Developing and Evaluating a Fully Integrated Treatment Program for Comorbid Social Anxiety and Alcohol Use Disorders

项目摘要 酒精使用障碍和社交焦虑障碍是高度共病的，并与显著的损害相关。 社交焦虑合并症与较差的成瘾治疗参与和结果相关。因此，在本发明中， 解决可能导致和维持酒精问题的潜在社交焦虑症状，以及 破坏酒精使用障碍的成功治疗，是有道理的。该提案旨在发展和 评估一个完全整合的门诊计划，共病的社交焦虑和酒精使用障碍，编织 社交焦虑障碍的循证治疗（即，认知行为疗法（Cognitive Behavioral Therapy） 酒精使用障碍的传统循证治疗。 首先，我们将制定完全整合治疗（FIT）的协议。FIT的首要目标是 同时提供酒精使用障碍治疗和社交焦虑障碍治疗。发展将 是一个由以前的研究（包括我们自己的研究）指导的迭代过程，并由临床医生的输入， 管理人员和门诊物质使用障碍治疗诊所的患者。在该协议之后， 开发，我们将使用我们建立的临床医生培训程序，以培训临床医生在我们的社区合作伙伴， 诊所能够胜任地提供干预。在方案制定和临床医生培训后，我们将进行 一项先导性随机临床试验（RCT），比较了我们的完全整合治疗（FIT）对共病患者的疗效 酒精使用和社交焦虑障碍到社区物质使用障碍专科的常规护理（UC） 诊所随机对照试验的目的是收集关于以下方面的可接受性、可行性和初步疗效的数据： FIT协议。我们将随机选择患有社交焦虑共病的寻求治疗的参与者（N = 60） 和酒精使用障碍。我们将评估治疗参与度、社交焦虑结果和酒精使用情况 基线、自基线起3个月和6个月的结局。我们还将收集定性和定量 完成FIT后患者的可接受性数据，这可能会指导FIT在测试前的最终改进， 更大规模的资助 从这项调查中获得的知识有可能显着改善酒精的治疗 使用疾病并对公共卫生产生重大影响。注重直接转化为社区实践 范式和强调充分的心理健康和成瘾治疗的整合显着推进 领域

Project Summary Alcohol use disorders and social anxiety disorder are highly comorbid and associated with significant impairment. Social anxiety comorbidity is associated with poorer addiction treatment engagement and outcomes. Thus, addressing underlying social anxiety symptoms that may lead to and maintain alcohol problems, as well as undermine successful treatment for alcohol use disorders, is warranted. This proposal aims to develop and evaluate a fully integrated outpatient program for comorbid social anxiety and alcohol use disorders that weaves evidence-based treatment for social anxiety disorder (i.e., exposure-based cognitive behavioral therapy) into a traditional, evidence-based treatment for alcohol use disorders. First, we will develop the protocol for the fully integrated treatment (FIT). The overarching goal of FIT will be to simultaneously deliver alcohol use disorder treatment and social anxiety disorder treatment. Development will be an iterative process guided by previous research (including our own), and by input from clinicians, administrators, and patients in an outpatient substance use disorder treatment clinic. After the protocol is developed, we will use our established clinician training procedures to train clinicians at our community partnered clinic to competently deliver the intervention. After protocol development and clinician training, we will conduct a pilot randomized clinical trial (RCT) comparing the efficacy of our fully integrated treatment (FIT) for comorbid alcohol use and social anxiety disorders to usual care (UC) in the community substance use disorder specialty clinic. The goals of the RCT will be to gather data regarding acceptability, feasibility, and preliminary efficacy of the FIT protocol. We will randomize treatment-seeking participants (N = 60) who have comorbid social anxiety and alcohol use disorders. We will assess treatment engagement, social anxiety outcomes, and alcohol use outcomes at baseline, 3-months, and 6-months from baseline. We will also gather qualitative and quantitative acceptability data from patients after completing FIT, which may guide final refinements of FIT prior to testing in a larger-scale grant. The knowledge gained from this investigation has the potential to significantly improve the treatment of alcohol use disorders and make a significant public health impact. The focus on direct translation to community practice paradigms and the emphasis on full mental health and addiction treatment integration significantly advance the field.