Computer-Based Treatment for Drug Dependence

描述（由申请人提供）：这是一份K01的修订申请，旨在启动一个独立的研究项目，该项目使用治疗性交互式语音应答（TIVR）和其他计算机辅助方法，为接受办公室丁丙诺啡维持和其他药物滥用治疗的患者提供药物咨询。这项申请建立在我在认知心理学、计算机技术、药物咨询、初级保健机构药物治疗和统计学方面的专业知识基础上，并充分利用了耶鲁大学的独特资源。K01可以在我职业生涯的关键时刻提供薪水支持，让我从其他项目中解脱出来，并让我全身心地投入到成为一名独立调查员的工作中。对于我的培训，K01将使我在三个领域增加我的技能和知识：1)基于计算机的药物滥用和其他精神疾病干预，2)开发和评估手动指导的行为干预，以及3)定性研究方法。在我的独立研究中，我建议分三个阶段进行一个研究项目，开发和评估一个TIVR原型，为在初级保健环境中接受丁丙诺平维持的阿片类药物依赖患者提供认知和行为治疗（CBT）。这三个研究阶段将涉及到TIVR个体治疗模块的生成、测试和修改。第1阶段将涉及跨越4个迭代的10个生成模块的可行性测试。第二阶段将比较TIVR系统的单个模块/会话与教育视频演示条件和单个治疗师提供的会话，以评估阿片类依赖患者开始丁丙诺啡治疗的近期疗效（n = 60）。第三阶段将包括在初级保健环境中对丁丙诺啡维持患者进行TIVR的试点试验。40名患者将被随机分配到TIVR组，接受为期4周的10个模块原型治疗，或接受常规治疗。这一试点将提供初步证据，证明在办公室环境中使用TIVR的有效性和可行性和可接受性指标。

DESCRIPTION (provided by applicant): This is a revised application for a K01 to launch an independent research program on the use of Therapeutic Interactive Voice Response (TIVR) and other computer-assisted methods to provide drug counseling to patients receiving office-based buprenorphine maintenance and other drug abuse treatment. This application builds on my expertise in cognitive psychology, computer technologies, drug counseling, drug treatment in primary care settings, and statistics, and takes advantage of the unique resources at Yale. A K01 would provide salary support at a critical juncture in my career, free me up from other projects, and allow me to devote 100% toward becoming an independent investigator. For my training, the K01 would allow me to increase my skills and knowledge in 3 areas: 1) computer based interventions for substance abuse and other psychiatric disorders, 2) the development and evaluation of manual-guided behavioral interventions, and 3) qualitative research methods. For my independent research, I propose to conduct a research project in 3 phases to develop and evaluate a TIVR prototype providing cognitive and behavioral treatment (CBT) to opioid dependent patients receiving buprenorpine maintenance in a primary care setting. The three research phases will involve the generation, testing, and modification of TIVR individual treatment modules. Phase 1 will involve feasibility testing of 10 generated modules across 4 iterations. Phase 2 will compare a single module/session of the TIVR system to an educational video presentation condition and a single therapist-provided session on proximal outcomes of effectiveness among opiate-dependent patients initiating buprenorphine treatment (n = 60). Phase 3 will consist of a pilot trial of TIVR for buprenorphine maintained patients in a primary care setting. Forty patients will be randomly assigned to either TIVR, receiving access to the 10 module prototype for 4 weeks, or to treatment-as-usual. This pilot will provide initial evidence of TIVR efficacy and indicators of the feasibility and acceptability of using TIVR in office-based settings. PUBLIC HEALTH RELEVANCE: Development of an effective, inexpensive, and easily accessible computer based CBT for drug abuse patients in primary care settings would greatly expand and improve available substance abuse services.