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并存的，并与严重的损害有关。 社交焦虑共病与较差的成瘾治疗参与度和结果相关。因此， 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必要的。这项提案旨在发展和 评估一项针对社交焦虑和酒精使用障碍的完全整合的门诊计划 社交焦虑症的循证治疗(即，基于暴露的认知行为治疗)转变为 酒精使用障碍的传统循证治疗。 首先，我们将制定完全综合治疗(FIT)的方案。FIT的首要目标将是 同时提供酒精使用障碍治疗和社交焦虑障碍治疗。发展将 是一个迭代过程，由先前的研究(包括我们自己的)指导，并由临床医生的输入指导， 管理人员和门诊药物使用障碍治疗诊所的患者。在协议被 ，我们将使用我们已建立的临床医生培训程序在我们的社区合作伙伴中培训临床医生 诊所才能胜任地提供干预。在制定方案和临床医生培训后，我们将进行 先导性随机临床试验(RCT)比较我们的完全综合治疗(FIT)对合并疾病的疗效 酒精使用和社交焦虑障碍在社区物质使用障碍专科的日常护理(UC) 诊所。随机对照试验的目标将是收集有关可接受性、可行性和初步疗效的数据。 合适的协议。我们将随机选择60名患有社交焦虑症的患者进行治疗 和酒精使用障碍。我们将评估治疗参与度、社交焦虑结果和饮酒情况。 基线、距基线3个月和6个月的结果。我们还将收集定性和定量的 在完成匹配后来自患者的可接受性数据，这些数据可以指导在测试之前对匹配的最终改进 一笔更大规模的赠款。 从这项调查中获得的知识有可能显著改善酒精的治疗 使用障碍并对公共健康产生重大影响。注重直接转化为社区实践 范式和对充分心理健康和成瘾治疗一体化的强调大大推动了 菲尔德。

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.