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Randomized Trial of Computerized Cognitive Behavioral Therapy for Alcohol Use Disorders: Efficacy as a Virtual Stand-Alone and Treatment Add-On Compared with Standard Outpatient Treatment.
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- Author(s): Kiluk, Brian D.; Devore, Kathleen A.; Buck, Matthew B.; Nich, Charla; Frankforter, Tami L.; LaPaglia, Donna M.; Yates, Brian T.; Gordon, Melissa A.; Carroll, Kathleen M.
- Source:
Alcoholism: Clinical & Experimental Research; Sep2016, Vol. 40 Issue 9, p1991-2000, 10p- Subject Terms:
ALCOHOL-induced disorders; REHABILITATION of people with alcoholism; ANALYSIS of variance; BEHAVIOR therapy; CHI-squared test; COGNITIVE therapy; COMBINED modality therapy; COMPUTERS; CONFIDENCE intervals; PATIENTS; PROBABILITY theory; RESEARCH funding; STATISTICAL sampling; RANDOMIZED controlled trials; TREATMENT programs; TREATMENT effectiveness; MAXIMUM likelihood statistics; DESCRIPTIVE statistics; ECONOMICS; THERAPEUTICS - Source:
- Additional Information
- Subject Terms:
- Abstract: Background Cognitive behavioral therapy ( CBT) is an evidence-based treatment for alcohol use disorders ( AUDs), yet is rarely implemented with high fidelity in clinical practice. Computer-based delivery of CBT offers the potential to address dissemination challenges, but to date there have been no evaluations of a web-based CBT program for alcohol use within a clinical sample. Methods This study randomized treatment-seeking individuals with a current AUD to 1 of 3 treatments at a community outpatient facility: (i) standard treatment as usual ( TAU); (ii) TAU plus on-site access to a computerized CBT targeting alcohol use ( TAU + CBT4 CBT); or (iii) CBT4 CBT plus brief weekly clinical monitoring ( CBT4 CBT + monitoring). Participant alcohol use was assessed weekly during an 8-week treatment period, as well as 1, 3, and 6 months after treatment. Results Sixty-eight individuals (65% male; 54% African American) were randomized ( TAU = 22; TAU + CBT4 CBT = 22; CBT4 CBT + monitoring = 24). There were significantly higher rates of treatment completion among participants assigned to 1 of the CBT4 CBT conditions compared to TAU (Wald = 6.86, p < 0.01). Significant reductions in alcohol use were found across all conditions within treatment, with participants assigned to TAU + CBT4 CBT demonstrating greater increases in percentage of days abstinent ( PDA) compared to TAU, t(536.4) = 2.68, p < 0.01, d = 0.71, 95% CI (0.60, 3.91), for the full sample. Preliminary findings suggest the estimated costs of all self-reported AUD-related services utilized by participants were considerably lower for those assigned to CBT4 CBT conditions compared to TAU, both within treatment and during follow-up. Conclusions This trial demonstrated the safety, feasibility, and preliminary efficacy of web-based CBT4 CBT targeting alcohol use. CBT4 CBT was superior to TAU at increasing PDA when delivered as an add-on, and it was not significantly different from TAU or TAU + CBT4 CBT when delivered with clinical monitoring only. [ABSTRACT FROM AUTHOR]
- Abstract: Copyright of Alcoholism: Clinical & Experimental Research is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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