Using Telephone Technology to Prevent Relapse After Alcoholism Treatment

Therapeutic IVR to Augment CBT in Alcohol Dependence

The purpose of this study is to determine whether a telephone based self-help program will prevent relapse among individuals undergoing standard substance abuse treatment.

Relapse rates in the first few months following substance abuse treatment are as high as 50%, in spite of the immediate effectiveness of treatments such as Cognitive Behavioral Therapy (CBT). Continuing use of therapy skills following treatment is associated with maintenance of treatment gains. We have programmed a telephone to deliver pre-recorded summaries and rehearsal sessions of skills learned in therapy. The system also includes monthly feedback messages from therapists. We expect that this ad-lib access to therapy skills would allow patients to generalize skills to their personal post-treatment lives. It would also allow individuals in remote or rural areas to obtain access to assistance without travel barriers.

Comparison(s): patients completing group CBT for substance abuse will be randomly assigned to two conditions. In one condition, patients will have unlimited access to the therapeutic telephone system for 4 months. The other condition is standard care (i.e., no formal relapse prevention).

Inclusion Criteria:

• Meets current DSM-IV criteria for alcohol dependence
• Active drinking during the three months prior to entry into treatment
• Minimum age of 19
• Minimum sixth grade reading level.

Exclusion Criteria:

• Meets criteria for a current psychotic illness
• Imminent plans to move or be incarcerated
• Presence of such severe hearing, visual, or cognitive deficit(s) that participation in CBT or use of an Interactive Voice Response (IVR) system are not possible
• Inability to identify at least one "locator" person to assist in tracking for follow-up assessments
• Does not have telephone service within the home
• Incarceration while in active protocol in the study
• Attendance of less than 8 of 12 CBT sessions