Computer Training in DBT-S Skills for BPD Drug Abusers

描述(申请人提供)：物质滥用者的辩证行为疗法(DBT-S)是一种综合的心理社会治疗方法，对患有边缘人格障碍的物质依赖者有效。在第一阶段，我们开发和评估了一个创新的基于计算机的培训原型，该原型是为药物治疗提供者提供的DBT-S技能子集的一个子集，使用原型开发的迭代过程。我们在试点随机对照试验(RCT)中测试了原型的有效性。所有第一阶段目标均已超额完成。在随机对照试验中，在所有主要结果变量上都观察到了有利于DBT的统计上的显著结果，包括技能知识获得、技能回忆、自我效能和治疗BPD患者的动机。在第二阶段，我们建议扩展DBT-S技能CBT课程，增加两个模块-专注力和人际有效性。我们将再次使用迭代开发过程，寻求专家和最终用户的反馈。我们建议进行一项随机对照试验(N=75)，比较三组：DBT CBT组、类似的基于文本的课程(团队训练)和CBT控制组。主要结果变量将包括DBT-S技能知识、回忆、自我效能、治疗物质依赖型BPD患者的动机和两项临床应用措施：基于绩效的评估和临床应用测试。此外，我们建议使用3个月的跟踪期来评估一段时间内的技能使用和保留情况。

DESCRIPTION (provided by applicant): Dialectical Behavior Therapy for Substance Abusers (DBT-S) is a comprehensive psychosocial treatment, efficacious for substance-dependent individuals with borderline personality disorder (BPD). In Phase I, we developed and evaluated an innovative computer-based training (CBT) prototype of a subset of DBT-S skills for drug treatment providers using an iterative process of prototype development. We tested the prototype's efficacy in a pilot randomized controlled trial (RCT). All Phase I aims were exceeded. In the RCT, statistically significant results favoring DBT were observed on all major outcome variables, including skills knowledge gains, skills recollection, self-efficacy, and motivation to treat BPD clients. In Phase II, we propose to expand the DBT-S skills CBT curricula to include two additional modules - mindfulness and interpersonal effectiveness. We will again use an iterative process of development, seeking feedback from experts and end-users. We propose to conduct a RCT (N=75) comparing three groups: the DBT CBT, a comparable text-based curriculum (Team Training), and a CBT control. Major outcome variables will include DBT-S skills knowledge, recall, self-efficacy, motivation to treat substance-dependent BPD clients, and two clinical application measures: a performance-based assessment and clinical application test. Additionally, we propose a 3-month follow-up period to assess skills use and retention over time.