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Efficacy and Mechanisms of CBT4CBT for Alcohol Use Disorders

CBT4CBT 对酒精使用障碍的疗效和机制

基本信息

批准号：
9917680
负责人：
BRIAN D. KILUK
金额：
$ 55.03万
依托单位：
YALE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2016
资助国家：
美国
起止时间：
2016-05-05 至 2022-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9917680
关键词：
Address Affective Alcohol consumption Ambulatory Care Behavioral Characteristics Client Clinical Cognitive Cognitive Therapy Computers Data Decision Making Empathy Evaluation Growth Heavy Drinking Individual Intervention Knowledge Link Manuals Measures Mediating Mediation Mediator of activation protein Modeling Monitor Motivation Neuropsychological Tests Online Systems Outcome Pilot Projects Play Process Randomized Randomized Controlled Trials Role Safety Short-Term Memory Supervision Testing Therapeutic TimeLine Training Urine Validation Work active method alcohol abuse therapy alcohol intervention alcohol use disorder base clinical practice cognitive function coping cost cost effective design drinking effective therapy effectiveness evaluation flexibility follow-up indexing meetings novel novel strategies programs public health relevance randomized trial reduced alcohol use response secondary outcome skill acquisition skills standard care sustained attention treatment as usual treatment effect virtual

项目摘要

DESCRIPTION (provided by applicant): Cognitive Behavioral Therapy (CBT) is an established approach for alcohol use disorders, yet it is hindered by a number of obstacles to dissemination and effective implementation in clinical practice, which include a limited understanding regarding how it exerts its effects (i.e., mechanisms of action). This proposal aims to evaluate a novel computer-based cognitive behavioral therapy program for alcohol use disorders (CBT4CBT) designed to address these obstacles. The proposed R01 project (which follows the completion of R21 AA 021405; Carroll, PI) will evaluate the efficacy of CBT4CBT or clinician-delivered CBT in comparison to standard treatment as usual (TAU) at reducing alcohol use among 180 outpatient treatment seekers. Treatments will be delivered over the course of 8-weeks and will include a 6-month follow-up period to assess durability of treatment effects. Multiple behavioral, experiential, and cognitive measures will be used to develop a more complete understanding of the mechanistic processes by which CBT works to reduce alcohol use. The specific aims of the project are as follows: 1. Evaluate the efficacy of CBT4CBT or clinician-delivered CBT relative to TAU at reducing alcohol use through an 8-week randomized trial, with 6-month follow-up. We expect either form of CBT will be more effective than TAU at increasing the percentage of days abstinent (PDA) during treatment and follow-up. 2. Evaluate the extent to which CBT's putative mechanisms act as a mediator of treatment effect on reducing alcohol use in both forms of CBT relative to TAU. We expect indices reflecting the acquisition and implementation of skills will mediate the effect of CBT on alcohol use (i.e., PDA). Exploratory aims will include the evaluation of levels of cognitive function as moderators of CBT's direct and indirect effects, as well as exploration of differences across CBT formats (clinician-delivered vs. computer- delivered) with respect to the mechanisms of action. This will be the first adequately powered randomized controlled trial to evaluate the effectiveness of a computer-delivered version of CBT as a virtual `stand-alone' intervention for alcohol use disorders, which could have clear implications for making this cost effective form of CBT more broadly accessible. Furthermore, the inclusion of traditional clinician-delivered CBT within the same trial will allow for novel examination of CBT's mechanisms, as the active ingredients can be evaluated with and without `relational' factors (e.g., therapist empathy, warmth, therapeutic alliance) that typically contribte to outcomes.

描述（由申请人提供）：认知行为疗法（CBT）是治疗酒精使用障碍的一种既定方法，但它在临床实践中的传播和有效实施方面受到许多障碍的阻碍，其中包括对其如何发挥作用（即作用机制）的了解有限。该提案旨在评估一种新颖的基于计算机的酒精使用障碍认知行为治疗程序（CBT4CBT），该程序旨在解决这些障碍。拟议的 R01 项目（在 R21 AA 021405 完成之后；Carroll，PI）将评估 CBT4CBT 或临床医生提供的 CBT 与常规标准治疗 (TAU) 相比在减少 180 名门诊治疗寻求者的饮酒方面的功效。治疗将在 8 周的时间内进行，并包括 6 个月的随访期，以评估治疗效果的持久性。将使用多种行为、体验和认知测量来更全面地了解 CBT 减少饮酒的机制过程。该项目的具体目标如下： 1. 通过为期 8 周的随机试验和 6 个月的随访，评估 CBT4CBT 或临床医生提供的 CBT 相对于 TAU 在减少饮酒方面的功效。我们预计，无论哪种形式的 CBT 在增加治疗和随访期间的戒断天数 (PDA) 百分比方面都比 TAU 更有效。 2. 评估 CBT 的假定机制在多大程度上作为相对于 TAU 的两种形式的 CBT 中减少饮酒的治疗效果的中介。我们预计反映技能获取和实施的指数将调节 CBT 对酒精使用（即 PDA）的影响。探索性目标将包括评估认知功能水平作为 CBT 直接和间接影响的调节因素，以及探索不同 CBT 形式（临床医生提供与计算机提供）在作用机制方面的差异。这将是第一个充分有力的随机对照试验，旨在评估计算机提供的 CBT 版本作为酒精使用障碍的虚拟“独立”干预措施的有效性，这可能对使这种具有成本效益的 CBT 形式更广泛地普及具有明确的意义。此外，将传统临床医生实施的 CBT 纳入同一试验将允许对 CBT 机制进行新颖的检查，因为可以在有或没有通常有助于结果的“相关”因素（例如治疗师的同理心、温暖、治疗联盟）的情况下评估活性成分。

项目成果

期刊论文数量（4）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

The rise and fall of substance use during treatment: Applying recency and expectancy principles to daily substance use patterns.

治疗期间物质使用的上升和下降：将新近度和预期原则应用于日常物质使用模式。

DOI：
10.1037/adb0000824
发表时间：
2023
期刊：
Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors
影响因子：
0
作者：
Benitez,Bryan;Frankforter,Tami;Nich,Charla;Kiluk,BrianD
通讯作者：
Kiluk,BrianD

The connection still matters: Therapeutic alliance with digital treatment for alcohol use disorder.

这种联系仍然很重要：与数字治疗酒精使用障碍的治疗联盟。