Computer Based Training in DBT-S Behavioral Analysis

描述（由申请人提供）：物质使用障碍（SUD）与边缘型人格障碍（BPD）共同发生，造成严重和复杂的公共卫生问题。物质滥用者的辩证行为疗法（DBT-S）是一种综合性的社会心理治疗，对边缘型人格障碍（BPD）的物质依赖者有效。 在第一阶段，我们开发和评估了一个创新的基于计算机的培训（CBT）原型的DBT-S行为链分析（BCA）的药物治疗提供者使用原型开发的迭代过程。我们在一项试点随机对照试验（RCT）中测试了原型的有效性，该试验在常规药物治疗计划的治疗提供者样本中比较了DBT-S CBT（n=12）和对照CBT（n=13）。结果表明，DBT-S CBT是有效的生产知识的收益，回忆过程中的策略，提高自我效能感治疗药物成瘾的BPD患者，并促进技能的使用在随后的几周。我们建议在第二阶段大幅度扩大课程内容及其评估。我们将再次使用迭代开发过程，依赖于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评价（N=120），其中我们将比较CBT（n=40）与其他标准培训方法，特别是教师主导的培训（n=40）和文本（n=40）。除了在I期评估的结果变量外，我们还将包括基于临床应用的性能测试，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.