Web-Based Mindfulness Treatment to Prevent Relapse to Substance Use

项目摘要 治疗药物使用障碍(SUD)后复发仍然是常态，而不是例外。 正念治疗是一种特别有效的门诊后护理方法，可减少 退出更密集的SUD治疗的个人(例如，住院或强化门诊患者)。 不幸的是，由于有限的临床医生培训，大多数患者无法获得后续正念治疗。 缺乏机会，缺乏有效的执行战略。例如，到目前为止，还没有存在 基于技术的(例如，基于网络的)善后正念治疗，以防止药物使用复发。 研究也缺乏关于正念治疗SUD的改变机制(即，如何以及为什么这样做 处理工程)。生态瞬时评估(EMA)，或通过以下方式进行密集纵向测量 智能手机，近乎实时地捕捉动态、高分辨率的数据。正念，消极/积极的情感， 压力和渴望--这些都是一天中会发生变化的瞬间状态--是推测的核心 Sud的正念治疗机制。SSD的正念治疗理论上是弱化或 将消极情绪与渴望、压力与渴望以及(低)积极情绪之间的短暂联系“分离” 用渴望来影响。然而，到目前为止，还没有研究使用EMA来评估这些假定的瞬时 Sud正念治疗后的脱钩机制。 拟议的K23职业发展奖提供培训，以支持Corey Roos博士成为 一家以患者为导向的独立研究人员，专注于以技术为基础的成瘾治疗和 成瘾康复中的变化机制。该奖项的培训目标集中在以技术为基础的 治疗开发、严格的临床试验研究、EMA和正念机制。鲁斯博士会 通过专家的直接指导、课程作业、会议和实践，接受有关这些目标的培训 研究活动。 这个K23应用程序的拟议研究项目涉及开发和评估UrgeSurfer， 第一个基于网络的正念疗法，用于预防肥皂泡患者的复发性物质使用。 Web程序将通过以用户为中心的设计框架迭代开发，涉及客户 反馈和可用性测试。然后，我们将进行一项试点随机对照试验，以评估UrgeSurfer 作为门诊辅助的善后治疗，防止复发。此外，作为这场审判的一部分，威尔 使用EMA研究假设的变化脱钩机制。这项K23奖项将推动Roos博士进入 作为一名独立的、以患者为中心的成瘾治疗研究人员，他的职业生涯很成功。

Project Summary Relapse following treatment for substance use disorder (SUD) remains the norm, not the exception. Mindfulness treatment is a particularly efficacious outpatient aftercare approach for reducing relapse among individuals stepping down from more intensive SUD treatment (e.g., residential or intensive outpatient). Unfortunately, aftercare mindfulness treatment is inaccessible to most patients, due to limited clinician training opportunities and a lack of effective implementation strategies. For example, to date there are no existing technology-based (e.g., web-based) aftercare mindfulness treatments for preventing relapse to substance use. Research is also lacking on mechanisms of change in mindfulness treatment for SUD (i.e., how and why this treatment works). Ecological momentary assessment (EMA), or intensive longitudinal measurement via smartphone, captures dynamic, high-resolution data in near real-time. Mindfulness, negative/positive affect, stress, and craving - which are momentary states that change over the course of a day - are central to putative mechanisms of mindfulness treatment for SUD. Mindfulness treatment for SUD is theorized to weaken or “decouple” the momentary associations of negative affect with craving, stress with craving, and (low) positive affect with craving. However, no studies to date have used EMA to evaluate these putative momentary decoupling mechanisms following mindfulness treatment for SUD. The proposed K23 career development award provides training to support Dr. Corey Roos in becoming an independent patient-oriented researcher focused on technology-based addiction treatment and mechanisms of change in addiction recovery. The training goals of this award focus on technology-based treatment development, rigorous clinical trial research, EMA, and mechanisms of mindfulness. Dr. Roos will receive training in these goals through direct mentorship from experts, coursework, conferences, and hands-on research activities. The proposed research project of this K23 application involves developing and evaluating UrgeSurfer, the first web-based mindfulness treatment for preventing relapse substance use among individuals with SUDs. The web program will be iteratively developed through a user-centered design framework involving client feedback and usability testing. We will then conduct a pilot randomized controlled trial to evaluate UrgeSurfer as an adjunctive outpatient aftercare treatment for preventing relapse. Moreover, as part of this trial, will investigate putative decoupling mechanisms of change using EMA. This K23 award will propel Dr. Roos into a successful career as an independent patient-oriented addiction treatment researcher.