Computer-based Training in Cognitive Behavioral Therapy: Web-based delivery of CB

基于计算机的认知行为治疗培训：基于网络的 CB 交付

• 批准号: 8300460
• 负责人: KATHLEEN M. CARROLL
• 金额: $ 9.92万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-09-30 至 2015-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8300460
• 关键词: Address; Alcohol or Other Drugs use; Award; Characteristics; Cocaine; Cognitive Therapy; Communities; Comorbidity; Computer Assisted; Computer-Assisted Therapy; Computers; Coping Skills; Counseling; Data; Discrimination; Drug Addiction; Drug abuse; Effectiveness; Evaluation; Evidence based treatment; Familiarity; Frequencies; Future; HIV; Illicit Drugs; Impaired cognition; Individual; Intervention; Measures; Mediator of activation protein; National Institute of Drug Abuse; Online Systems; Outcome; Outcome Measure; Outpatients; Participant; Protocols documentation; Randomized; Randomized Clinical Trials; Randomized Controlled Clinical Trials; Relative (related person); Research; Risk Reduction; Rural Population; Sampling; Severities; Specificity; Staging; Toxicology; Training; Training Programs; Urine; Work; base; cost; cost effectiveness; design; follow-up; meetings; methadone maintenance; novel; primary outcome; programs; randomized trial; response; satisfaction; secondary outcome; standard care; success; treatment effect; treatment program

DESCRIPTION (provided by applicant): Our initial evaluation of the CBT4CBT program as an adjunct to outpatient treatment indicated statistically significant effects on percent of urine toxicology screens that were positive for illicit drugs as well as significant durability of effects over 6 months. However, despite the enormous promise of computer- based treatments as well as very encouraging initial data from our work and others, well-controlled randomized clinical trials of computer-assisted therapies are still rare. The proposed project will be the first evaluation of CBT4CBT delivered with minimal clinician support, rather than as an adjunct to treatment, and will allow preliminary evaluation of CBT4CBT as a potential 'stand-alone' intervention. It will also be the first trial of CBT4CBT to include a clinician-delivered CBT condition, and thus will permit some exploration of the types of individuals for whom this approach might be most appropriate versus those who respond to clinician-delivered CBT. Specific aims are: "To conduct a 12 week randomized trial with 180 treatment-seeking individuals meeting current criteria for illicit drug abuse or dependence. Participants will be randomized to one of three conditions: (1) standard outpatient counseling at a community treatment program, (2) individual clinician delivered CBT, or (3) web-based CBT4CBT with minimal counseling. "To evaluate the long-term durability and/or delayed emergence of treatment effects through a six month follow-up after termination of the study treatments. For these analyses, we hypothesize that either version of CBT (clinician and web-based) will be more effective than standard treatment. The primary outcome measures will be reduction in substance use, operationalized as the frequency of substance use by week confirmed by urine toxicology screens. Measures of treatment utilization and relative costs of the interventions will be used to evaluate cost effectiveness of the protocol interventions. As an exploratory aim, we hypothesize that incremental cost-effectiveness ratios (ICERS) will favor computer- delivered over clinician delivered CBT. Other secondary outcomes will be used to evaluate whether web- based CBT4CBT retains key characteristics of traditional clinician-administered CBT (e.g., acquisition of coping skills, use of change strategies) and to evaluate these as potential mediators of outcome as well as several participant variables that may moderate response to clinician-delivered versus computer-delivered CBT.

描述（由申请人提供）：我们对CBT 4CBT计划作为门诊治疗辅助手段的初步评估表明，对非法药物阳性的尿液毒理学筛查百分比具有统计学显著影响，并且在6个月内具有显著的效果持久性。然而，尽管基于计算机的治疗有着巨大的前景，而且我们的工作和其他人的初步数据非常令人鼓舞，但计算机辅助治疗的对照良好的随机临床试验仍然很少。拟议的项目将是第一次评估CBT 4CBT提供最少的临床医生的支持，而不是作为辅助治疗，并将允许CBT 4CBT作为一个潜在的“独立”干预的初步评估。这也将是CBT 4CBT的第一次试验，包括临床医生提供的CBT条件，因此将允许对这种方法可能最适合的个人类型与那些对临床医生提供的CBT有反应的人进行一些探索。具体目标是：“对180名符合现行非法药物滥用或依赖标准的寻求治疗的个人进行为期12周的随机试验。参与者将被随机分配到以下三种情况之一：（1）社区治疗计划中的标准门诊咨询，（2）个体临床医生提供的CBT，或（3）基于网络的CBT 4CBT，最小咨询。“通过研究治疗终止后6个月的随访，评价治疗效果的长期持久性和/或延迟出现。对于这些分析，我们假设CBT的任何一个版本（临床医生和基于网络的）都比标准治疗更有效。主要结局指标将是物质使用的减少，可操作为通过尿液毒理学筛查确认的每周物质使用频率。将使用治疗利用率和干预措施的相对成本来评价方案干预措施的成本效益。作为一个探索性的目标，我们假设增量成本效益比（ICERS）将有利于计算机提供的临床医生提供的CBT。其他次要结果将用于评估基于网络的CBT 4CBT是否保留传统临床医生管理的CBT的关键特征（例如，获得应对技能，使用改变策略），并评估这些作为结果的潜在中介因素，以及几个参与者变量，这些变量可能会缓和对临床医生提供的CBT与计算机提供的CBT的反应。