Cognitive Therapy for PTSD in Addiction Treatment

描述(由申请人提供)： 这是一份修订后的K23指导下的以患者为导向的研究职业发展建议，用于药物滥用领域的培训和研究。该培训计划利用了以前的经验、目前在达特茅斯的职位，以及一支坚实的指导团队的专业知识和承诺。该计划详细说明了在常规成瘾治疗环境中获得知识和技能以修改针对创伤后应激障碍(PTSD)的认知行为疗法(CBT)。基于NIDA的行为治疗开发阶段模型，具体目标是获得进行第一阶段行为治疗研究的方法学要求方面的专业知识，最终产品是NIH关于CBT治疗创伤后应激障碍第二阶段疗效研究的建议。候选人的职业目标是成为完全有能力进行高质量和独立的研究，特别是将有效的共生障碍行为治疗方法转化和转移到社区。该研究计划建议在接受成瘾治疗的人中测试CBT对创伤后应激障碍的影响。背景和初步研究发现，创伤后应激障碍是一种常见的共生障碍类型，具有相关的负面结果，并具有可供测试和潜在实施的有希望的行为治疗方法。创伤后应激障碍是成瘾治疗提供者的主要关切，他们已经准备好采用有用的做法。这些治疗的特点已经根据患者结局和成瘾计划匹配标准进行了检查，这里提出了一种进行测试。创伤后应激障碍的CBT将使用行为疗法研究开发的阶段模型进行审查：1)Ia阶段I(治疗开发和可行性测试)；2)Ia阶段II(治疗程序和培训手册的说明)；3)Ib阶段III(试点试验：比较PTSD的CBT加常规治疗与注意控制+常规治疗)。主要的结果标准是：治疗保留、物质使用和创伤后应激障碍症状。如果第一阶段的研究结果有根据，最终目标是第二阶段的疗效建议，使用更严格和可控的实验设计，测试更高针对性的治疗程序，并研究更同质的药物使用和创伤后应激障碍患者样本。

DESCRIPTION (provided by applicant): This is a revised K23 Mentored Patient-Oriented Research Career Development proposal for training and research in the field of drug abuse. The training plan capitalizes on previous experience, the present position at Dartmouth, and on the expertise and commitment of a solid mentoring team. This plan details the acquisition of knowledge and skill to modify a cognitive behavioral therapy (CBT) for posttraumatic stress disorder (PTSD) in routine addiction treatment settings. Based upon the NIDA stage model for behavioral treatment development, the specific goal is to gain expertise in the methodological requirements to conduct Stage I behavioral therapy research, with the end product a NIH proposal for a Stage II efficacy study of CBT for PTSD. The candidate's career goal is to become fully capable of high quality and independent research, with a particular focus on translating and transferring efficacious behavioral treatments for co-occurring disorders into the community. The research plan proposes to test CBT for PTSD among persons in addiction treatment. Background and preliminary studies find PTSD to be a common type of co-occurring disorder, with correlated negative outcomes, and with promising behavioral treatments that are available for testing and potential implementation. PTSD is of documented major concern to addiction treatment providers, who have a readiness for adopting useful practices. Characteristics of these treatments have been examined on patient outcome and addiction program fit criteria, and one is proposed for testing here. CBT for PTSD will be examined using the stage model of behavioral therapy research development: 1) Stage Ia Phase I (therapy development and feasibility testing); 2) Stage Ia Phase II (specification of therapy procedure and training manual); and, 3) Stage Ib Phase III (Pilot Trial: comparing CBT for PTSD plus treatment-as-usual to an attention control plus treatment-as-usual). The primary outcome criteria are: treatment retention, substance use and PTSD symptoms. If warranted by Stage I findings, a final aim is a Stage II Efficacy proposal, using a more rigorous and controlled experimental design, testing a more highly specified therapeutic procedure, and studying a more homogenous sample of persons with co-occurring substance use and posttraumatic stress disorders.