Substance Abuse Clinical Trial
Official title:
NIDA-CTN-0044: Web-delivery of Evidence-Based, Psychosocial Treatment for Substance Use Disorders Using the Therapeutic Education System (TES)
The main objective of this study is to evaluate the effectiveness of including an interactive, web-based version of the Community Reinforcement Approach (CRA), called the Therapeutic Education System (TES), as part of community-based, outpatient substance abuse treatment.
The principal objective of the planned trial is to evaluate the effectiveness of including an
interactive, web-based version of the Community Reinforcement Approach (CRA), called the
Therapeutic Education System (TES), as part of community-based, outpatient substance abuse
treatment. CRA is a cognitive-behavioral intervention which seeks to give patients skills to
achieve and maintain abstinence and improve social functioning and is often paired with
contingency management, where patients earn rewards contingent upon drug negative urines. CRA
is an intensive treatment, generally delivered in individual sessions 2 to 3 times per week.
Thus, it is expensive and time-consuming to deliver, to train clinical staff, and to provide
supervision to maintain clinical staff skill. However, because CRA is oriented toward
knowledge and skills, it lends itself to being delivered by computer, using
computer-interactive learning technologies.
Individuals accepted into community-based outpatient treatment for substance use disorders
(excluding those receiving opioid pharmacotherapy for opioid dependence) will be eligible to
participate. This is a multi-site, controlled trial, using NIDA's Clinical Trials Network
platform, at approximately 10 Community Treatment Programs, in which participants (N =
approximately 500) will be randomized to receive 12 weeks of either: (1) Treatment-as-Usual
(TAU), reflecting standard treatment at the collaborating treatment programs in which
participants are enrolled, or (2) a modification of TAU which includes access to the TES. It
is hypothesized that access to TES will improve substance use outcome and retention in
outpatient treatment.
Computer interactive interventions like TES have the potential to deliver science-based
psychosocial treatments with high fidelity and cost-effectiveness while conserving clinician
time to focus on monitoring and addressing patients' needs. If found to be effective, TES
could substantially advance the substance abuse treatment system by improving quality of care
delivered, increasing availability of treatment slots by extending and leveraging the efforts
of clinical staff, and projecting treatment to rural and other underserved areas.
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