Cognitive Therapy for PTSD in Addiction Treatment

描述（由申请人提供）： 这是一个修订后的K23指导以病人为导向的研究职业发展建议，用于药物滥用领域的培训和研究。培训计划充分利用了以前的经验、达特茅斯目前的职位以及一个坚实的指导团队的专业知识和承诺。该计划详细介绍了在常规成瘾治疗环境中获得知识和技能，以修改创伤后应激障碍（PTSD）的认知行为疗法（CBT）。基于行为治疗开发的NIDA阶段模型，具体目标是获得进行第一阶段行为治疗研究的方法学要求方面的专业知识，最终产品是NIH关于PTSD CBT第二阶段疗效研究的建议。候选人的职业目标是完全能够进行高质量和独立的研究，特别注重将有效的行为治疗方法转化和转移到社区中。该研究计划建议在成瘾治疗中测试CBT对PTSD的影响。背景和初步研究发现PTSD是一种常见的并发症，具有相关的负面结果，并且具有可用于测试和潜在实施的有希望的行为治疗。创伤后应激障碍是记录在案的主要关注成瘾治疗提供者，谁有准备采取有用的做法。这些治疗的特点已被检查患者的结果和成瘾计划的适合标准，并提出了一个测试在这里。将使用行为治疗研究开发的阶段模型来检查PTSD的CBT：1）阶段Ia I期（治疗开发和可行性测试）; 2）阶段Ia II期（治疗程序和培训手册的规范）;和3）阶段Ib III期（初步试验：比较PTSD的CBT加常规治疗与注意力控制加常规治疗）。主要结果标准是：治疗保留，物质使用和PTSD症状。如果第一阶段的研究结果证明有必要，最终的目标是第二阶段的疗效建议，使用更严格和控制的实验设计，测试一个更高度指定的治疗程序，并研究一个更同质的样本的人共同发生的物质使用和创伤后应激障碍。

DESCRIPTION (provided by applicant): This is a revised K23 Mentored Patient-Oriented Research Career Development proposal for training and research in the field of drug abuse. The training plan capitalizes on previous experience, the present position at Dartmouth, and on the expertise and commitment of a solid mentoring team. This plan details the acquisition of knowledge and skill to modify a cognitive behavioral therapy (CBT) for posttraumatic stress disorder (PTSD) in routine addiction treatment settings. Based upon the NIDA stage model for behavioral treatment development, the specific goal is to gain expertise in the methodological requirements to conduct Stage I behavioral therapy research, with the end product a NIH proposal for a Stage II efficacy study of CBT for PTSD. The candidate's career goal is to become fully capable of high quality and independent research, with a particular focus on translating and transferring efficacious behavioral treatments for co-occurring disorders into the community. The research plan proposes to test CBT for PTSD among persons in addiction treatment. Background and preliminary studies find PTSD to be a common type of co-occurring disorder, with correlated negative outcomes, and with promising behavioral treatments that are available for testing and potential implementation. PTSD is of documented major concern to addiction treatment providers, who have a readiness for adopting useful practices. Characteristics of these treatments have been examined on patient outcome and addiction program fit criteria, and one is proposed for testing here. CBT for PTSD will be examined using the stage model of behavioral therapy research development: 1) Stage Ia Phase I (therapy development and feasibility testing); 2) Stage Ia Phase II (specification of therapy procedure and training manual); and, 3) Stage Ib Phase III (Pilot Trial: comparing CBT for PTSD plus treatment-as-usual to an attention control plus treatment-as-usual). The primary outcome criteria are: treatment retention, substance use and PTSD symptoms. If warranted by Stage I findings, a final aim is a Stage II Efficacy proposal, using a more rigorous and controlled experimental design, testing a more highly specified therapeutic procedure, and studying a more homogenous sample of persons with co-occurring substance use and posttraumatic stress disorders.