Computerized Psychosocial Treatment for Offenders with Substance Use Disorders

描述（由申请人提供）：美国刑事司法环境中的大多数人迫切需要针对药物使用和艾滋病毒风险行为的基于科学的心理社会治疗。调查小组已经开发并证明了一个互动的，基于计算机的，心理社会治疗方案，治疗教育系统（TES），可以满足这一需求的有效性。TES理论上以循证心理治疗（社区强化方法和认知行为疗法）为基础，并采用最先进的，经过验证的信息技术和多媒体学习工具来促进技能获取，体验学习和行为改变。这种基于计算机的治疗工具允许以保真度提供复杂的干预措施，以基于证据的模型，并且由于其自我导向的性质（例如，所需工作人员时间/培训最少），从而为今后的可持续性和在刑事司法系统内的传播提供了相当大的潜力。 该研究采用随机分配的监禁的男性和女性罪犯与物质使用障碍（N=526），要么（1）TES（N=263），或（2）标准护理（N=263），在一个多站点的试验进行了8监狱物质滥用方案。沿着NDRI（申请机构）、合作研究中心（加州洛杉矶大学，坦普尔大学和肯塔基州大学）经营的研究中心属于刑事司法药物滥用治疗研究（CJDATS）网络，NIDA资助的合作协议，它已经建立了与刑事司法合作伙伴的关系，从惩教部门在美国的目标1是测试比较有效的工商业污水附加费与药物使用措施的标准治疗（例如，在监狱释放后3个月和6个月，以及使用正式的惩教部记录的重新监禁率，禁欲周）和艾滋病毒风险行为（性相关和药物相关的艾滋病毒风险行为）。目的2是评估TES相对于标准护理的成本和成本效益。研究人员预测，工商业污水附加费将显着更有效和成本效益比标准护理。 该项目的重要意义在于它使用了一种创新的、基于计算机的技术，并有可能大幅提高向监狱中药物滥用罪犯提供基于科学的心理社会治疗的有效性和成本效益，从而做出相当大的贡献公共卫生。因此，为拟议的两年期项目提供资金可以明显加快研究和传播工作的步伐和成就，通过为其大量滥用药物的人口提供有效和实用的治疗干预措施，满足美国惩教界的需要。 公共卫生相关性： 拟议项目的重要之处在于使用了一种创新的计算机技术（对相关的药物使用者群体证明有效），大大提高了对男女药物滥用罪犯进行有效和具有成本效益的心理社会治疗的效率，从而对公众健康产生了重大影响。资助拟议的2年研究项目有可能加快研究和传播工作，使基于科学的心理社会治疗能够广泛覆盖美国各地刑事司法环境中的个人。

DESCRIPTION (provided by applicant): The majority of individuals in criminal justice settings across the U.S. have a critical need for science- based, psychosocial treatment that targets substance use and HIV risk behavior. The investigative team has developed and demonstrated the efficacy of an interactive, computer-based, psychosocial treatment program, the Therapeutic Education System (TES), which can answer this need. TES is theoretically grounded in evidence-based psychosocial treatments (Community Reinforcement Approach and Cognitive Behavioral Therapy), and employs state-of-the-art, proven informational technologies and multimedia learning tools to promote skills acquisition, experiential learning and behavioral change. This computer-based therapeutic tool allows complex interventions to be delivered with fidelity to the evidence-based model and at low cost due to its self-directed nature (e.g., minimal staff time/training needed), thus offering considerable potential for future sustainability and dissemination within criminal justice systems. The study employs random assignment of incarcerated male and female offenders with substance use disorders (N=526) to either (1) TES (N=263), or (2) Standard Care (N=263), in a multi-site trial conducted in 8 prison substance abuse programs. Along with NDRI (the applicant organization), the collaborating study sites (University of California Los Angeles, Temple University, and the University of Kentucky) operate Research Centers that belong to the Criminal Justice Drug Abuse Treatment Studies (CJDATS) network, a NIDA-funded cooperative agreement, which has established relationships with criminal justice partners from Departments of Corrections across the U.S. Aim 1 is to test the comparative effectiveness of TES vs. Standard Care on measures of drug use (e.g., weeks of abstinence) and HIV risk behavior (both sex-related and drug-related HIV risk behavior) at 3- and 6-months post prison discharge, as well as on reincarceration rates using official Department of Corrections records. Aim 2 is to evaluate the cost and cost-effectiveness of TES relative to standard care. The investigators predict that TES will be significantly more effective and cost effective than Standard Care. The project is significant in its use of an innovative, computer-based technology and in its potential to produce a major increase in the effective and cost-effective delivery of science-based psychosocial treatment to substance-abusing offenders in prison, and thereby make a considerable public health contribution. Thus, funding the proposed 2-year project can markedly accelerate the pace and achievement of research and dissemination efforts to meet the needs of the U.S. correctional community by providing effective and practical treatment interventions for its large substance-abusing population. PUBLIC HEALTH RELEVANCE: The proposed project is significant in its use of an innovative computer-based technology (of demonstrated efficacy with a related population of substance users) to produce a dramatic increase in the effective and cost- effective delivery of psychosocial treatment for male and female substance-abusing offenders, and thereby have a substantial impact on public health. Funding the proposed 2-year research project has the potential to accelerate research and dissemination efforts to enable widespread reach of science-based psychosocial treatment to individuals in criminal justice settings across the U.S.