variables assessed in Phase I, we will include a performance-based test of clinical application where role-plays will be video taped and coded for adherence.