Computer-Based Treatment for Drug Dependence

描述(由申请人提供)：这是一份修订后的申请，要求K01启动一项独立研究计划，利用治疗互动语音应答(TIVR)和其他计算机辅助方法为接受办公室丁丙诺啡维持治疗和其他药物滥用治疗的患者提供药物咨询。这个应用程序建立在我在认知心理学、计算机技术、药物咨询、初级保健环境中的药物治疗和统计学方面的专业知识基础上，并利用了耶鲁大学独特的资源。K01将在我职业生涯的关键时刻提供工资支持，将我从其他项目中解放出来，并允许我100%致力于成为一名独立调查员。在我的培训中，K01将使我在3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障碍干预，2)手动指导行为干预的开发和评估，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，开发和评估一种TIVR原型，为在初级保健环境中接受丁丙诺平维持治疗的阿片依赖患者提供认知和行为治疗(CBT)。这三个研究阶段将涉及TIVR个体化治疗模块的生成、测试和修改。第一阶段将涉及在4次迭代中对10个生成的模块进行可行性测试。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由治疗师提供的关于阿片依赖患者开始丁丙诺啡治疗的近期疗效的会议(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，接受为期4周的10模块原型治疗，或接受照常治疗。这一试点将提供TIVR有效性的初步证据以及在办公室环境中使用TIVR的可行性和可接受性的指标。 公共卫生相关性：为初级保健环境中的药物滥用患者开发有效、廉价和易于使用的基于计算机的CBT将极大地扩大和改善现有的药物滥用服务。

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.