Development of CONNECT: a Social Media Intervention for Depressed Cannabis Users

项目摘要 这项研究的目的是改进成人抑郁症和共病大麻使用的治疗。 通过一种创新的社交媒体辅助干预策略，对精神障碍(CUD)进行治疗。拟议的干预措施 将通过Facebook提供的朋辈和治疗师社交网络支持与计算机辅助的集成 结合认知行为疗法(CBT)和动机增强疗法(MET)的治疗方案 以减少大麻的使用和抑郁症状。2014年，申请人获得了NIDA高优先级、短期- 试行测试阴影(酒精和其他药物使用和抑郁的自助)的学期项目奖，a 将CBT和MET相结合的计算机化干预，在初级精神护理环境中，其中整合 针对精神健康和物质使用障碍(SUDS)的干预措施并不容易获得。 初步数据表明，将阴影与精神护理结合起来治疗抑郁症：(A)是可行的， 可接受，(B)促进难治性共病人群的治疗参与和保留 (C)显著减少抑郁症状和吸食大麻 使用。为了优化这种对抑郁的大麻使用者实施循证心理治疗的模式 在初级精神病学环境中接受日常护理(TAU)，拟议的研究整合了社会网络 将支撑件纳入遮阳干预计划。本研究的具体目的是：1) 利用用户反馈，开发社交媒体辅助干预(互联大麻用户网络，用于 增强认知疗法；CONNECT)用于抑郁症大麻吸毒者，将阴影与 同龄人和治疗师通过Facebook私人群组提供社交网络支持，以减少大麻使用和 抑郁和改善治疗保留率；2)在试验性随机对照试验(N=50)中测试 在改善大麻使用、抑郁和医疗保健结果方面与遮光罩相关联 3)检查社交网络变量 缓和或调解连接的影响。我们假设色调连接会产生更好的效果 在减少大麻使用、改善抑郁症状和治疗方面与遮荫相关的临床结果 保留和减少治疗期间和治疗后的卫生服务利用率。此外，我们预计， 社交网络支持组件的连接将直接影响到的质量和数量 参与者对成瘾和抑郁康复的社会支持网络，这是一种公认的变化机制 在CBT和MET中治疗共病人群的方法，这些变化将与 与大麻的使用和抑郁的结果有关。通过提供临床医生和同行支持来最大限度地提高技能 从Shade，Connect收购可能为以下方面提供经济高效且易于部署的战略 在初级精神护理环境中治疗抑郁的大麻使用者，这一模式可以扩展到 肥皂水处理不足的其他环境。

PROJECT ABSTRACT The objective of this research is to improve treatment for adults with depression and comorbid cannabis use disorders (CUD) with an innovative, social media-assisted intervention strategy. The proposed intervention combines peer and therapist social network support via Facebook with an integrated, computer-assisted therapy program combining cognitive behavioral therapy (CBT) and motivational enhancement therapy (MET) to reduce cannabis use and depressive symptoms. In 2014 the applicant received a NIDA High Priority, Short- Term Project Award to pilot test SHADE (Self-Help for Alcohol and Other Drug Use and Depression), a computerized intervention combining CBT and MET, in a primary psychiatric care setting, where integrated interventions addressing both mental health and substance use disorders (SUDs) are not readily accessible. Preliminary data indicate that integrating SHADE with psychiatric care for depression: (a) is feasible and acceptable, (b) facilitates treatment engagement and retention in a difficult-to-treat comorbid population with major depression and CUD; and (c) produces significant reductions in depressive symptoms and cannabis use. To optimize this model of evidence-based psychotherapy implementation for depressed cannabis users receiving usual care (TAU) in a primary psychiatric setting, the proposed study integrates a social network support component into the SHADE intervention program. The specific aims of this research are: 1) To develop, with user feedback, a social media-assisted intervention (Connected Cannabis Users’ Network for Enhancement of Cognitive Therapy; CONNECT) for depressed cannabis users that combines SHADE with peer and therapist social network support via a private Facebook group for reducing cannabis use and depression, and improving treatment retention; 2) To test, in a pilot RCT (N=50), the incremental efficacy of CONNECT over and above SHADE in improving cannabis use, depression, and healthcare outcomes among depressed adults with CUD in a primary psychiatric setting; 3) To examine whether social network variables moderate or mediate the impact of CONNECT. We hypothesize that SHADE + CONNECT will yield superior clinical outcomes relative to SHADE in reducing cannabis use, improving depressive symptoms and treatment retention, and reducing health service utilization during and after treatment. Moreover, we expect that the social network support component of CONNECT will have a direct effect on the quality and quantity of participants’ social support network for addiction and depression recovery, a recognized mechanism of change in CBT and MET approaches to the treatment of comorbid populations, and these changes will be associated with cannabis use and depression outcomes. By providing both clinician and peer support to maximize skills acquisition from SHADE, CONNECT may provide a cost-effective and easily deployable strategy for the treatment of depressed cannabis users in a primary psychiatric care setting, a model that may be extended to other settings where SUDs are undertreated.