Computer-Based Treatment for Drug Dependence

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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.